Beruflich Dokumente
Kultur Dokumente
FRACTURES
Mulya Gunawan
FRACTURE
A fracture is a complete or
incomplete break (discontinue) in a
bone or cartilage resulting from the
application of excessive force.
Incidence
Problem
Problem
Fracture disease
Pneumonia
Abdominal distended
UTI
Disused Atrophy
Osteoporotic
Stiff joint
Decubitus
Recognize
Reduction
Resistance
Rehabilitation
Life is movement
Open fracture
INJURY ASSESSMENT
HISTORY
VELOCITY OF IMPACT
INJURY
ASSESSMENT
ENVIRONMENTAL
EXPOSURE
Advance Trauma Life Support programme for Doctors 6th Ed. 1997
2.
2. Gustilo et al. JBJS (Am) 1990
Classification
TYPE I
TYPE II
TYPE III
WITHIN 6 HOURS1
PREVENT CONTAMINATION
SURGICAL MANAGEMENT
INFECTION
With in GOLDEN PERIOD
Principle of Treatment
1.
2.
3.
4.
5.
6.
7.
GOAL
Early closure
Avoidance of sepsis
Establishing durable soft tissue
coverage
Facilitating future reconstruction
surgery
Containing cost
Treatment
OF Type 1
Debridement + ORIF or Ex Fix, primary
closure the wound is accepted
OF Type 2
Debridement + ORIF or Ex Fix, closure
the wound at second look
Treatment
Type 3
A
Debridement +external fixation
ORIF depend on operator
B
Debridement +external fixation
Second look soft tissue coverage
C
Debridement +external fixation
Repair vascular
WHICH ONE?
CASE 1
OPEN GRADE IIIa LEFT TIBIAL
PLAFOND
CASE 2
OPEN GRADE IIIa RIGHT TIBIAL
PLAFOND
CASE 3
OPEN GRADE IIIa RIGHT TIBIA
CASE 4
OPEN GRADE IIIb RIGHT TIBIA
CASE 5
OPEN GRADE IIIb RIGHT TIBIA
THANK YOU