FRACTURE OF LONG BONE & PELVICProf. dr. Armis, SpB. SpOTDepartment of Orthopaedic & TraumatologicFaculty of Medicine, GMU

Armis - 2005

PROBLEMSTraffic accident / severe traumaHigh energy traumaHigh rate of mortality and morbidityHigh rate of complicationsTrauma other regionsEmergency

Armis - 2005

Armis - 2005

THE PATIENT NEED

To improve the functionTo prevent or reduce the mortality and morbidity

Armis - 2005

BONE TRAUMAENERGYTRAUMA Direct

Indirect

chronic traumaLowMedSevereFRACTURESClosedOpenOUTCOMEHEALINGPrimary (OSTEONAL)Secondary (CALLUS)Influencingfactors UNION

DELAYED UNION

NONUNION

MALUNION

OSTEOMYELITIS

TREATMENT

Armis - 2005

Armis - 2005

Education Objectives

The student should be able:1. To describe the fracture, location, pattern, amount of fragment displacement and integrity of the skin and soft tissue enveloped around the fracture

Armis - 2005

Educational Objectives1.a. To know the definition of fracture and how the fracture happened

Armis - 2005

Educational Objectives1.b.To understand simple fracture, comminuted fracture, hairline fracture, greenstick fracture, compression fracture, impacted fracture and pathologic fractureTransversal < 30ooblique > 30o

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Educational Objectives1.c. To identify the location of fracture (anatomical division and AO terminology)ProximalDiaphysis / ShaftDistal

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Educational Objectives1.d. To realize the displacement of fracture fragment (no displacement, and others, bone contact, angulation and fragment rotation)CONTACT 80%

ANGULATION 0O

NO ROTATION

SLIGHT DISPLACEMENT

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Educational Objectives1.e. To know the integrity of the skin(closed or open fracture)

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Educational Objectives1.f. To differentiate between adult and children fracture

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Educational Objectives2. To understand how the fracture heal (primary and secondary healing process: hematoma form, fibrous tissue form, blood supply reestablished, callus form and bone reabsorbed or remodeling process)

Armis - 2005

Education Objectives

The student should be able:3. To analyze and identify the history, physical and additional examination data in knowledge to make a diagnosis

Armis - 2005

History (Basic Skill)To know how to take the patient history (complaint and location, the nature of accident, biomechanic of trauma, the point of impact and some precipitating factor) in knowledge.

Armis - 2005

Physical Examination (Basic Skill)To identify the looking data (any asymmetry of contour or posture, local bruising, swelling)To look for the palpation data (tenderness, abnormal movement, and crepitation)To look for the condition of distal part of the lesion.

Armis - 2005

Radiographic Examination (Basic Skill)To know what location and which views do you order for diagnosis, confirmation or plan treatment.

To identify the radiographic data

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Diagnosis of FractureTo analyze the history, physical and radiograph examination data to make a diagnosis of fracture (which bone, location, closed or open)To know the pitfalls diagnosis of fracture (elderly patient, dashboard injury, calcaneus fracture, ankle injury, unconscious trauma patient and impacted humerus neck fracture in children and others)

Armis - 2005

Armis - 2005

Education Objectives

The student should be able:4. To plan the management and know the simple treatment and priority intervention for life saving and live limb

Armis - 2005

Education Objectives

The student should be able:5. To predict complication of the fracture (Bleeding, hypovolemic shock, DVT, fat emboli etc.)

Armis - 2005

Education Objectives

The student should be able:6. To decide the reason for admission to hospital

Armis - 2005

Education Objectives

The student should be able:7. To identify the union evaluation and simple rehabilitation to the patient