Fracture [Compatibility Mode]

8/3/2019 Fracture [Compatibility Mode]

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Fracture

Fracture

Ramses Indriawan

Department of Surgery

NTB Province General HospitalMataram


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Fracture is a breakin the structural continuity of thebone

Fracture is a breakin the structural continuity of thebone

What is a fracture?

it consist ofit consist of

Closed fracture (simple fracture) Open fracture (compound fracture)


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Diskontinuitas struktur tulang


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The Mechanism of FractureThe Mechanism of Fracture

How fracture happens?

Single traumatic incidence

Repetitive stress

Abnormal weakening of thebone


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Fractures of single traumaticincidence,

Fractures of single traumaticincidence,

Single Traumatic Incidence

can e ue tocan e ue to

Direct force

Indirect force


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and result inand result in

twisting spiral

bending transverse

Single Traumatic Incidence

combination of bending and

compressing

combination of twisting, bendingand compressing

pulling


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Spiral Oblik


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Steps of Fracture HealingSteps of Fracture Healing1. Tissue destruction and hematom

How do fracture heals?

2. Inflammation and cellularproliferation (within 6 hours)

3. Callus formation

4. Consolidation

5. Remodeling


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PENYEMBUHAN FRAKTUR

1. Std. Destruksi / Hematom

2. Std. Inflamasi & Proliferasi sel

3. Std. Pembentukan kalus4. Std. Konsolidasi

5. Std. Remodelling

Fraktur Union Konsolidasi Remodelling


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Causes of Non-UnionCauses of Non-Unionno/ unstable fixation (motion between

Some fractures never healed

(non union)

infection on fracture site

too much gap between fracture

segment lack of blood supply

Others (metabolic, age, general

condition)


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NON UNION


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Pain and tenderness

What are the clinical signs of

fracture?

Deformity

Abnormal mobility and crepitus

Neurovascular injury


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Treatment of Fractureconsists of

Treatment of Fractureconsists of

How do we treat fractures?

EMERGENCY CARE

DEFINITIVE TREATMENT

REHABILITATION


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Immobilize the extremities

Immobilize the extremities

What do you do in emergency

care?

How? SplintingHow? Splinting


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Prevention of soft tissue injury Immobilization to relief pain

Why is splinting important?

Lower the incidence of clinical fatembolism and shock

Patient transportation and tofacilitate radiographic studies


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Definitive Treatment ofFractureDefinitive Treatment ofFracture

What are the definitive

treatments of fractures?

L ED REDU TI N OPEN REDUCTION INTERNAL

FIXATION

OPEN REDUCTION EXTERNALFIXATION


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ORIF (OPEN REDUCTION AND INTERNAL FIXATION)

Plate - screw Fixasi External


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Types of Immobilizationin closed reductionTypes of Immobilizationin closed reduction

Fracture and dislocation

PLASTER OF PARIS

FIBERGLASS CAST

SKIN TRACTION in children

SKELETAL TRACTION


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CARA GIP

Stockingette Padding

PLESTER SLAB


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Bryant s / Gallows

traction

Buck Extension


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RUSSEL TRACTION

TRAKSI BERIMBANG( SUSPENDED OR

FLOATING TRACTION )


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Indication for OperativeTreatment Indication for Operative

Treatment

When do we need to perform surgery

to immobilize a fracture?

a ure o c ose re uc on Contra - indication of closed

reduction

Fracture with displaced jointsurfaces


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Indication for OperativeTreatmentIndication for Operative

Treatment Fracture due to metastasis of

When do we need to perform surgery

to immobilize a fracture? (2)

Fracture associated with arterialinjury

Multiple injuries The need for early mobilization Cost reduction


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in these fractures,closed reduction isNOT recommended

examples

1. Galleazzifracture1. Galleazzifracture


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2. Distal radio-ulnar fracture inchildren2. Distal radio-ulnar fracture inchildren


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3. Montegiafracture3. Montegiafracture


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4. Central hip-

dislocationfracture

4. Central hip-

dislocationfracture


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Rehabilitation Following

Fractures

Rehabilitation Following

Fractures

Maintenance of oint motion

How do we perform

rehabilitation of a fracture?

Muscle exercise Gait training

Ambulation aid

Heat therapy

Massage

Orthoses prostheses


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Fracture [Compatibility Mode]