CASE REPORT

CLOSE FRACTURE RADIUS

ULNA DISTAL SINISTRA

Supervisor:
dr. Wisnu Murti, Sp.OT

Presented by:
Rizka Nur Ikfina
30101206783
 Patient’s Identity
IDENTITY
• Name : Mr. FS
• Age : 10 years old
• Sex : Male
• Job : Student
• Address : Pidodo Kulon
• Room : Kenanga
• Register Number : 4009xx
• Date of in patient : Dec, 17th 2017
ANAMNESA
• Chief complaint
– Pain in the leftof forearm.
• Present status
– The patient came to the emergency
department of RSUD with his family after
falling from the tree. While the incident patient
fall to the left side. His left of arm was prop
the body and hit the ground. He complined
that his left of forearm felt pain if he moved it.
And its look like swelling..
Medical condition history
• History of trauma : denied
• History of asthma and allergies : denied
• History of heart disease : denied
• History of hypertension : denied
• History of diabetes : denied
Family history
• History of asthma and allergies : denied
• History of heart disease : denied
• History of hypertension : denied
• History of diabetes : denied
Socioeconomic status
• Patient haven’t any health insurance
 PHYSICAL EXAMINATION
• GCS : 15
• Vital sign
– BP : 100/90 mmHg
– HR : 96 x/m
– RR : 25 x/m
– to : 36,7o C
• Nutritional status
– Weight : 30 kg
– Height : 140 cm
– BMI : 19.3 kg/m2 (normoweight)
 LOCAL EXAMINATION
Right of forearm Left of forearm

Skin condition Eritema (-) Eritema (+)

Swelling (-) (+)

Local temperature Normal Warm

Tenderness (-) (+)

Crepitus (-) Used spalk

ROM (-) Restricted

 LOCALIS STATUS
Left forearm
• Look : swelling (+), eritema (+),
deformity (-),
• Feel : warm (+), pain (+), crepitus
(using spalk)
• Move :
– Active and passive restricted.
 LABORATORY RESULT
(Dec, 17th 2017)

Hematology Result Reference value

Hemoglobin 11.4 gr/dL (L) 11.5 – 16.5

Leukosit 7.95 10^3/uL 4.0 – 10.0

Trombosit 326 10^3/uL 150 – 500

Hematokrit 33.8 % (L) 35.0 – 49.0

PT 16.3 s 11.3 – 14.7

APTT 39.7 s (H) 27.4 – 39.3

 Reference
Blood Chemistry Result
Value

Natrium 137 mmol/l 135-155

Calium 3.5 mmol/l 3.5 – 5.5

Calcium 1.18 mmol/l 1.13 – 1.31

RADIOLOGY

• Before:
• Ro antebrachii
sinistra (AP-lat).
(Dec, 17th 2017)
 DIAGNOSE

• Close fracture radius ulna

distal sinistra
 TREATMENT
INITIAL PLAN •Ip. Operatif
• Ip Terapeutik • ORIF with small
DCP 5 holes
– Medical treatment (radius) and
• Infus futrolit 15 tpm intramedullary K-
• Inj. Cefazolin 2x300 mg wire (ulna)
• Inj. Novaldo 2x1 amp
•Ip. Monitoring
• PO: cefixime 2x100 mg
• General situation,
• Ibuprofen tab 2x400
mg
Vital sign, the
• Cholcatriol 1x1
result of supporting
examination, ROM
exercise.
• After ORIF:
• Ro antebrachii
sinistra (AP-lat).
(Dec, 18th 2017)
 PROGNOSIS

• Quo ad vitam : ad bonam

• Quo ad sanam : ad bonam

• Quo ad fungsionam : ad bonam

ANATOMY
LONG BONES
 FRACTURE
• A fracture is a break in the structural
continuity of bone. It may be no more
than a crack, a crumpling or a splintering
of the cortex; more often the break is
complete and the bone fragments are
displaced.
TYPES OF FRACTURE
• Green stick fracture
Ussually occurs in children whose bones are still pliable
(like green sticks). A break occurs straight across part of the
width of the bone, perpendicular to the long axist.
• Transverse fracture
Cuts across the bone at right angles to its axist often
caused by direct injury.
• Oblique fracture
The fracture line crosses the bone at an oblique angle.
• Comminuted fracture
The bone is fragmented into more than two pieces.
• Impacted fracture
The broken ends of the bone are jammed together.
• Spiral fracture
Usually result from twisting injuries. The fracture line
has the appearance of a spring
Types of fracture of the radius and ulna fracture

• Fractured head of radius  Radial head

fractures are common in adults but are
hardly ever seen in children
• Fracture of the radial neck
• Fracture of the diaphysis radius
• Fractures of the distal radius
GALEAZZI FRACTURE

•The radius fractures

in its lower third and
the inferior radio-
ulnar joint
subluxates or
dislocates.
MONTEGGIA FRACTURE

Fracture of the shaft

of the ulna
associated with
dislocation of the
proximal radio-ulnar
joint; the
radiocapitellar joint
is inevitably
dislocated or
subluxated as well.
COLLES FRACTURE
A transverse
fracture of the
radius just above
the wrist, with
dorsal
displacement of
the distal fragment.
It is the most
common of all
fractures in older
people
SMITH’s FRACTURE
FRACTURE OF EPIPHYSEAL PLATE
 TREATMENT OF FRACTURE
The 4 AO principles, in their basic form have
governed the society’s approach to fracture
management for decades. They are as follows:
1. Anatomic reduction of the fracture fragments
2. Stable fixation, absolute or relative, to fulfill
biomechnical demands.
3. Preservation of blood supply to the injuried area
of the extremity and respect for the soft tissue.
4. Preservation of blood supply to the injuried area
of the extremity and respect for the soft tissue.
 • ORIF
operative • OREF
• IM NAILING

• For functional
NON fracture brace with
OPERATIVE good interosseous
mold
BONE HEALING