Ankle joint
Ankle joint = articulatio talocrural
Sendi engsel sinovial
Terletak antara
1. ujung distal dari tibia
2. ujung distal dari fibula
3. bagian superior dari talus.
Ujung distal tibia dan fibula membentuk rongga
yang dalam (malleolar mortise), memungkin
bagian trocklear dari talus dapat masuk ke
dalamnya.
Talocrural Joint
Talocrural Joint
Syndesmosis
MEKANISME INJURI
DIAGNOSIS
ANAMNESIS
Riwayat terjatuh dengan gaya memutar pada daerah pergelangan kaki
baik karena tersandung saat aktivitas sehari-hari maupun pada atlit
olahraga, kecelakaan lalu lintas yang menyebabkan ciderea pada
pergelangan kaki disertai adanya Nyeri hebat pada pergelangan kaki
dan Ketidakmampuan menumpu dengan kaki tersebut.
1.
2.
3.
4.
5.
6.
PEMERIKSAAN FISIK
Ekimosis (hematom)
Deformitas (displacement ke lateral, medial, atau posterior)
Edema
Luka terbuka
Nyeri tekan pada tulang maleoulus medial atau lateral
Pemeriksaan neurovaskular distal (palpasi arteri dorsalis pedis, tibialis
anterior dan capilary refill time)
7. Pemeriksaan motorik
PEMERIKSAAN FISIK
Inspeksi cara berdiri dan berjalan
Look
Warna kulit (ekimosis,eritema)
Swelling
deformity
Feel
Suhu
Pulse
Oedema
Nyeri
Move
Dorsoflexi, plantar flexi, inversi, eversi
Stand on tiptoes
Walk on tiptoes
PEMERIKSAAN
PENUNJANG
An ankle x-ray series is only required if there is any pain in the malleolar zone and any of
these findings:
1.bone tenderness at A OR
2.bone tenderness at B OR
3.inability to take 4 complete steps both immediately and in ED
A foot x-ray series is only required if there is any pain in the midfoot zone and any of these
findings:
1.bone tenderness at C OR
2.bone tenderness at D OR
3.inability to take 4 complete steps both immediately and in ED
KLASIFIKASI
Klasifikasi Lauge-Hansen
Klasifikasi Danis-Weber
The Danis-Weber
classification system
for rotational ankle
fractures
AO/Orthopedic Trauma
Association system(OTA)
TATALAKSANA
KOMPLIKASI
1.
EARLY COMPLICATIONS
Cedera vaskular
Infeksi
Ruptur tendon achilles
Compartement syndrome
2.
LATE COMPLICATIONS
Mal-union
Non-union
Joint stiffnesss
Algodystrophy
Osteoartritis sekunder
PROGNOSIS
Ad vitam
: ad bonam
Ad functionam : dubia ad bonam
Ad sanationam : dubia ad bonam
Radiographic diagnosis
of fractures
FRAKTUR
1.
2.
3.
4.
5.
6.
Pattern
rule of two
1. Two views. At 90 degrees, usually anteriorposterior and lateral.
2. Two joints. The joints above and below.
3. Two occasions. Some fractures are not
easily visible immediately after trauma.
4. Two limbs. If required for comparison.
Joints
Is the joint in the correct position? Is it
dislocated- which direction?
Does a fracture involve the joint?
Are there any features of joint damage or
degeneration?
Soft tissues
Is there any evidence to suggest this is an open
fracture?
Can you see any localised swelling?
http://www.blackwellpublishing.com/content/BP
L_Images/Content_store/Sample_chapter/9780727
915283/9780727915283_4_001.pdf
http://apps.who.int/iris/bitstream/10665/42457/1/
9241545550_eng.pdf