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    TASK GROUP

    FRAKTUR

    Name

    Ach.Afriyanto

    Eric Juan Maldini

    Mitha Okniart Tabi

    STIKES Maharani Malang

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    DefinitionA bone fracture 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.

    Circumstances in which the bones that form the joints are no longer connected anatomically.

    Bone fracture is the interruption of continuity and determined according to the type and

    extent. (Smeltzer & Bare S.C B.G, 2001)

    Fraktur is any crack or fracture in the bone intact.( reeves C.J,Roux G & Lockhart R,2001 )

    Can be concluded that the fracture is a bone integrity disorder characterized by the

    destruction or breaking of continuity of bone tissue due to excessive pressure.

    Etiology

    A.Fractures due to trauma events.

    Most fractures are caused by sudden power / sudden and excessive which can be a beating,

    destruction, or withdrawal. When the pressure force directly, bone can fracture at the affected

    places and soft tissue also bound to come damaged. Beatings usually causes transverse

    fracture and damage to the skin above it. destruction is likely to cause fracture accompanied

    komunitif extensive soft tissue damage.

    B.Fractures due to repeated pressure.

    Cracks can occur in bone as well as on metal and other objects due to repeated pressure. This

    condition is most often presented in the tibia, fibula or matatarsal especially in athletes,

    C.Pathological fractures due to bone disorders.

    Fractures can occur by the normal pressure when the bones are soft (eg by a tumor) or the

    bones are very brittle (osteoporosis).

    Pathophysiology

    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.

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    At this stage, some of the fibroblasts begin to lay down bone matrix (calcium hydroxyapatite)

    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. The bone shards can also

    embed in the muscle causing great pain. 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.

    Complications

    Some fractures can lead to serious complications including a condition known as

    compartment syndrome. If not treated, compartment syndrome can result in amputation of the

    affected limb. Other complications may include non-union, where the fractured bone fails to

    heal or mal-union, where the fractured bone heals in a deformed manner.

    Clinical manifestations

    A.Painful

    Pain is felt immediately after the trauma. This is caused by muscle spasm, the pressure of the

    fracture or damage to surrounding tissues.

    B.Edema

    Edema appears faster due to serous fluid (plasma protein) that is localized to the fracture area

    and extravasi areas in the surrounding tissue.

    C.Decreased sensation

    Occur because of nerve damage, nerve depressed because of edema.

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    D.Disfunction

    Occurred because of the instability of bone fractures, pain or muscle spasms, paralysis can

    occur due to nerve damage.

    Theraphy

    Conservative Therapy

    A.Protection only

    For example mitela to fractur collum chirurgicum humari with good standing.

    B.Immobility without repositioning,

    eg installation of gypsum on fractur incomplete and fractures with good standing.

    Operative Therapy

    A.Reposition open, internal fixation

    B. Closed repositioning with fixation followed by radiological control eskterna

    Operative therapy with anatomical repositioning followed by internal fixation (open

    reduction and internal fixation) arteoplasti ekssisional, fragment excision and mounting

    endoprosteus.

    (Mansjoer, 2000: 348)

    Sugestion

    when performing heavy activity should be careful because it can cause broken bones.

    when fatigue during activities do not perform activitiy heavy .

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    References

    1.http://www.ota.org/compendium/2007JOTFractureCompNew/97042.2Introduction%20S1-

    S6.pdf

    2. ^ "Fracture and dislocation compendium. Orthopaedic Trauma Association Committee for

    Coding and Classification" (pdf). J Orthop Trauma 10 Suppl 1: vix, 1154. 1996. PMID

    8814583. Archived from the original on 2007-09-28.

    http://web.archive.org/web/20070928083805/http://www.ota.org/compendium/intro.pdf.

    Retrieved 2007-11-28.

    3. ^ "Orthopaedic Trauma Association/ Committee for Coding and Classification: Fracture

    and Dislocation Compendium". Orthopaedic Trauma Association.

    http://www.ota.org/compendium/compendium.html. Retrieved 2007-11-28.

    4. ^ "Proximal forearm - AO Surgery Reference".

    http://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3h

    ng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFI

    Hr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEw

    R0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&pop

    upStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsp.

    5. ^ 1590689797 at Gpnotebook

    http://www.ota.org/compendium/2007JOTFractureCompNew/97042.2Introduction%20S1-S6.pdfhttp://www.ota.org/compendium/2007JOTFractureCompNew/97042.2Introduction%20S1-S6.pdfhttp://www.ota.org/compendium/2007JOTFractureCompNew/97042.2Introduction%20S1-S6.pdfhttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.aofoundation.org/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os3hng7BARydDRwML1yBXAyMvYz8zEwNPQwN3A6B8JJK8gUWAm4GRk6m_oUlwgBFIHr9uP4_83FT9gtyIcgCExWfz/dl2/d1/L2dJQSEvUUt3QS9ZQnB3LzZfQzBWUUFCMUEwR0dSNTAySkowOFVIRzIwVDQ!/?segment=Proximal&bone=Radius&soloState=true&popupStyle=diagnosis&contentUrl=srg/popup/further_reading/PFxM2/15_Fx_Class.jsphttp://www.ota.org/compendium/2007JOTFractureCompNew/97042.2Introduction%20S1-S6.pdfhttp://www.ota.org/compendium/2007JOTFractureCompNew/97042.2Introduction%20S1-S6.pdf