Presented by
Ainil Fatima Zainodin
Advisor
dr. Rizan
dr. Jansen
Supervisor
dr. M. Ruksal Saleh, Ph.D, Sp. OT (K)
CASE REPORT
PATIENT’S IDENTITY
Name •N
Sex • Male
• Patent
Airway • Airway blockage (-)
• RR: 18x/min, Symmetric
Breathing • Thoracoabdominal type
• 90x/min, regular, strong, full
Circulation • BP: 110/80mmHg
ANTERIOR VIEW
LATERAL VIEW
MEDIAL VIEW
RADIOLOGY IMAGING
CT 7’ 00’’ 4-10
BT 3’ 00’’ 1-7
o IVFD RL
o Antibiotic
o Analgesic
o Tetanus Prophylaxis
o Plan for Debridement and External Fixation
DISCUSSION
{ FRACTURE TIBIA & FIBULA
EVIDENCES LEADING TO DIAGNOSIS
PATIENT EVALUATION
In this patient had high energy trauma from direct hit in a motor vehicle accident which
results in fracture segmental on Os Tibia Dextra and fracture 1/3 distal Os Fibula Dextra
INJURY CLASSIFICATION FOR OPEN FRACTURE
In this patient the wound size was >10 cm long, contaminated and the fractured bone
can be adequately covered by soft tissue with high energy trauma from direct hit in a
motor vehicle accident which results in fracture segmental on Os tibia and fracture 1/3
distal Os fibula dextra.
Koval, Kenneth j.; Zuckerman, joseph d. handbook of fractures, 4th edition
TREATMENT
Antibiotics
Debridement
Prophylaxis
Early
Stabilization definitive
wound cover
Solomon. L. et al. Injury’s of the Knee and Leg in Apley’s System of Orthopedics and Fractures 9th Edition. UK: Arnold. 2010.
Debridement
•To remove constraint
•Removal of devitalized tissue
•Wound cleansing
•Prevent severe infection
•Promote healing
Solomon. L. et al. Injury’s of the Knee and Leg in Apley’s System of Orthopaedics and Fractures 9th Edition. UK: Arnold. 2010.
Operative
Indications
• Unstable fracture
• Open fracture
• Intra articular fracture
• Assosiated with vascular complication
• Failed of closed reduction
Solomon. L. et al. Injury’s of the Knee and Leg in Apley’s System of Orthopaedics and
Fractures 9th Edition. UK: Arnold. 2010.
External Fixation
Complication
• Joint stiffness
• Over distraction
• Pin tract infection
Solomon. L. et al. Injury’s of the Knee and Leg in Apley’s System of Orthopaedics and Fractures 9th Edition. UK: Arnold. 2010.
COMPLICATION
Early Late
Solomon, L, Warwick D.L, Nayagam,S. Apley’s system of orthopedic and fractures. 8th editions. 2008. p695-9
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