TASK GROUP FRAKTUR

Name Ach.Afriyanto Eric Juan Maldini Mitha Okniart Tabi

STIKES Maharani Malang

Definition A bone fracture medical condition in which there is a break in the continuity of the bone. A bone fracture can be the result of high force impact or stress, or trivial injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture. Circumstances in which the bones that form the joints are no longer connected anatomically. Bone fracture is the interruption of continuity and determined according to the type and extent. (Smeltzer & Bare S.C B.G, 2001) Fraktur is any crack or fracture in the bone intact.( reeves C.J,Roux G & Lockhart R,2001 ) Can be concluded that the fracture is a bone integrity disorder characterized by the destruction or breaking of continuity of bone tissue due to excessive pressure. Etiology A.Fractures due to trauma events. Most fractures are caused by sudden power / sudden and excessive which can be a beating, destruction, or withdrawal. When the pressure force directly, bone can fracture at the affected places and soft tissue also bound to come damaged. Beatings usually causes transverse fracture and damage to the skin above it. destruction is likely to cause fracture accompanied komunitif extensive soft tissue damage. B.Fractures due to repeated pressure. Cracks can occur in bone as well as on metal and other objects due to repeated pressure. This condition is most often presented in the tibia, fibula or matatarsal especially in athletes, C.Pathological fractures due to bone disorders. Fractures can occur by the normal pressure when the bones are soft (eg by a tumor) or the bones are very brittle (osteoporosis). Pathophysiology The natural process of healing a fracture starts when the injured bone and surrounding tissues bleed, forming a fracture Hematoma. The blood coagulates to form a blood clot situated between the broken fragments. Within a few days blood vessels grow into the jelly-like matrix of the blood clot. The new blood vessels bring phagocytes to the area, which gradually remove the non-viable material. The blood vessels also bring fibroblasts in the walls of the vessels and these multiply and produce collagen fibres. In this way the blood clot is replaced by a matrix of collagen. Collagen's rubbery consistency allows bone fragments to move only a small amount unless severe or persistent force is applied.

At this stage, some of the fibroblasts begin to lay down bone matrix (calcium hydroxyapatite) in the form of insoluble crystals. This mineralization of the collagen matrix stiffens it and transforms it into bone. In fact, bone is a mineralized collagen matrix; if the mineral is dissolved out of bone, it becomes rubbery. Healing bone callus is on average sufficiently mineralized to show up on X-ray within 6 weeks in adults and less in children. This initial "woven" bone does not have the strong mechanical properties of mature bone. By a process of remodeling, the woven bone is replaced by mature "lamellar" bone. The whole process can take up to 18 months, but in adults the strength of the healing bone is usually 80% of normal by 3 months after the injury. Several factors can help or hinder the bone healing process. For example, any form of nicotine hinders the process of bone healing, and adequate nutrition (including calcium intake) will help the bone healing process. Weight-bearing stress on bone, after the bone has healed sufficiently to bear the weight, also builds bone strength. The bone shards can also embed in the muscle causing great pain. Although there are theoretical concerns about NSAIDs slowing the rate of healing, there is not enough evidence to warrant withholding the use of this type analgesic in simple fractures. Complications Some fractures can lead to serious complications including a condition known as compartment syndrome. If not treated, compartment syndrome can result in amputation of the affected limb. Other complications may include non-union, where the fractured bone fails to heal or mal-union, where the fractured bone heals in a deformed manner. Clinical manifestations A.Painful Pain is felt immediately after the trauma. This is caused by muscle spasm, the pressure of the fracture or damage to surrounding tissues. B.Edema Edema appears faster due to serous fluid (plasma protein) that is localized to the fracture area and extravasi areas in the surrounding tissue. C.Decreased sensation Occur because of nerve damage, nerve depressed because of edema.

D. Disfunction Occurred because of the instability of bone fractures, pain or muscle spasms, paralysis can occur due to nerve damage. Theraphy
Conservative Therapy A.Protection only For example mitela to fractur collum chirurgicum humari with good standing. B.Immobility without repositioning, eg installation of gypsum on fractur incomplete and fractures with good standing.

Operative Therapy A.Reposition open, internal fixation B. Closed repositioning with fixation followed by radiological control eskterna Operative therapy with anatomical repositioning followed by internal fixation (open reduction and internal fixation) arteoplasti ekssisional, fragment excision and mounting endoprosteus. (Mansjoer, 2000: 348) Sugestion
when performing heavy activity should be careful because it can cause broken bones. when fatigue during activities do not perform activitiy heavy .

References 1.http://www.ota.org/compendium/2007JOTFractureCompNew/97042.2Introduction%20S1S6.pdf 2. ^ "Fracture and dislocation compendium. Orthopaedic Trauma Association Committee for Coding and Classification" (pdf). J Orthop Trauma 10 Suppl 1: vix, 1154. 1996. PMID 8814583. Archived from the original on 2007-09-28. http://web.archive.org/web/20070928083805/http://www.ota.org/compendium/intro.pdf. Retrieved 2007-11-28. 3. ^ "Orthopaedic Trauma Association/ Committee for Coding and Classification: Fracture and Dislocation Compendium". Orthopaedic Trauma Association. http://www.ota.org/compendium/compendium.html. Retrieved 2007-11-28. 4. ^ "Proximal forearm - AO Surgery Reference". http://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3h ng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFI Hr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEw R0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&pop upStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsp. 5. ^ 1590689797 at Gpnotebook