d a

oedahz
B e h
2 dr.
D
E
A

Y
U
L
I
A

L
U
B
I
S
 SKDI 3B
Fraktur
Lokasi
• Diafisis Tenis Fraktur Orientasi
Displacement
• Epifisis Hub dengan
komplit
.

•
• Metafisis Jaringansekitar
• lnkompi.it : Torus ,
Greenstick .
Bowing s
• Salter -
Harris

lzproksimal
'

Terbllka Tertlltup
Yzmedial Open closed
⑦ Tejas / Luka ① Tejas / Luka
Yztistal terbllka terbuka
Gustin
K1asifikasiTschern@EtiTraUma.Kondisipato1ogis.St
1
restoring
Anderson
Bone expose -0 Bone expose -01 DX Gangguanmobilisasilgerakl
:@

• Nyeri area Fraktur

Grade -1 PD : Look :
perdarahan hematoma pucat ,

Grade I
, ,

• Luka < 1cm

Gradelita Grade 1116 Grade IIC deformities .dk
Luka
.

• 1- 10cm • Luka > 10cm

• Luka > • Luka >
nyeri.krepitasiiNVD@FR.kominutiF-0loo.F
R.kominutip-R-so.FR kominutif
Feel poem 10cm :

Ringan FR.kominutif@FR.kominutif
.

⑥ Skin lost -0
Berat ⑥ Move : ROM terganggu
⑥ Skin lost ⑥ Skin lost -① Berat
-0
natertutup ⑥ skin%FF-ohet.at Skin lost -10
Penllnjang :X -

Ray ( Rule of Two )

jar Lunak )
-

( Taking tertutup ( Taking tertutup

jar Lunak )
- jar lunak )
-

• Duasisi • Duajejas
DX Fraktur tertlltliplterbllkacr ?
:
,
• cederavaskdar-oo.cederavo.sk"1ar④
• Duasendi • Duawaktu
Duaekstremitas
DIS •

arahpatahantposisi DIMIP Osapa ? ,

/
Tx :@ primary survey
Management Fraktur 412 • AB Sefalosporin
/
cth-T-rakturterbukagradei.lt/3Obliqmedial0sFemurdextra * Recognition
••
Retention Aminoglikosidalvtisiam
* Reduction *
DX inisiasi casting Splinting * Rehabilitation
" "
, open / Closed .

imobilisasiltraksiibidail reduction
FR.ORIF.OREF-ierbukat-isioterapi
-11 -ertutupi-erbuka-l.IR
 II. Fraktur Tertutup
SKDI 3B
Radius-Ulna

Radius Yztistal Ulna 1/3 Prox

I
4- Dislokasi
-
Dislokasi + Dislokasi Radius
Ulna Ulna
1
Displacement
/
Dorsal Ventral Monteggia
gapeazzi
I 1
Colles Smith
D

r ¥ +

islokasi-IH.in#.:yjJ q.aMonteggia
1)
I 1
Smart Way

Ulna
Garden Spade
Dinner Fork deformity Galeazzi Radius
deformity

.ae#o*oo.:ni.:jyyy-----------------------..
÷ T.is/okasi
Smart Way
←,•M

zyy ☒¥
\

Holes belakang Tx : Primary survey ABIDE

Smith depart
• Management Fraktur 412
• Farmakologisimptomatik
guyana , , ,µ, ,, , , , ,µ ,
 ¥72 Fraktur Clavicula SKDI 3A

DX : Nyeri gangguanmobilisasi tengan

,
atas

Penunjang : ✗ -

Ray clavi cuta → Garis patahan 0s clavicula

Tertutup / Terbllka
lasifikasi Allman

Tx : • Primary survey ABEDE

p M D
⑥ Management Fraktur 412
M Middle lateral
⑥ Farmakologisimptomatik
e.dial ⑥ Utama : 1st Figure 01=8
43 Medial & 13 Proksimal
'
Fr .
0s Claviculatertutup
⑥ Arm sling / MiteHa
Or Figure of eight / Bandage
Fr 0s Claviculatertutup 43 distal & Fr claviculaterbuka
.
.

