MUSCULOSKELETAL TRAUMA

Dr. M. Ruksal Saleh, Ph.D., Sp.OT

Bagian Ortopedi & Traumatologi

Fakultas Kedokteran Universitas Hasanuddin
Makasasar, 2006
 Introduction
 Millions of cases annually.
 Multiple MOI :
 Falls, Automobile collisions, Crashes,
Violence, etc
 Multi-system trauma
 Rarely life threatening
 Improperly treated can result permanent
disability.
Anatomy & Physiology of the
Musculoskeletal System
Structures
 Skin
 Bones
 Joints – where bones interact
 Muscles
 Tendons - connect muscle to bone
 Ligaments - connect bone to bone
 Neurovascular
The Skeleton
Types of Muscles
The Neurovascular
Function
 Protects organs
 Allows for efficient movement
 Stores salts and other materials needed
for metabolism
 Produces RBCis
 Scaffolding / Support
Pathophysiology of the
Musculoskeletal System
Injuries to the Musculoskeletal System

Four basic types of musculoskeletal injuries are:

 Strain - An extreme stretching or tearing of MUSCLE & /
OR TENDON.
 Sprain - partial or complete tearing of LIGAMENTS and
tissues at the joint.
 Dislocation - displacement or separation of a bone from its
normal position at the joint.
 Fracture - a break or disruption in bone
 closed - the broken bones do not penetrate the skin
 open - the skin is pierced by broken bone fragments
Injuries to the Musculoskeletal System

Four basic types of musculoskeletal injuries are:

 Strain - An extreme stretching or tearing of MUSCLE & /
OR TENDON.
 Sprain - partial or complete tearing of LIGAMENTS and
tissues at the joint.
 Dislocation - displacement or separation of a bone from its
normal position at the joint.
 Fracture - a break or disruption in bone
 closed - the broken bones do not penetrate the skin
 open - the skin is pierced by broken bone fragments
Injuries to the Musculoskeletal System

Four basic types of musculoskeletal injuries are:

 Strain - An extreme stretching or tearing of MUSCLE & /
OR TENDON.
 Sprain - partial or complete tearing of LIGAMENTS and
tissues at the joint.
 Dislocation - displacement or separation of a bone from its
normal position at the joint.
 Fracture - a break or disruption in bone
 closed - the broken bones do not penetrate the skin
 open - the skin is pierced by broken bone fragments
Musculoskeletal Injury Assessment
Scene Size-up
Initial Assessment
Focused history and physical exam
 Rapid Trauma Assessment
Detailed Physical Exam
Ongoing Assessment
Scene Size-up
Initial Assessment
Focused history and physical exam
 Rapid Trauma Assessment
Detailed Physical Exam
Ongoing Assessment
Scene Size-up
Initial Assessment
Focused history and physical exam
 Rapid Trauma Assessment
Detailed Physical Exam
Ongoing Assessment
Scene Size-up
Initial Assessment
Focused history and physical exam
 Rapid Trauma Assessment
Detailed Physical Exam
Ongoing Assessment
Scene Size-up
Initial Assessment
Focused history and physical exam
 Rapid Trauma Assessment
Detailed Physical Exam
Ongoing Assessment
Common Signals of Musculoskeletal Injury :
 Pain
 Swelling
 Deformity
 Discoloration of the skin (bruising)
 Inability to use the affected part normally
 Loss of sensation in the affected part.
Musculoskeletal Injury Management
General Principles
 Protecting Open Wounds
 Positioning the limb
 Immobilizing the injury
 Checking Neurovascular Function
Immobilizing a joint
Four months post-op

One years post-op

Preoperative
Debridement + necrotomy Identification of artery, veins,
nerves & tendons
Bone Fixation Repair ulnar artery
Repair of extensor tendons Repair of flexor tendons
7 weeks post operation
 Summary
 Patient Assessment is the foundation
of all that you will do for your patients.
 Only with systematic approach you
will be able to give quality care.
Thank You