Fracture

Definisi
Fraktur adalah terputusnya kontinuitas jaringan tulang. Fraktur comminuted
merupakan patahnya tulang menjadi lebih dari 2 fragmen.
Fraktur
Tertutup Terbuka
Jika kulit intact/utuh Jika kulit atau rongga kavitas rusak
:> infeksi

Etiologi
Trauma Tekanan/stress berulang Fraktur pathological
 Complete Fracture Incomplete Fracture
The bone is split into two or more fragments. the bone is incompletely divided and the perios-
teum remains in continuity.
Displacement Dislocation
 Degree of Ligament Sprain
First-degree
is a tear of only a few fibres of
the ligament. It is characterised
by minimal swelling, localised
tenderness but little functional
disability.
Second-degree
is the one where, anything from
a third to almost all the fibres of
a ligament are
disrupted. The patient presents
with pain, swelling and inability
to use the limb. Joint
movements are normal. The
diagnosis can be made on
performing a stress test as
discussed subsequently.
Third-degree
is a complete tear of the
ligament. There is swelling and
pain over the torn ligament.
Contrary to expectations, often
the pain in such tears is minimal.
Diagnosis can be made by
performing a stress test, and by
investigations such as MRI or
arthroscopy.
UNION, CONSOLIDATION AND NON-UNION
UNION, CONSOLIDATION AND NON-UNION
Union
Union is incomplete repair;
the ensheathing callus is
calcified. Clinically the
fracture site :
still a little tender and,
though the bone moves in
one piece (and in that sense
is united), attempted
angulation is painful. X-Rays
show the fracture line
still clearly visible, with fluffy
callus around it.
Repair is incomplete and it is
not safe to subject the
unprotected bone to stress.
Consolidation
is complete repair; the
calcified callus is ossified.
Clinically the fracture site is
not tender, no movement
can be obtained
and attempted angulation is
painless. X-rays show the
fracture line to be almost
obliterated and crossed by
bone trabeculae, with well-
defined callus around it.
Repair is complete and
further protection is
unnecessary.
Non Union
Sometimes the normal
process of fracture repair is
thwarted and the bone fails
to unite.
Causes of non-union :
(1) distraction and separation
of the fragments
(2) excessive movement at
the fracture line
(3) A severe injury that
renders the local tissues non-
viable or nearly so;
(4) a poor local blood supply
(5) infection