RUJUK Ke Rs → ORIF
 X

M 4
6 12

43 lateral / 43 distal

✗ tennpp Its medial / pwhrimae

 Komplikasi Fraktur mg

Early ( Awal ) Late Ckronis )

sindromakompartemen /
Acute Limb Ischemia CALI ) ☒ Cedera Nervus
FR :@ Frtertutuplcrurislantebrachii )
Malllnion

""""
• Lukabakar ) @ layed Nonunion
•
Hambatanmekaniklbidailceips)
Pain Parastesia ANJAN Kaki Union
DX :5P • •

• Pallor • Paralisis + + +
• Pulse less
Persistent
Nyeri
-

: -

onset 718mg
" "
" '
" ' " '
'
" '
'

Axillaris Radialistledianuslllnaris Peroneus Tibialis

com" "'s
Opener claw foot
Krepitasi ; + +

GR
jam
FR.sekitart-R.co/lumchirurgicum
• IX. Axillaris
Wtvt Pseudoartrosis
Tx : Rujukkers Abduksibahuterganggu ,
Drop foot ( false joint )
• T-r.tertutup-t-asiotomiatrofiM.de/toid
• Luka bakar → Eskarotomi parastesialateralbawahbahu =/ dorsofleksi
• Hambatanmekanik → Lepas Garis + + -

• IX. Radials :

£•¥¥iy y y y
Smart Way
FR shaft humerus
Drop Hand
.
Fraktur Pertumbuhan
Kalas minimal
Ujungtulang
atrofilhipertrofi
Anomali
Alignment

÷¥¥:÷÷:÷
" Plantarfleksi
twang
0M KU DR
FR.su/oracondylar humerus
Mediants Ulnaris Radians Obstetric Hand ,
Hand of
benedict ,
pinched
FR epicondylus medial
.
Ape sign
Claw Hand Hand 0=1
 Dislokasi
SKDI 3A
① Krepitasi Dislokasi Subluksasi
Senai Besar
* Subluksasicaputradii /
Shoulder Joint Joint Nursemaid elbow
Hip
( Glenohumeral )
kaki Tarikanpadatangananak
Tongan PD : ⑧ Nyeri
⑧
Tanganpronasitdptsupinasil
Anterior posterior Anterior posterior
TX RUJUK → Sllpinasipasif
adduksi.e.no/orotasiabdUKS1ieksorotasi
:
adduksi @ nclorotas , ,

PD abdukslieksorotasi Kemlldianfleksikansiku
,

Fleksi
Fleksi fleksi
piers ;
" P "tF°M" "
Caput Femoris
"
"
Bulb OF lamp app
"

X-Ray Half-moon overlap

"

didepan /dibawah acetabulum dibelakangldiatas acetabulum

I-EE.in#.:yJJT
I

Smart Way
←,•M

dibelakangcmendekat.li#- - - - - - - - .*
Tx :@ Primary survey ABEDE
• Farmakologisimptomatik Abang di Depan ( menjauh)
⑥ Utama → Rlyukkers → Reposisisendi
Adak
 Drop hand
ON KU DR

Sind Roma Komparturient

Nyeri -0
Krepitasi -0
FR -0

Colles
smile DX :D shoulder anterior
.

DMD

→ posterior
 Cedera Ligament & Tendon
ATFL
SKDI 3 A
4=1
Anke Joint Ligament SKDI 2
SKDI 3 A Knee Joint Ruptur Tendon
( Sprain ) Achilles
H**
Grade -1 Grade -11 Grade II ACL PCL Meniscus MCL LCL Et : Olahraga
Et: Regangan Robekan Robekan Basket tenis rehang
, ,

ligament Parsial Total

DX Gangguanmobilitasinyeri
: ,

DX :@ Nyeritungkai • Nyeritungkai • Nyentungkai Kaki -0 plantar flexi

sedang Berat
• Edema -01min Edema pergelangankaki ,
-

• Edema
sedang • Edema berat PD :
•

Berjalannyeriooberjalanpincang • Tidakdapat
Act
Gap in tendon

berjalan.iq#:nq...t ? T J J PCL Pemeriksaan Thompson test

/

¥-= É¥**?É÷É÷É⇐ ⇐
:
Smart Way
J J y y
Smart Way
simmona
Rest
••÷

Tx : istirahatkansendi " "" Hang :L's .

