Adalah hilangnya kontinyuitas tulang Dapat diakibatkan oleh trauma maupun keadaan patologis
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Macam-macam fraktur
Akibat kecelakaan lalu lintas Kecelakaan kerja Jatuh dari ketinggian Trauma minimal pada tulang yang sudah patologis: tumor,infeksi, osteoporosis 3 4/1/2013
Fraktur patologis
Macam-macam fraktur
Fraktur terbuka
Fraktu yang disertai dengan luka, dimana tulang pernah atau sedang berhubungan dengan lingkungan luar Syarat: luka berjarak < 5 cm dari patahan tulang Fraktur yang tidak disertai luka
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Fraktur tertutup
Comminutive
Greenstick
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Penyembuhan Tulang
Fase hematom Fase proliferasi sel Fase kalus Fase konsolidasi Fase remodelling
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Jenis Reposisi
Reposisi tertutup (close reduction) Reposisi terbuka (Open reduction)
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Jenis Imobilisasi
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Macam Traksi
Dari bahan plester Tulang di tarik melalui kulit Maksimum 2 minggu dan beban 5 kg K- wire atau steinmann pin Langsung menarik tulang Beban sampai 20 kg
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JENIS INSTRUMENTASI
INTERNAL FIKSASI EKSTERNAL FIKSASI
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DI NEGARA MAJU
In North America, and I suspect in most other technically advanced countries, closed methods of fracture management are in a marked decline. The ability to produce anatomical alignment and maintain it by internal fixation, particularly by interlocking nails, is apparently making such methods pass. It has been our observation during the past 5 years that orthopaedic residents are incapable of applying casts with any degree of dexterity, although they are very expert in inserting a variety of nails. Similarly, the application of traction is an arcane, antique procedure of historical interest alone Charles A. Rockwood, JR 1996
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KOMPLIKASI FRAKTUR
lokal
Nonunion and Malunion Infection Nerve Injury Vascular Injury Compartment Syndrome Refracture Muscle and Tendon Entrapment and Adherence
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KOMPLIKASI FRAKTUR
sistemik
Shock
1. Hematogenic (oligemia) 2. Neurogenic (caused primarily by nervous influences) 3. Vasogenic (initially decreased vascular resistance and increased vascular capacity) 4. Cardiogenic (caused by either failure of the heart as a pump or diminished cardiac output from various causes)
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TABLE 8-1 Classes of Acute Hemorrhage Class I Blood loss (mL) Blood loss (units) Blood loss* (%) Pulse rater (bpm) Class II 750 1-2 15 72-84 Class III 2-3 20-25 >100 118/82 36 Delayed 20-30 Class IV 3-4 30-35 >120 110/80 30 Delayed 30-40 5 40-50 >140 70-90/50-60 20-30 Delayed >35 10-20 <50-60 systolic
Blood pressure (mm Hg) Pulse pressure (mm Hg) Capillary blanch test Normal Respiratory rate 14-20
30-35
25-30
5-15
Negligible
Mildly anxious Crystalloid + Blood Anxious and
Crystalloid + Blood
Percentage of blood volume in a standard 70-kg man. Assume normal of 72 bpm. Assume normal of 120 / 80 mm Hg. (Alexander, R.H., and Proctor, H.J.: Shock. In Committee on Trauma (eds): Advanced Trauma life Support ManualProgram for Physicians, p. 86. Chicago, American College of Surgeons, 1993.)
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KOMPLIKASI FRAKTUR
sistemik
long-bone fracture
respiratory
pulmonary
edema
39 to 40C
stupor, or coma
craniocerebral
trauma ?
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Prognosis
tergantung dari
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