surgical: fracture 4 diagnosis

1. Anamnesis
Often patients come with complaints that have been broken because bone explained the situation for these fracture patients. Otherwise might, broken bones are not by people, and they come out with strained, especially with the broken fragments with a minimum of disturbance. Diagnosis fracture also begins with the anamnesis: the existence of a particular trauma, such as falls, twist , light, strong, and how trauma is. In the perception of trauma can be even though it is actually light weight, can be rather mild, although it is actually heavy. In addition to historical trauma, pain complaints are usually found, although the fracture fragments broke stable, sometimes does not cause pain complaints. Many broken bones have a unique injury (Sjamsuhidajat & de Jong, 1997).
Fracture's main complaint is pain, swelling, and deformities lost or reduced function.
When there is no trauma history means fracture pathologies. Trauma must be itemized type, light-weight trauma, trauma and the direction or position of the extremity (trauma mechanism) (Reksoprodjo et al., 1995).

From anamnesa can only suspected:
- Possibility of poly trauma
- Possibility of multiple fracture
- Possibility of fractures particular, for example: fracture Colles, fracture supracondylair humerus, fracture collum femur
- On anamnesa have pain but can not clear the fracture incomplete
- No interference function, for example: fracture femur, the patient can not walk. Sometimes the function still survive in the fracture incomplete impacted and fracture (impaksi bone cortical in bone spongiosa) (Reksoprodjo et al., 1995).

2. Physical examination
Also find possible common complications, such as: multiple shock on fracture, fracture pelvis or fracture open, signs of sepsis in the fracture open infected (Reksoprodjo et al., 1995).

3. Vetting status localise
Mansjoer et al. (2000) mentioned that in the examination status localise fracture must include:
a. Look, if there is a search:
- Deformitas, consists of a projection of abnormal (eg, the fracture condilus laterals humerus), angulasi, rotation and abridgment.
- Function laesa (loss of function), for example, on the fracture cruris can not walk.
- See also the size of long bones, compare left and right, for example, on the bottom of the leg covering apparent length (distance between the umbilicus with maleolus medialis), and true length (distance between the malleolus medialis with SIAS).
b. Feel, if there is a painful hit. Examination painful axis is not done anymore because it will add to trauma.
c. Move, to search for:
- Krepitasi, fracture feel when driven. But in the spongiosa bone or cartilage epifisis not feel krepitasi. This should increase because not done trauma.
- Pain when moved, both the active and passive movements.
- How far interference-interference functions, movements that are not able to do, range of motion (degrees from the scope of joint movement, and strength).

4. Radiology examination
Radiology examination is the key to diagnose the fracture. Radiography long bones should include adjacent joints (joints in the distal proximal and fracture) to avoid dislocation of joints associated with the fracture. Results from radiography joints can be confusing because the extremity is not standard at the position, such as fracture and stress due to the wrong place fracture (Displaced fracture). In this case the fracture not appear until the bones absorbted lesi location (1-4 weeks), especially if lesi fracture occur in bone scaphoideus. Additional examination as tomography, CT scan, MRI, etc. are not needed difficult diagnosis true with x-ray images (Armis, 2001).