Case Reportorto Kamal

8/19/2019 Case Reportorto Kamal

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P R E S E N T E D B Y :

K A M A L F A U Z E E

C 1 1 1 0 8 7 6 0

A D V I S O R S :

D R . F A D I L M U L A P U T R A

D R . A H M A D R I Z A N H E N D R A W A N

S U P E R V I S O R :

D R . M . R U K S A L S A L E H , P H D , S P O T K !

CASE REPORT



P"#$%&#'( I)%&#$#*

N"+% : Ny LB

A% : 45 years old

S%- : FemaleD"#% / A)+$(($& : 17th Jue !"14

M%)$" R%2) : ##$!#%



H$(#2* T"3$&

A&"+&%($( : Pat&et 'ame to (ah&d&Sud&rohusodo )os*&tal +&th 'h&e, 'om*la&t o,*a& at le,t lo+er le-. su,,ered s&'e / %" m&utes

0e,ore adm&ss&o due to tra,,&' a''&det

M%4"&$(+ / T2"5+" : Pat&et 'ross the roadthe suddely -ot h&t 0y a motor'y'le ,rom the le,t

s&deNo h&story o, u'os'&ousess ad 2om&tted



P2$+"2* S52%*:

A$2"* : 'lear

B2%"#4$&: RR 1$3m&. s*otaeous.thora'oa0dom&al ty*e. symmetr&'al

C$25"#$& : BP 1%"$" mm)-. )R $!3m&.

re-ular. adeuate

D$("$$#* : 6CS 15 E48#95 . *u*&l &so'or.

;: !5mm!.5mm. l&-ht re,le3 <<

E&$2&+%&# : T: %#5=C a3&llary



S%&)"2* S52%*

R%$: L%/# C252$(

L3

>e,orm&ty <. edema <. hematoma <. +oud <e3'or&at&o aterolateral as*e't s&?ed !31 'm

F%%

Tederess<

M%+%&#

A't&2e @ Pass&2e mo2emet o, ee ad ale o&t'aot 0e e2aluated due to *a&

NVD: ormal ses&0&l&ty. CRT !D. *ulsat&o o, a

dorsal&s *ed&s &s *al*a0le



Le- Le-th >&s're*e'&es

R&-ht Le,t

ALL $ 'm $ 'm

TLL $! 'm $! 'm

LLD " 'm



Cl&&'al F&d&-s





Rad&olo-y ,&d&-s



LABORATOR FGN>GN6S

(BC : 17" 3 1"%mm%

RBC : %5 3 1"#mm%

)6B : 1!1 -dL

)CT : %5$ H

PLT : !# 3 1"%mm%

BT : %I"D

CT : $I "D



Resume

45 years old. ,emale adm&tted +&th 'om*la&t o, *a& at thelo+er le,t le- s&'e %" m&utes a-o due to tra,,&' a''&det

From *hys&'al e3am&at&o see de,orm&ty. edema.hematoma. e3'or&at&o aterolateral as*e't s&?ed !31'm ad

tederess &s oted at the +oud s&te RO8 o, the ee ad ale o&t 'aot 0e e2aluated due to

*a& N9> &s ormal

From rad&olo-&'al ,&d&-s. +e ,oud that there are o0l&ue,ra'ture o, the 1% m&ddle t&0&a ad 1% m&ddle ,&0ula



>&a-os&s

Closed ,ra'ture 1% m&ddle le,t t&0&a

Closed ,ra'ture 1% m&ddle le,t ,&0ula



8aa-emet

G9F>

Aal-es&'

A**ly lo- le- 0a' sla0 o, the le,t lo+er l&m0

Ele2at&o o, lo+er le,t l&m0O0ser2e ,or 'om*artmet sydrome

Pla ,or o*erat&2e treatmet O*e Redu't&oGteral F&3at&o



>&s'uss&o



BASE OF DIA9NOSIS

o2al J. Ku'erma J> T&0&a F&0ula Sha,t )ad0oo o, Fra'ture 4th ed Ne+ or: (&ll&am @ (&l&s !""# * %$7M7

• h&-h eer-y&ury >&re'ttrauma usually o0l&uety*e o, ,ra'turead usually&2ol2e 0otht&0&a ad ,&0ula

Aames&s

• Le,t le- re-&o

• E3'or&ated +oud>e,orm&ty < a-ulat&o• )ematoma<.

