LOCOMOTOR SYSTEM LOCOMOTOR SYSTEM DISORDERSDISORDERS

ACUTE CHRONIC

INF. & INFL. Bone and

Joint

Muscles & tendon/liga

ment neuro-

vaskuler injury.

Armis-2005

- Osteomyelitis- Osteoarthritis. Rhematoid and CPPD (Goats)

-Fractures and Dislocations- Sprain- Strain

Muscle/tendon/ligament and neurovascular ruptures. Surgery Department

NON-TRAUMA

TRAUMA

Ortopedi & Traumatologyand Internal Medicine Departments

BONE & JOINT INJURY

Ortthpaedic and traumatologic Department

Orthopaedic and Traumatologyand Neurology & Vascular surgery Departments

LOCOMOTOR SYSTEM DISORDERS

ACUTE

CHRONIC

INFECTION/INFLAMMATION BONE TUMOR

TRAUMA NON-TRAUMA

FRACTURES

DISLOCATIONS

SPRAIN & STRAIN

METABOLICDYSFUNCTION

CONGENITAL ANOMALY

MUSCLEWEAKNESS

OSTEOMYELITIS

RHEUMATOID ARTHRITIS

GOUT AND PSEUDO-

ELDERLY PROBLEM

LOCOMOTOR SYSTEM LOCOMOTOR SYSTEM DISORDERSDISORDERS

ACUTE KHRONIC

INF. & INFL. Bone and

Joint BONETUMOR

Metabolic Dysfunction

/ Elderly

Muscles & neuro-

vaskuler diseases

Combine with or withoutabnormalitypain, etc

Armis-2005

TRAUMA

OVERUSE INJURY

(block 3.4)

Congenital. Anomaly

NON-TRAUMA

- Osteomyelitis- Osteoarthritis. Rhematoid and CPPD (Goats)

Benign and malignant

Bone Tumor- Osteoporosis- Degeneration of the joint

- Clubfoot- DDH.

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

Pathologic fracture,dan sebagainya.

Complication (?)

Complication (?)

Bagian Syaraf, Orthop. B. vaskul, Parasites

FRACTURE & DISLOCATIONAND SPRAIN & STRAIN

DEFINITION OF FRACTURE

Segment

DEFINITION OF FRACTURE

DISCONTUNUITY OF BONE STRUCTURE COMPLETE OR INCOMPLETE

INTRAARTICULAR OR EXTRAARTICULARCOMMUNITIVE/SEGMENTAL

TRANSVERSAL, OBLIQUE OR SPIRALCLOSED 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

PASIEN

KELUHAN

PEMERIKSAAN FISIK

DIAGNOSIS/DIFFERENTIAL

DIAGNOSISMENEJEMEN

LookFeelMove

History Taking

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: RADIOGRAPHS AP AND LATERAL

Menejemen Fraktur

Primarycare

DefinitiveTreatment

Imobilization & Transportation

(Closed Fracture)

Irigation, debridement, antibiotic, imobilization,

and transportation(Open Fracture)

surgery

HOSPITAL

PUSKESMASOR HOME CARE

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

District Health Service(PUSKESMAS)/

Emergency Unit

Open Fracture Case

Deadat the

scene/prehospital

Population

no medic. attention

1. History 2. Physical Examination& investigation.

3. Management:Irrigation, debridement, antibiotic,

& immobilization

HOSPITALIZED

Dead nt the treatment Rehabilitation

Dead Impairment

Disability Compl. recovery

RISK FACTORUMAH SAKITArmis - 2005

Handicap

Preventable

POPULATION

Incident casesAcute injuries

Died at scene or prehospital

Medical attention received

No medical attention at time of

injury

Out-patient treatment

Discharged home

Admitted toDistrict health seviceDied in

District health service/ emergency unit

of the hospital

Died in hospital

Discharged to long-term

careDischarged

to rehabilitationDischarged

home

Status at endof acute care and initial

rehabilitation

Died post-discharge Residual

impairments 2o medical

conditions

Limitation in

activity

Limitation in

participation

Completerecovery

A

BA

CBA

DCBA

Admitted toHospital

Risk factoRumah Sakit

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 DISLOCATIONAND FRACTURE-DISLOCATION

DIAGNOSIS

PHYSICAL EXAMINATION: LOOK, FEEL, AND MOVE

DISLOCATION PATIENT

CLOSED OPENAssess for Associated injuries

SurgeryClosed Reduction(PUSKESMAS or

HOME CARE) OpenReduction

FailHospital Discharge

home

What should you do

Armis 2010

SPRAIN OR STRAIN PATIENT

PRICE

Dischargehome

What should you do

REPAIR inHOSPITAL

Armis 2010