fraktur tertutup kominutif humerus

8/20/2019 fraktur tertutup kominutif humerus

1/8

PORTOFOLIO

FRAKTUR TERTUTUP KOMINUTIF HUMERUS DEXTRDENGAN PALSI NERVUS RADIALIS

Oleh:

dr. Medisiana S. S

Dokter Pembimbi!:

dr. H. Muhammad Adijayansyah, Sp. OT

Dokter Pe"#m$i!:

dr. Hesti Sasmila Wardani

%AGIAN&SMF ILMU %EDAH ORTOPEDI

RSUD %AN'AR%ARU

%AN'AR%ARU

M#ret( )*+,


2/8

I"etit#-

Nama penderita Tn. A!

!enis "elamin laki- laki #mur $$ tahun

Alamat %anau Sala&

Pe&erjaan '

A(ama Islam Status per&a)inan *lm

meni&ah

Su&u +anjar

Tan((al MRS - $/ Tan((al peri&sa $0 $/

N1. Re( $$234-

A#me-i-

KU : N.eri le!# k## #t#-

RPS :P#-ie "#t#! ke IGD%#/#rb#r0 r0/0k# "#ri RS D#"e!# "i#!o-i- 1r#kt0r h0mer0- "e2tr#3 4 /#m -ebel0mRS $#-ie me!#l#mi ke5el#klit#-3 P#-ie me!e"#r#i motor3 P#-ie me!!0#k# helmme!e"#r#i motor "e!# #m0 ti"#k i!#t ber#$# km&/#mbert#br#k# "e!# -e$e"# m

#r#h berl#6##3 P#-ie ter/#t0hk##( kem0"i# ter-eret 7Mek#i-me ter/#t0h ti"#k "Setel#h ke5el#k## $#-ie -#"ti"#k #"# kel0#r "#r#h "#ri m0l0t( "# hi"0!3 Ti"#k #"# mm0t#h3 H#.# ter#-# be!k#k "

$#"# le!# k## #t#-3 L#l0"ib#6# ke RS D##0 S#l#kme"#$#tk# $ertolo!#3 Di RS#l#k $#-ie "i beb#t "# "i bi"#


3/8

•"# tampa& sa&it sedan( Nadi -05m•"esadaran 6M Suhu 24./7 6•86S 9:;/M4 "L d*n

• Te&anan darah /0hial de5tra • Look • Terpasan( *idai, Lu&a ?'@, pus ?'@, *en(&a& ?@, hemat1m ?'@, de=1rmitas ?@

• Feel • Suhu sama den(an daerah se&itar, nyeri te&an ?@, &repitasi ?@, >apillary reBll time C$

deti&, pulsasi arteri ?@,Sensi*ilitas hip1estesi sepanja( distri*usi radial nerve, pulsasi darteri radialis tera*a

• Move • 8era&an a&ti= dan pasi= dari sendi punda& dan si&u tida& dapat dieDaluasi &arena nyeri

• Special Test • 9&stensi jari jemp1l ?'@, e&stensi per(elan(an tan(an ?'@, OK sign ?@, a*du&si dan addu

di(iti ?@

Status L1&alis


4/8

P9M9RI"SAAN P9N#N!AN8

'ei- Pemerik-## H#-il Nil#i Norm#l

Hb 13,4 12 – 18 gr/dl

Leukosit 10400 4000-10000/mm3

Trombosit 196000 100000 – 400000/mm3

Hematokrit 36% 36 – %

L!" 14 0 – 20 mm/#am

$T 10 2- 6 me&it

'T 12 1 – 3 me&it

Hitu&g (e&is

'aso)il

!osi&o*+il

'ata&g

egme&

Lim)osit

o&osit

0

1

2

.4

20

3

0 – 1%

1 – 4%

2 – 6%

3 – 80%

1 – 0%

2 – 8%

Hbsg &egati) egatie

" 100 11 mg/100 ml

T 42 Lk sd 3./L5 r sd 31 /L

T 30 Lk sd 43 /L5 r sd 32 /L

reum 41 1-0 mg/100 ml

rotei& total 6 6 – 82 gr/100 ml

7reati&i& 12 am*ai 14 mg/100 ml


5/8

• Fra&tur &1minuti= tertutup 2 medial humerus &a•

Radial nerve palsy &anan

%ia(n1si

s

• I;F% RL $0 tpm• Tramad1l %rip ampul• Inje&si "et1r1la> 20 m(- jamiD• Inje&si Ranitidin $/ m($ jamiD• Inje&si de5ametas1n : m($jamiD• Inje&si me>1*alamin ampul$: jamiD• Inje&si 1ndan>entr1n : m( apa*ila muntah• Pr1 ORIF E e&spl1rasi nerDus tan((al $ %esem*

Terapi


6/8

P9M+AHASAN Status l1&alistanda tanda =ra&tur

Pemeri&saan penunjan(L9% G, R1nt(en


7/8

hialis ?%@L11& len(anterpasan( tertutupper*an, lu&amerem*es ?'@Feel nyeri te&an ?@M1Dement ROMlimited

"es 6M86S 9:;/M4Status l1&alis ar*ra>hialis ?%@L11& len(anterpasan( tertutupper*an, lu&amerem*es ?'@Feel nyeri te&an ?@M1Dement ROMlimited

86S 9:;/M4Status l1&alis ar*ra>hialis ?%@L11& len(anterpasan( tertutupper*an, lu&amerem*es ?'@, lu&a*ai&, nanah ?'@Feel nyeri te&an?@M1Dement ROM

limited

8

St*L1tepem*aFe?M

lim

A ' Closed fracture 1/3edial !ueruscoinutive displaced"d#$ %ulnus eksoriatuultiple

' Closed fracture 1/3edial !ueruscoinutive displaced"d#$ %ulnus eksoriatuultiple

' Closed fracture 1/3edial !ueruscoinutivedisplaced "d#$ %ulnus eksoriatuultiple$ susp radial nervein&ury

' 'ost OR(F ecClosed fracture 1/3edial !ueruscoinutivedisplaced "d#$ Radial nerve palsy

' 'ost OR(F ecClosed fracture 1/3edial !ueruscoinutivedisplaced "d#$ Radial nerve palsy

$ 'ost OR(F ecClosed fracture1/3 edial!ueruscoinutivedisplaced "d#$ Radial nerve palsy

$ 'C1/!ucodi$ R pa

P Pr1 r1nt(en humerus

APlatI;F% RL $0 tpmtramad1l dripInj. "et1r1la> 25 20 m(Inj. Ranitidin $5 ampInj. Ondan>entr1n &pmuntah

I;F% RL $0 tpm

neur1san*e drip amp&1l= Inj. "et1r1la> 25 20 m(Inj. Ranitidin $5 ampInj. Ondan>entr1n &pmuntahInj de5ametas1n

I;F% RL $0 tpm

neur1san*e drip amp&1l= Inj. "et1r1la> 25 20m(Inj. Ranitidin $5ampInj. Ondan>entr1n &p

I;F% RL 0 tpm

neur1*i1n dripInj 6e=tria51ne $5(rInj. "et1r1la> 2520m(Inj. %e5ametas1n5: m(

I;F% RL 0 tpm


I;F% RL 0 tpm


Pa

dpR"1Ode


8/8

T9RIMA

"ASIH

fraktur tertutup kominutif humerus

Documents

Transcript of fraktur tertutup kominutif humerus