lansia tergelincir jatuh

Wanita berusia 70 tahun dibawa ke UGD oleh keluarganya, 12 jam lalu jatuh
terpeleset di kamar mandi. Keluarga membawa pasien dengan cara membawa
dengan 2 orang. Pasien merasa begitu banyak rasa sakit di pinggul kirinya, tak
bisa bergerak kaki kirinya. Saat ini pasien hanya bisa terlentang di tempat tidur,
nyeri saat mengubah posisi sedikit. Keluarga hanya memiliki menggosok tawon
minyak di pinggul kirinya dan tidak ada perbaikan sama sekali. Dari hasil yang
diperoleh, kompos mentis kesadaran, tekanan darah 140/90 mmHg, nadi 86x,
pada lokal status pinggul dan tungkai kiri diperoleh: inspeksi terlihat pinggul kiri
sedikit memar, pembengkakan, deformitas + dibandingkan dengan sisi pinggul
kanan, leg perbedaan muncul. Nyeri tekan pada palpasi ditemukan di pinggul
kiri, hasil pengukuran panjang kaki adalah panjang kaki perbedaan 0f 5 cm.
pasien tidak bisa bergerak kaki kirinya. dokter ER mengirimkan pasien ke
instalasi radiologi untuk AP pemeriksaan radiologi dan pelvis lateral.
Setelah itu dokter UGD membuat rujukan ke spesialis ortopedi untuk
mendapatkan perawatan lebih lanjut.
gejala

Out-of-place or misshapen limb or joint

Swelling, bruising or bleeding

Intense pain

Numbness and tingling

Limited mobility or inability to move a limb

What Are Fractures?

A fracture is the medical term for a broken bone.
Fractures are common; the average person has two during a lifetime. They occur when the
physical force exerted on the bone is stronger than the bone itself.
Understanding Bone Fractures
Find out more about bone fractures:
Basics
Symptoms
Diagnosis and Treatment
Prevention

Your risk of fracture depends, in part, on your age. Broken bones are very common in
childhood, though children's fractures are generally less complicated than fractures in adults.
As you age, your bones become more brittle and you are more likely to suffer fractures from
falls that would not occur when you were young.
There are many types of fractures, but the main categories are displaced, non-displaced, open,
and closed. Displaced and non-displaced fractures refer to the way the bone breaks.
In a displaced fracture, the bone snaps into two or more parts and moves so that the two ends
are not lined up straight. If the bone is in many pieces, it is called a comminuted fracture. In a
non-displaced fracture, the bone cracks either part or all of the way through, but does move
and maintains its proper alignment.
A closed fracture is when the bone breaks but there is no puncture or open wound in the skin.
An open fracture is one in which the bone breaks through the skin; it may then recede back
into the wound and not be visible through the skin. This is an important difference from
a closed fracture because with an open fracture there is a risk of a deep bone infection.

Some fracture types are:

Greenstick fracture: an incomplete fracture in which the bone is bent. This type occurs
most often in children.

Transverse fracture: a fracture at a right angle to the bone's axis.

Oblique fracture: a fracture in which the break has a curved or sloped pattern.

Comminuted fracture: a fracture in which the bone fragments into several pieces.

An impacted fracture is one whose ends are driven into each other. This is commonly
seen in arm fractures in children and is sometimes known as a buckle fracture. Other
types of fracture are pathologic fracture, caused by a disease that weakens the bones,
and stress fracture, a hairline crack.

Other types of fracture are pathologic fracture, caused by a disease that weakens the
bones, and stress fracture.

The severity of a fracture depends upon its location and the damage done to the bone and
tissue near it. Serious fractures can have dangerous complications if not treated promptly;
possible complications include damage to blood vessels or nerves and infection of the bone
(osteomyelitis) or surrounding tissue. Recuperation time varies depending on the age and
health of the patient and the type of fracture. A minor fracture in a child may heal within a
few weeks; a serious fracture in an older person may take months to heal.
A bone fracture (sometimes abbreviated FRX or Fx, Fx, or #) is a medical condition in
which there is a break in the continuity of the bone. A bone fracture can be the result of high
force impact or stress, or trivial injury as a result of certain medical conditions that weaken
the bones, such as osteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture
is then properly termed a pathologic fracture.[1]
Although broken bone and bone break are common colloquialisms for a bone fracture,
break is not a formal orthopedic term.

Signs and symptoms

Although bone tissue itself contains no nociceptors, bone fracture is painful for several
reasons:[2]

Breaking in the continuity of the periosteum, with or without similar

discontinuity in endosteum, as both contain multiple nociceptors.

Edema of nearby soft tissues caused by bleeding of torn periosteal blood

vessels evokes pressure pain.

