Fractures

Definition
A fracture is a break of continuity of bone
 Etiology

Direct trauma; direct trauma and resulting bone fr

acture hit the ground.
Indirect trauma;the point of impact with the occur
rence of a fracture at a distance
 Fracture classification
Fractures distinguished;
1. open fracture ; there are wounds that connects the fractur
e to the skin surface.
2. closed fracture ; no injuries to the bone that connects the o
utside world
 How to diagnose a fracture?

Diagnosis is made on the basis of fracture;

1. anamnesis; history of trauma, ask trauma m
echanism.
2. General inspection; find possible common c
omplications such as shock, sepsis, etc.
3. Localist status check; look, feel, move.
 Look (inspection)

On inspection note;
 deformity
 Abnormal protrusion
 angulation
 Rotation
 abridgment
 Functio laesa (malfunctioning); unable to
move the organ fracture
 Feel (palpation)
 Fractured area, things that must be assessed;
 Tenderness
 Pain axis / tendernes,
 Value sensory and motor
 Acral cold or warm.
 Move (movement)

1. crepitation; fracture felt when actuated

2. Pain when you move in motion an active / passive.
3. Impaired function.
 Movements are not able to do
 Range of motion and strength decrease
4. abnormal movements
5. Joints false / pseudo joint; such as joint movement.
 Radiology

Radiology need to complete the description of

the fracture and the basis to take further actio
n. photo to be eligible;
- Photo of at least two projections are ante
romedial posterior and lateral
- Looks two joints; proximal and distal.
 complications of fracture

A. Early complications. (Local / systemic)

I. Local
 Vascular complications; compartemen syndrome
is elevation pogressif pressure in a compartment t
hat impair circulation to the compartment and the
distal part. 5P symptoms namely; Parese / paralys
e, Pain, Pulselesnes, pallor, parasthesia
 neurological complications; periper nerve lesions
or spinal cord
II. systemic fat embolism, can occur 24 hours I,
but most often occur on days 3 to 21 after fra
cture
 Handling of open fractures

Prinsif handling of open fractures

1. prophylactic antibiotics
2. Stabilization; prinsif reposition, fixation / imobilisai
Fixation function for
1. relieve pain
2. Ensuring pooling good position
3. allow movement earlier.
 Handling a closed fracture

The principle of a closed fracture treatment

 Immobilization with a splint (fx stable without dislocation
)
 Reposition closed and cast immobilization (fx stable after
repositioning)
 Reposition closed with traction (skin / skeletal) and later
diimmobilisasi with gypsum (fx femur, vertebra).
 Reposition closed then fixation (if after repositioned hard
to maintain its position)
 Reposition open and internal fixation with a plate / screw
or pin