LOCOMOTOR SYSTEM

DISORDERS
CHRONIC

ACUTE

TRAUMA
NON-TRAUMA
Muscles &
tendon/liga
ment
neuro-

INF. & INFL.

Bone and
Joint

vaskuler

BONE &
JOINT INJURY

injury.
- Osteomyelitis

- Osteoarthritis
. Rhematoid and
CPPD (Goats)

Ortopedi &
Traumatology
and Internal
Medicine
Departments

Muscle/tendon/ligament and
neurovascular ruptures
. Surgery Department

Orthopaedic and
Traumatology
and Neurology &
Vascular surgery
Departments

-Fractures and
Dislocations

- Sprain
- Strain

Ortthpaedic and
traumatologic
Department
Armis-2005

LOCOMOTOR SYSTEM
DISORDERS
ACUTE
CHRONIC
NON-TRAUMA

TRAUMA
INFECTION/
INFLAMMATION

FRACTURES

BONE TUMOR

CONGENITAL
ANOMALY

DISLOCATIONS

METABOLIC
DYSFUNCTION

MUSCLE
WEAKNESS

SPRAIN & STRAIN

OSTEOMYELITIS
RHEUMATOID ARTHRITIS
GOUT AND PSEUDO-

ELDERLY PROBLEM

LOCOMOTOR SYSTEM
DISORDERS

ACUTE

Combine with or without

abnormality
pain, etc

KHRONIC

TRAUMA

NON-TRAUMA

OVERUSE
INJURY
(block 3.4)

INF. & INFL.

Bone and
Joint

BONE
TUMOR

Metabolic
Dysfunction
/ Elderly

Muscles &
neurovaskuler
diseases

- Osteomyelitis

- Clubfoot

Benign and
- Osteoarthritis
malignant
. Rhematoid and
- Osteoporosis
Bone Tumor
CPPD (Goats)
- Degeneration
Complication (?)

- DDH.

of the joint
Pathologic
fracture,dan
sebagainya.

Congenital
. Anomaly

- Froze

Complication (?)

shoulder
Tennis & Golf Elbow
De Quervain
Osgood schlatter.
Sport injury, dan lain-lain

Bagian Syaraf,
Orthop. B.
vaskul, Parasites
Armis-2005

FRACTURE & DISLOCATION

AND SPRAIN & STRAIN
DEFINITION OF FRACTURE

Segment

DEFINITION OF FRACTURE
DISCONTUNUITY OF BONE STRUCTURE
COMPLETE OR INCOMPLETE
INTRAARTICULAR OR EXTRAARTICULAR
COMMUNITIVE/SEGMENTAL
TRANSVERSAL, OBLIQUE OR SPIRAL
CLOSED OR OPEN

OTHERS CLASIFICATION OF
FRACTURE
TRAUMATIC FRACTURE
PATOLOGIC FRACTURE
STRESS FRACTURE
AVULSION FRACTURE
GREENSTIC FRACOMPLETED
FRACTURECTURE
BURST FRACTURE
BUCKLE FRACTURE

INTRODUCTION OF THE LOCOMOTOR

SYSTEM DISORDERS AND TRAUMA
History
Taking
KELUHAN

PASIEN

DIAGNOSIS/
DIFFERENTIAL
DIAGNOSIS

PEMERIKSAAN
FISIK

Look
Feel
Move

MENEJEMEN

DIAGNOSIS OF FRACTURE
1. PATIENT COMPLAINT:

PAIN, NO MOVEMENT
CAUSE BY PAIN, SWELLING, CREPITATION, DEFORMITY
(COMPLETE FRACTURE)

2. PHSICAL EXAMINATION:

LOOK, FEEL, AND

MOVE.

3. INVESTIGATION:
LATERAL

RADIOGRAPHS AP AND

Imobilization &
Transportation
(Closed Fracture)

Primary
care
Menejemen
Fraktur

Irigation, debridement,
antibiotic, imobilization,
and transportation
(Open Fracture)

HOSPITAL
Definitive
Treatment

PUSKESMAS
OR HOME CARE

surgery
Sling, backslab, or plaster
cast
(Sprain, Strain, or
Incomplete fracture)
Armis 2010

FRACTURE COMPLICATIONS
SHOCK HYPOVOLEMIC
VASCULAR DAMAGE/RUPTURE
INFECTION
AVASCULAR NECROSIS
COMPARTMENT SYNDROME
FAT EMBOLISM
DELAYED UNION
NON-UNION
MALUNION

RISK FACTORUMAH SAKIT

Population

Armis - 2005

Open Fracture
Case
Dead
at the
scene/prehospital

District Health Service

(PUSKESMAS)/Emergenc
y Unit

1. History

no medic.
attention

2. Physical Examination

& investigation.

3. Management:

Irrigation, debridement, antibiotic,

& immobilization

HOSPITALIZED
Dead nt the treatment

Dead

Impairmen
t

Rehabilitation

Disability

Handicap

Compl.
recovery

Preventable

POPULATION

Risk factoRumah Sakit

Incident cases
Acute injuries

BA

CBA

Died at scene
or prehospital

Died in
District health service/
emergency unit
of the hospital

Died in
hospital

Medical attention
received

Admitted to
District health sevice
Admitted to
Hospital

Discharged to
long-term
care

No medical
attention at time of
injury

Discharged
to rehabilitation

Out-patient
treatment
Discharged home
Discharged
home

Status at end
of acute care and initial
rehabilitation
Died postdischarge
DCBA

Residual
impairments 2o
medical
conditions

Limitation
in
activity

Limitation
in
participation

Complete
recovery

DISLOCATION AND SPRAIN & STRAIN

DEFINITION DISLOCATION AND SUBLUXATION

DISLOCATION AND SPRAIN & STRAIN

DEFINITION SPRAIN AND STRAIN

SPRAIN GRADING
I.II, AND III

DISLOCATION AND SPRAIN & STRAIN

DEFINITION FRACTURE AND DISLOCATION
AND FRACTURE-DISLOCATION

DIAGNOSIS
PHYSICAL EXAMINATION:
LOOK, FEEL, AND MOVE

DISLOCATION PATIENT
What should you do

Assess for
Associated injuries

CLOSED

OPEN

Surgery
Closed Reduction
(PUSKESMAS or
HOME CARE)

Fail
Hospital

Open
Reduction

Discharge
home

Armis 2010

SPRAIN OR STRAIN PATIENT

What should you do

REPAIR in
HOSPITAL

PRICE

Discharge
home

Armis 2010