OT
Putusnya hubungan kesinambungan/ diskontinuitas tulang dan atau tulang rawan Fraktur tertutup :Bila kulit sekitar intak Fraktur terbuka :Bila ada luka, sehingga kemungkinan terjadi kontaminasi atau infeksi
DEFINITION
PICTURE
ANKLE
TIBIA
Gustilo Classification I Low energy, wound less than 1 cm II Wound greater than 1 cm with moderate soft tissue damage High energy wound greater than 1 cm with extensive soft tissue damage III IIIA IIIB IIIC Adequate soft tissue cover Inadequate soft tissue cover Associated with arterial injury
I.
1.Fraktur tertutup
2. Fraktur terbuka
COMPLETE/ UNCOMPLETE FRACTURE LINE FORM FRACTURE LINE DISPLACED /UNDISPLACED CLOSED OR OPEN FRACTURE
TRAUMA
MEKANISME TRAUMA
OPEN FRACTURE
IN THE SCENE
DEFORMITY
abnormal MOVEMENT , angulation, rotation dan discrepency
Classical fracture easy to diagnose Non Classical Fractur need radiological examination Minimal 2 AP/Lateral projection Axial, alar and obturator. Chidren : need opposite side
Include 2 joint
1.OPEN FRACTURE IS EMERGENCY CASE 2.INITIAL EVALUATION (ATLS) 3.ANTIBIOTIC FROM EMERGENCY ROOM, OPERATING THEATER AND POST OPERATION 4.ADEQUATE DEBRIDEMENT DAN IRIGATION 5.REPEAT DEBRIDEMEN (24-72 HOURS)
2.DEBRIDEMENT
3.STABILIZATION
TISSUE NECROTIC EXC. NO VASC.TISSUE SKIN, SUB CUTAN, FAT, FASCIA AND MUCLE BONE FRAGMENT
4.WOUND CLOSURE
5.antibitic
3-5 days
LATE COMPLICATION JOINT STIFFNESS/CONTRACTURE DISUSE ATROFI MALUNION NONUNION DELAYED UNION GROWTH DISTURBANCE CHRONIC OSTEOMYELITIS
DIAGNOSA FRAKTUR : Historycal examination Physical examination Radiological examination Open fracture Managemen Fracture Complication