§É
A L Ot Pe Seg MRI
squeeze
Ice tompreses Anterior
Lachman Pivot Posterior
Drawer Sag sign
compression bebattekan Drawer Tx :
Rujuk → Operatip
Elevation angkatlebihtinggi
daribatangtubuh.ie#z.*JJJJ
.*....Meniskt -&•••%•÷Éyyyy¥••m% LCL
's
MCL
Smart Way
•¥Éjyyy Smart Way Smart Way

¥¥ ¥¥¥¥ "Jj¥=f¥¥
MRI / USE

¥ ¥¥
Tes Apel Marah
"

Gum
Thessaly Apley McMurray Valgus test Varus test
endorotasi → Lateral
eksorotasi → medial
✗
✗

DX R Tendon achilles
-

: .

Alot
 SKDI 3A
Maksila -

Klasifikasi Lefort
Penunjang : Foto waters

TX : Fiksasi internal

Fraktur Maksila Horizontal NasoFrontalis Zigomatikum

(Fraktur Guerin) Syd
Tulang Wajah Floating palate Zigomatikum
Syd
Orbita
( Fraktur Piramid ) Fraktur
Floating Maxilla Craniofacial Junction )
Floating Face

Mandibular DX Maloklusisetelahtrauma
:

Foto Panoramic CT scan

Penunjang : ,

TX : Awal lmobilisasi
: → wire

Definitif : Fiksasi internal

 Penyakit Muskuloskeletal Infeksi

SupuratifFRilUkater6Uka.hematogenDxi0D@mam.n
Et lnfeksi Staphylococcus
: Osteomyelitis SKDI 3B ¥72 Tenosinovitis
. SKDI 3B

yori Et Jaritertusukjarumldllri
:

PD Eritemq edema
:
,
lnfeksi staphylococcus
hangatinyeritekan Akllt Sllbakut Kronis pp :
Tanda inflamasi :
Eritema edema
,

( < 2mg ) 12 -4mg ) ( 74mg ) hangatinyeritekan

Penllnjang : ☐
Tariterkuncidalamposisifleksi
"
Kanara sign
"

X-Ray
"
Soft tissue " "
Absesbrodie "
Sequestrume
"

Swelling Involucrum "

Tx : Be Resusitasic -

AB

• Antibiotic cephalosporin Nltsimptomatik Tx : lnsisi Drainage

• Rujuk → Operatif AB Blaktam / Cephalosporin

+

Simptomatik
FR Guerin.

FR pyramid
.

FR craniofacial
.

junction

Kanavu sign
 Kelainan Tulang Belakang
SKDI 2
SKDI 1 SKDI 1
Deformities spinal spondilitisspondilosislspondilolis-tesisspondiloptos.is Spondilolisis
Spondiloartrosispergeseranrrterae Spondilolistesis Cederapada
SKDI 2 Pars articular's
0A Vertebrae grade -1
-

lordosis Kifosis Skoliosis Ankylosing TB SKDI 3B vertebrae

Slc Scotty dog

"
Alltoimun • Pott 's disease
PENUNJANG
•
:
CHIA -827 ) • Lop ,Riw -18 . Sian "

X-RAY
"
• "
Bamboo spine Gibbus -01 100%

Postural Struktural • Defisitneurologis

X-Ray
I /
:

Frakturkompresi
Schober test
"
Kembali
"m

Menetap
'

normal
X-Ray :

X-Ray lateral Cobb 's angle Tx :

Rujuk → Terapioltttsteroid
opetratif
Osteoporosis
Et : Primer Tipet :
Menopause Penllnjano :
( dep estrogen ,
.

Tipe 2 i.
Senilislusia > 651 Bone Mass Densitometry
T score
Sekunder
-

:O bat obatan
-

, Hipertiroid , N :> -

ISD

DX : • Asimptomatik
steroid Hiperparatiroid Osteopenia :-# slot -2,5513
• Renton Fraktur Osteoporosis :<-2,5 SD

• Anomali vertebrae Ckifosisskoliosis ) Tx :(alooomgtprovitl

Spesifik Bifosfonat
:
 Keganasan pada Tulang

Osteosarcoma
SKDI 1 \ Osteokondroma
SKDI 1 Ewing Sarcoma Kondrosarcoma
• seringpdmetafisistulangpanjang • Padaanaklo 20th -
• Berasaldarikartilago • Tumorjinak
"
Berasaldariselendotelial "
Popcorn
"
• Berasaldarikartilago
"
sunburst app " "
Codmann triangle @
sumsumtulang "
cauliflower "

