CLOSED FRACTURE 1/3 DISTAL LEFT FEMUR

By
By ::
Akbar
Akbar (C111
(C111 07
07 099)
099)

Mentor
Mentor ::
dr.
dr. Fendy
Fendy
dr.
dr. Rico
Rico

Supervisor
Supervisor ::
dr.
dr. W.
W. Supriyadi,
Supriyadi, Sp.OT
Sp.OT

Orthopaedic
Orthopaedic and
and Traumatology
Traumatology Department
Department
Hasanuddin
Hasanuddin University
University
Makassar
Makassar
2013
2013
PATIENT IDENTITY
Name : Mr. AY
Sex : Male
Age : 51 years old
Date of Admittance : March 23rd 2013
MR Number : 600467
HISTORY TAKING

Chief complain
Pain at the left thigh
History of illness
Since 2 hours before admitted to the hospital
due to traffic accident
Mechanism of trauma
The patient was riding a motorcycle and got
hit by a truck from the back side.
History of unconscious (-), nausea (-), vomit (-)
History of previous treatment (-)
PRIMARY SURVEY

A :Patent airway
B :Symetrical, RR: 20 x/minute,
Thoracoabdominal type, spontaneous
C :BP: 120/80 mmHg, PR: 92 x/minute,
regular
D :GCS 15 (E4M6V5), pupil isochors,
: 2,5 mm/2,5 mm , light reflex +/+
E :Temperature: 36.7oC (axillar)
SECONDARY SURVEY

Left Femur Region

Inspection :Deformity (+), Swelling (+), Hematoma
(+), wound (-)
Palpation :Tenderness (+)
ROM :Active and passive motion of the hip
and knee joints are limited due to pain
NVD :Sensibilty is good, dorsalis pedis
artery pulse is palpable, CRT < 2 seconds
 LEG LENGTH DISCREPANSY
(LLD)
Right Left

ALL 89cm 86 cm

TLL 81 cm 78 cm

LLD 3 cm
CLINICAL PICTURE
DIAGNOSTIC IMAGING
DIAGNOSTIC IMAGING
DIAGNOSTIC IMAGING
DIAGNOSTIC IMAGING
 Laboratorium
WBC 18,16x 103/uL
RBC 4,89 x 106/uL
HGB14,5 gm/dL
HCT44,5 %
PLT 215 x 103 /uL
CT 08 00
BT 02 30
 Resume
A 51 years old man with pain at the left thigh due to traffic

accident. There is no history of unconsiousness, nausea and vomit.

From physical examination of the left thigh : there is deformity,

swelling, and hematoma, excoriation wound at anterior aspect of the

left genu, there is no tenderness, active and passive motion of the hip

and knee joints are limited due to pain, NVD is within normal limit.

From radiologic finding, there is a fracture in 1/3 distal of the left

femur.
 DIAGNOSIS
Closed Fracture of 1/3 Distal of The
left Femur
TREATMENT

Analgetic
Apply skin traction load 2,5 kg
Plan for Open Reduction Internal
Fixation
DISCUSSION
FRACTURE OF
SHAFT FEMUR
 Thompson, J. Netters Concise
Anatomy Orthopaedic Anatomy 2nd Edition.
Kansas : Elsevier.
Anterior Muscle
Medial Muscle
Posterior Muscle
Anterior Division Nerves
Posterior Division Nerves
CLASSIFICATION WINGUIST AND HANSEN
MECHANISM OF INJURY

Koval KJ, Zuckerman JD. In : Handbook of Fractures Third Edition. USA :

Lippincott Williams & Wilkins. 2002
DIAGNOSIS

Koval KJ, Zuckerman JD. In : Handbook of Fractures Third Edition. USA :

Lippincott Williams & Wilkins. 2002
RADIOGRAPHIC EXAMINATION

Anteroposterior (AP) ,
lateral views of the femur,
hip, knee as well as an AP
view of the pelvis

Solomon. L. et al. Apleys System of

Orthopaedics and Fractures 9th Edition. New
York : Arnold. 2010

Koval KJ, Zuckerman JD. In : Handbook of

Fractures Third Edition. USA : Lippincott Williams &
Wilkins. 2002
TREATMENT

Solomon. L. et al. Apleys System of Orthopaedics and Fractures 9 th Edition. New

York : Arnold. 2010
Koval KJ, Zuckerman JD. In : Handbook of Fractures Third Edition. USA :
Lippincott Williams & Wilkins. 2002
Solomon. L. et al. Apleys System of Orthopaedics and Fractures 9 th Edition.
New York : Arnold. 2010
COMPLICATION

Solomon. L. et al. Apleys System of Orthopaedics and Fractures 9 th Edition. New

York : Arnold. 2010
THANK YOU