Edema <• Tederess <.

s+ell&- <.

Phys&'ale3am&at&o:

• Fra'ture o0&ue1% m&ddle le,t ost&0&a ad ,ra'ture

o0l&ue 1% m&ddlele,t os ,&0ula ,&0ula

Rad&o-ra*hy



NERVES

SENSORGC 8OTORGC

Su*er,&'&al Peroeal >ee* Peroeal

T&0&al&s

>ee* *eroeal

Su*er,&'&al Peroeal

N9> e3am&at&o o lo+er e3trem&t&es

Thom*so JC Le- ad ee Netter Co'&se Ortho*aed&' Aatomy !d ed Sauders Else2&er * %1#M!!



N9> e3am&at&o

Thom*so JC Le- ad ee Netter Co'&se Ortho*aed&' Aatomy !d ed Sauders Else2&er * %1#M!!

A2#%2*

>orsal&s *ed&s

T&0&al&s Poster&or



Rad&olo-y ,&d&-s

O0l&ue ,ra'ture 1% m&ddle le,t t&0&aO0l&ue ,ra'ture 1% m&ddle le,t ,&0ula



Other Poss&0le Gury

Solomo L et al GuryIs o, the ee ad Le- & A*leyIs System o, Ortho*aed&'s ad Fra'tures th Ed&t&o : Arold !"1"

Com*artmetSydrome

Pa&

ParlourPulseless

Paresthes&aParalys&s

G, sus*e'ted.• The a,,e'ted l&m0 &s *la'e at the le2el o, the heart Release the 0ada-es ad 'asts• Gmmo0&l&?e the lo+er le- +&th the ale & sl&-ht*latar ,le3&o



B%4"$52 O/ T4% I&52*


The se2er&ty o, the 0oe &ury O0l&ue ,ra'ture

Sta0&l&ty o, the ,ra'ture sta0le

>&s*la'emet o, the 0oe From the rad&olo-y *hoto.

'ort&'al a**os&t&o Q5"H

So,t t&ssue dama-e 8&&mal to moderate

G,lue'e the 'ho&'e o, treatmet

TGBGA FGBLA



C&(%2"#$% O;%2"#$%

Gmmo0&l&?at&o O*e Redu't&oGteral F&3at&o

M"&"%+%&#




M"&"%+%&#

8&ller >8. Thom*so SR. )art JA Re2&e+s o, Ortho*aed&'s #th ed&t&o !"1! Else2&er Sauders P7#1

Coser2at&2e o, T&0&a F&0ula ,ra'ture

M Closed redu't&o uder -eeral aaesthes&a ad a lo-le- '&r'ular 'ast&-

Gd&'at&o:• 8&&mal d&s*la'ed +&th a''e*ta0le al&-met• Closed ,ra'tures• Lo+ eer-y trauma• 8&&mal so,t t&ssue dama-e•

Cort&'al a**os&t&o -reater tha 5"H• Sta0le ,ra'ture *atter

5 2arusM2al-usa-ulat&o

1" APPa-ulat&o1'm shorte&-



M"&"%+%&#


Gd&'at&o:

sta0le ,ra'tures that 'aot 0e adeuately ma&ta&ed & aredu'ed *os&t&o

Fa&led oMo*erat&2e maa-emet

Pat&ets +&th ,ra'tures that are o+ to heal *oorly ,ollo+&- oMo*erat&2e maa-emet

Fra'ture & &d&2&duals +ho +ould *oorly tolerate *rolo-ed&mmo0&l&?at&o

O*erat&o

O*e Redu't&o Gteral F&3at&o



Com*l&'at&os

Solomo L et al GuryIs o, the ee ad Le- & A*leyIs System o, Ortho*aed&'s ad Fra'tures th Ed&t&o :Arold !"1"

E"2* L"#%

Neuro2as'ular &ury 8alu&o. delayed

u&o. oMu&oCom*artmet

sydrome8us'le 'otra'ture

Jo&t st&,,ess

Documents

Case Reportorto Kamal