( Bungakol )
"
Onion peelskinapp
"

Et : Trauma ,
F. Risk → manuverpadatulang .

ldiopatik
DX : Massa talang Panjang . nyeritulang
•
Terjadipadausiamudafsotahun
• IIBB dan anemia
 it : 25 -50% I :< 25%
In : 50 -75%
iv. :
7757 .

lspondiloarlhwris

HLA 8-27

< -2,5 SD

765
 Rheumatology
SKDI 3A ¥73
Atritisseptik.

K-1 :
Diuretik Et :/nfeksi Staphylococcus ,

Osteoarthritis ( OA ) HCT Monoartritis Trauma / njeksiintraarticuler

sp
,
osteofit * osleofit oswtagofit
SKDI 3A Kecil
¥4 DX :@ Nyerisendibesar
Et : Degenerate .
. . .
nai

: ::
=.
SKDI 4 "

genu
"
,
unilateral

lperubahanstruktursinovi.at/ sklerotik Kissing ⑥ Demam 738°C

""

kartilagosenc.li/F.Risk:Obesi-tas ¥7.604T & ⑥ PD : Tandainflamasisendi

Pseudogout
DX :@ Nyerisendibesar .
unilateral E : Dietpurine Benson
# : PEMMIANG :

Aspirasicairansiendi
Bayan Emping Melinjo , Olahanlaut)
""
• Sandi Kecil → late onset ,
,
PIP
Bouchard Heberden 's node

Nyerisedangberat@UnilateraL.sendiKeciLMTPtPenunjangi.X
& ✗ : ⑥

Ray ⑤ late onset :

-10ms
Tx ABCgol.se/--a10sporin )
• Penyempitancelahsendi Akut : podagra :

lnsisidrainase
• Osteofit Penunjang : Rujuk :

⑨ Sklerotik Awal :
As .urato→ > 6mg / dl:

9- 77mg /dL
Modifikasigayahidup
:

Tx :
Goldstd :
Aspirasicairansendi Txiseranganakut :

DOC paracetamol 3111000mg

: 1m91 Kolkisin ( < 725am )
0,5mg

NSAID lain PSCUdogoutmaxloms.ws/HDlain:lndometasin60Ut

:
Nyeri Allopurinol ① :

Polmboldahah Kristal calcium pirofosfat / Rhomboid

Kristal Monosodium uratljarum 1×300 mg

Brifingent test -0 /Biru

-

Brifingent test -01 / Merah

-
lxioomglh"
 Sistemik Lupus Eritematosus ( SLE ) SKDI 3A
oral ANA Immune
ulcer testa ) deficiency Artritis Hematologic anemia
DOPAM IN RASH
Discoid Photo Malar Neurologic Renal Serositis
Rash Sensitive Rash Disorder Failure
spesifik 1
Penllnjang : Awal : LED #
a Lupus TX : Kortikosteroidsistemik

Autoimun B. emas : 1. Anti 5M (Smith )

2. Anti
antibodi
Nephritis Rujuk
DS -
DNA

sensitive -73 ANA .

Test

autoimun
¥72 .
Arthritis Rellmathoid SKDI 3A ¥95
"
Hiperekilensi
" DIP
Hsia Mada
"
_

DX :
Nyeri sendikecillphalangs ) bilateral ,
Hiperekstensifiekn.

PIP
late onset Swan neck deformity
:
, Dip

Nyeri / Kaku ulnar devices i. botunieresign

> liam Penllnjang : RF (t) , Anti CCP G) / ACPA
TX : Awal : NSAID Kortikosteroidsistemik
,

tepat :
Rcljuk → DMARDS :
Methotrexate
 As . Vrt
F- Akut :
Gejala ,
Tanda TT
today R
Gout F '

lnlerktitikal Gejala-0 Tanda-0

:

{All upwind
,

Arthritis As UMTTT
.

F. Kronik :
Gejala-0 / Tanda -01
↳ Tophus

DIVRETIK ✗
✗

✗
✗

F. Knnik

RA
PIP Hiperekstensi DX :

DIP Flekh
'

DX : SLE

, Anti DS DNA , ANA test

-