Muscle spasms trying to hold bone fragments in place

Damage to adjacent structures such as nerves or vessels, spinal cord and nerve roots (for
spine fractures), or cranial contents (for skull fractures) can cause other specific signs and
symptoms.

Pathophysiology
Main article: Bone healing

The natural process of healing a fracture starts when the injured bone and surrounding tissues
bleed, forming a fracture hematoma. The blood coagulates to form a blood clot situated
between the broken fragments. Within a few days blood vessels grow into the jelly-like
matrix of the blood clot. The new blood vessels bring phagocytes to the area, which gradually

remove the non-viable material. The blood vessels also bring fibroblasts in the walls of the
vessels and these multiply and produce collagen fibres. In this way the blood clot is replaced
by a matrix of collagen. Collagen's rubbery consistency allows bone fragments to move only
a small amount unless severe or persistent force is applied.
At this stage, some of the fibroblasts begin to lay down bone matrix in the form of collagen
monomers. These monomers spontaneously assemble to form the bone matrix, for which
bone crystals (calcium hydroxyapatite) are deposited in amongst, in the form of insoluble
crystals. This mineralization of the collagen matrix stiffens it and transforms it into bone. In
fact, bone is a mineralized collagen matrix; if the mineral is dissolved out of bone, it becomes
rubbery. Healing bone callus is on average sufficiently mineralized to show up on X-ray
within 6 weeks in adults and less in children. This initial "woven" bone does not have the
strong mechanical properties of mature bone. By a process of remodeling, the woven bone is
replaced by mature "lamellar" bone. The whole process can take up to 18 months, but in
adults the strength of the healing bone is usually 80% of normal by 3 months after the injury.
Several factors can help or hinder the bone healing process. For example, any form of
nicotine hinders the process of bone healing, and adequate nutrition (including calcium
intake) will help the bone healing process. Weight-bearing stress on bone, after the bone has
healed sufficiently to bear the weight, also builds bone strength. Although there are
theoretical concerns about NSAIDs slowing the rate of healing, there is not enough evidence
to warrant withholding the use of this type analgesic in simple fractures.[3]
Effects of smoking

Smokers generally have lower bone density than non-smokers, so have a much higher risk of
fractures. There is also evidence that smoking delays bone healing. Some research indicates,
for example, that it delays tibial shaft fracture healing from a median healing time of 136 to a
median healing time of 269 days.[4] This means that the fracture healing time was
approximately doubled in smokers. Although some other studies show less extreme effects, it
is still shown that smoking delays fracture healing.
Fractures or Dislocations Overview

A fracture is a break or crack in the bone. Several types of fractures exist, but fractures
resulting in bone fragments that penetrate the surface of the skin (called compound fractures
or open fractures) are particularly dangerous. Poor positioning of the fractured extremity can
obstruct blood flow to the affected limb.
A dislocation occurs when 2 bones are out of place at the joint. Dislocation may also cause
injury to nerves and blood vessels. Joints that become dislocated and later heal are more
likely to become dislocated again.

Bone Fractures & Joint Dislocation

Two of the most common bone and joint injuries are fractures and dislocations. Both injuries
should be considered emergency situations and set into place as soon as possible by a trauma
specialist. Moving a fractured or dislocated bone may cause further damage to the bone and
surrounding blood vessels, nerves and tissue.
Types of Bone Fractures

Bone fractures can happen in a variety of ways, including accidents, repetitive stress injuries,
osteoporosis and tumors.
The most common types of bone fractures are:

Closed or simple bone fracture: a break in the bone in which the skin is
still intact.

Open or compound bone fracture: a break in the bone in which the skin is
perforated by the bone or by a blow at the time of the fracture.

Segmental or multiple bone fracture: a break at two or more places on the

same bone.

Comminuted bone fracture: a break in which the bone is shattered into

pieces.

The line of the bone fracture may be:

Transverse: Forms a right angle with the axis of bone.

Oblique: Runs slanted to the axis of the bone.

Longitudinal: Runs along the line of its axis.

Joint Dislocations

Joint dislocation is the displacement of a joint from its normal position, usually caused by a
blow, fall or other trauma. In addition to displaced bones, there may be damage to the joint
capsule and surrounding muscles, blood vessels and nerves. Symptoms of joint dislocations
include loss of motion, swelling and pain and sometimes a joint visibly out of place.
Fractures or Dislocations Symptoms

Tenderness, swelling, deformity, and discoloration occur with fractures

and/or dislocations.

Bleeding occurs when a fractured bone pierces the skin (a compound

fracture).

Sensation may be lost below the fracture or dislocation, indicating possible

nerve injury