MAKALAH

ORTHOPAEDY SURGERY FEMORAL FRACTURES

By.
Group 4
DIAN SUSANTO ( 7 )
YUSTINA BHIJU LONGA ( 8 )
AVRIZAL FALEFI ( 28 )
YUNITA SAKTI NINGSIH ( 27 )

KEMENTERIAN KESEHATAN RI
POLITEKNIK KESEHATAN KEMENKES MALANG
JURUSAN KEPERAWATAN PRODI DIV PERIOPERATIF KEPERAWATAN
MALANG
2015
WHATS FEMORAL FRACTURE

Common injury due to major violent trauma , 1 femur fracture/ 10,000 people,
More common in people < 25 yo or >65 yoFemoral Fracture is a break in the
continuity of femur bone cause condition of trauma or osteophorosis. Motor
vehicle, motorcycle, aircraft, and gunshot wound accidents are most frequent
causes
Blood Supply

Reaming destroys intramedullary endosteal blood supply

Periosteal blood flow increases

Medullary blood supply is

re-established over 8-12
weeks if spaces left in
canal by implant

Unreamed intramedullary nailing decreases blood flow less; restoration of

endosteal blood flow earlier but equal to reamed canal at 12 weeks

Anatomy

Long tubular bone, anterior bow, flair at femoral condyles

Blood supply

Metaphyseal vessels

Single nutrient artery in diaphysis enters through the linea aspera

Nutrient

artery

communicates

with

medullary

arteries

in

intramedullary canal

Medullary arteries supply 2/3 of endosteal blood supply

Femur Fracture Classification

Type 1 - Insignificant butterfly fragment with transverse or short oblique

fracture

Type 2 - Large butterfly of less than 50% of the bony width cortex intact

Type 3 - Larger butterfly leaving less than 50% of the cortex in contact

Type 4 - Segmental comminution

Sign and Symptom

1. Painfull in fracture area
2. An able extremity movement
3. Tumor, Functiolesa, Crepitation, Deformation.

Medic Management

X-Ray

Bone Scans, MRI Scans

Femur Fracture Management

Initial traction with portable traction splint or transosseous pin and

balanced suspension

Evaluation of knee to determine pin placement

Timing of surgery is dependent on:

Resuscitation of patient

Other injuries - abdomen, chest, brain

Isolated femur fracture

Diaphyseal fractures are managed by intramedullary nailing through an

antegrade or retrograde insertion site

Proximal or distal fractures maybe managed best with a plate or an

intramedullary nail depending on the location and morphology of the
fracture

External Fixator for Femoral Shaft Fracture

Exchange Nailing in the femur is safe and yields high union and low
infection rates

Case..!!!!

Mr. X get an accident when he go working. He fall from his motocycle and
get injury. He feel his right foot cant movement and painfull. Then, someone is
coming and give aid to Mr. X. He bring Mr. X in the near hospital. In Hospital Mr.X
get diagnose femur fracture and must operate to implant nail quickly. After get
agreement to Mr.X, medic team operate Mr. X.

Daftar Pustaka
Mansjoer, dkk, (2000). Kapita Selekta Kedokteran, edisi 3 media
Aesculapius : Jakarta
Sjamsuhidajat R. (1997). Buku Ajar Ilmu Bedah, Edisi Revisi, EGC :
Jakarta
Smeltzer & Bare, (2003). Buku Ajar Keperawatan Medical Bedah.
Volume. 3. Edisi 8. EGC : Jakarta