Professional Documents
Culture Documents
Open
Fracture
Open fractures are graded accordingto
the following criteria:
Grade I is a clean wound less than 1 cm
long
Grade II is a larger wound without extensive
soft tissue damage
Grade III is highly contaminated, has
extensive soft tissue damage, and is the
most severe.
Pain
Bone
Ray
Menentukan lokasi/luas/jenis fraktur
Dua posisi (AP/Lat), dua sendi terlibat
Bone Scanning
Menunjukkan tingkat keparahan
fraktur, identifikasi kerusakan jar lunak
Arteriogram
Jika terdapat kerusakan vaskuler
Perform
Reduction
Closed
Reduction
bringing the bone fragments into
position through manipulation and
manual traction
The immobilizing device maintains the
reduction and stabilizes the extremity
for bone healing
X-rays are obtained to verify that the
bone fragments are correctlyaligned
Open
Reduction
Internal fixation devices may be
used to hold the bone fragments in
position until solid bone healing
occurs
Internal fixation devices ensure
firm approximation and fixation of
the bony fragments
Immobilization
Maintaining
Immobilization
of fracture fragments
Maximum bone fragment contact
Sufficient blood supply
Proper nutrition
Exercise: weight bearing for long
bones
Hormones: growth hormone, thyroid,
calcitonin, vitamin D
Extensive
Bone
local trauma
loss
Inadequate immobilization
Space or tissue between bone
fragments
Infection
Local malignancy
Age
Fat
Embolism Syndrome
Fat embolism is a potentially life
threatening complication of long bone
trauma, blunt trauma, and
intramedularry manipulation
This syndrome manifest anywhere from
4 hours to several days after injury or
orthopedic surgery.
Fat globules, release from bone
marrow, can embolize and occlude
Osteomyelitis
Compartment
Syndrome
Compartment syndrome develops when the
presure in a muscle compartment exceeds the
intraarterial hydrostatic pressure, causing
collapse of capilaries and venules, which lead to
iskhemia and tissue necrotic
The exact pressure at which this develops is
unclear, but intracompartment pressure greater
than 30 mmHg generally are considered greatly
elevated
A grace periode of about 6 hours exists before
irreversible soft tissue demage occurs
Bleeding
Delayed
Neurovascular
assessment
Use five P to evaluate limb
circulation, sensation and motor
function
Pain : a description of pain is
helpful
Pallor
Pulses
Parasthesia
Inspection, the
following:
Color
Disrupted skin integrity
Extremity position
Edema, swelling, or echhimosis
Range of motion
Symmetry, alignment, deformity
Palpation, the
following :
Skin temperature
Pain
Bony crepitus, joint instability
Peripheral nerve function : sensory
and motor
Acute
pain
Impaired physical mobility
Risk for peripheral neurovaskuler
dysfunction
Risk for imbalance fluid volume
Teach
Teach