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KEGAWATDARURATAN MUSCULOSKELETAL KREKI · PDF file FRAKTUR TERBUKA KLASIFIKASI RAMON GUSTILO . Fraktur Terbuka Gr II. Fraktur Terbuka Gr IIIA. Fraktur terbuka gr IIIB. Fraktur Terbuka

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  • KEGAWATDARURATAN MUSKULOSKELETAL

    MUHAMMAD SAKTI

    Department of Orthopaedic & Traumatology, Faculty of Medicine, Hasanuddin University, Indonesia

  • KECELAKAAN LALU LINTAS

    88897 96073

    106591 104327 107968

    2014 2015 2016 2017 2018

    KORBAN LALU LINTAS

    KORBAN LALU LINTAS

    Korps Lalu Lintas (Korlantas) Polri data kecelakaan lalu lintas yang terjadi di Indonesia 2014 - 2018

  • KEGAWATDARURATAN MUSKULOSKELETAL

    • PATAH • DISLOKASI • LUKA DENGAN PERDARAHAN

    HEBAT • TERAMPUTASI • COMPARTMENT SYNDROME

  • F R A C T U R E

    • FEMUR • PELVIS • TERBUKA

  • FEMUR FRACTURE

    • PERIKSA TANDA VITAL • SHOCK HYPOVOLEMIC à 800 – 1500 CC • DISERTAI CEDERA YANG LAIN

  • SPLINT

  • TRACTION SPLINT

  • SKIN TRACTION

  • PELVIC FRACTURE

  • PELVIC FRACTURE

  • PELVIC FRACTURE

    • High energy blunt trauma • Mortality rate 15-25% for closed fractures, as much as 50% for

    open fractures : • SHOCK hemorrhage à > 1500 CC • Associated injuries à (chest injury – long bone fractures – head and

    abdominal/pelvic organs injury – spine fractures)

  • PELVIS

    Primary survey : • Selalu mulai dengan ABCs (airway, breathing,

    and circulation), hemodynamic status!

    Secondary survey : • PELVIC COMPRESSION/DISTRACTION test • Hematoma : Flanks,lower back ,scrotam and

    labial, Perineum • Rectal & vaginal • Urethral injury • Lower limbs.

  • PELVIC FRACTURE

  • PELVIC CLAMP

  • EXTERNAL FIXATION

  • OPEN FRACTURE

    1. SHOCK àDISERTAI TRAUMA VASKULER & SARAF PERIFEER

    2. INFEKSI, SEPSIS, TETANUS, OSTEOMYELITIS

    3. COMPARTMENT SYNDROME

  • Fraktur Terbuka Gr I

    FRAKTUR TERBUKA KLASIFIKASI RAMON GUSTILO

  • Fraktur Terbuka Gr II

  • Fraktur Terbuka Gr IIIA

  • Fraktur terbuka gr IIIB

  • Fraktur Terbuka Gr IIIC

  • OPEN FRACTURE GRADE 3

  • PENANGANAN

    • ATLS • RESUSITASI • FOTO RONTGEN • TETANUS PROPHYLAXIS • ANTIBIOTIKA :

    GRAM (+) DAN GRAM Θ

  • FRACTURE TERBUKA + PERDARAHAN

  • VS

  • BLEEDING CONTROL

    KITS

  • OSTEOMYELITIS

  • CERVICAL INJURY

  • CERVICAL SPINE

    1. Any injury above the clavicle 2. Unconsciuous polytrauma 3. Neck pain 4. Localising signs

  • MANAGEMENT CERVICAL INJURY

    • Cervical spine- need to be protected early • In-line cervical immobilization • Hard cervical collar- indications

    – Log-rolled when want to turn patient – Coordinated spinal lift

    • Do not do more harm. All movement if must have to be active movement and not passive.

  • D I S L O K A S I

    • SENDI BAHU • SENDI PANGGUL

  • SHOULDER DISLOCATION

  • HIPPOCRATIC TECHNIQUE

  • TRACTION COUNTER TRACTION

  • STIMPSON’S METHODE

  • KOCHER’S METHODE

  • MILCH’S METHODE

  • AFTERCARE

  • HIP DISLOCATION

  • BIGELOW MANEUVER

  • ALLIS MANEUVER

  • summary

    • Fracture : femur, pelvis, fr. terbuka • Penanganan perdarahan --> semua “first responders emergency”

    harus diperlengkapi dengan “bleeding control kits” • Dislokasi : cervical à perlu diajarkan ke masyarakat

  • TERIMA KASIH