surgical: fracture 6 definition

Definition
Fracture open fracture or open fracture is associated with the outside world as a result of violence. Fracture has a risk of infection, delayed union and nonunion. Fracture is open on the long bones often be amputated to save the life of the patient. However, doctors now more focus on specialist treatment to maintain function and prevent complications (Armis, 2001).
On the fracture is open there is a connection between the bones with the outside environment. Muscle and skin of the injury and damage to heavy network software will be proportionate to the energy that straight cause. Damage is accompanied by bacterial contamination, causing an open fracture problem of infection, healing disturbances and interference function (Krantz et al., 1997).

Diagnosis open fracture
To diagnose a fracture need to be open anamnesis, physical examination and the examination was the right diagnosis so that certainly can known:
1. Anamnesis:
Patients complained about the pain, deformitas, the inability of the body of the sick, injured and bleeding on the skin (Armis, 2001).
2. Physical examination
Examination showed the wounds and deformities. Wounds on the skin should be assessed and the condition of long bones, if there is contamination. Check up to the bone concerned. Checking on the network software in general covers a larger area of fracture own. Interference in the system are examined with a view neuromuskuler color and skin sensitivity to the stimulus. Ask the patient to the distal part of the lesi. Do not forget to check the patients vital signs to predict the shock the next time (Armis, 2001).
If there are open wounds near joints, should be considered is related to the wound or into the joints, and surgical consultation should be done. May not enter or liquid pigment to prove hollow joints associated with injury or not. The best way to prove the relationship with the open wound is a joint exploration and surgical wound cleaning (Krantz et al., 1997).

3. Radiology examination
Like closed fracture, radiologist examination is the key to diagnose a fracture.
To detect such fracture or dislocation, Palmer et al. (1995) states that the rays is not enough with only one image:
a. 2 photos with the necessary projection of perpendicular to one another when there is suspected fracture or dislocation, except in the pelvis where the image oblique will be very useful. Sometimes required several projecting eg at the wrist, but first note the projection routine first.
b. Make sure that the image seen on the joints above and below the fracture in the arms or legs, except when the clinical fracture clear that there is only on the most distal part. But in this case also the closest socket must join photo.
c. Damaged tendon and blood vessel can not be seen with the photo routine.
Photo rays must meet several requirements, namely broken bones must lie in the mid-ray image and should permeate this place, the vertical rays because the image is a photo image shadow. When the rays penetrate the sloping, images become hazy, unclear, and the other from the reality. Should always be made with two pieces of photo direction perpendicular to each other (Sjamsuhidajat & de Jong, 1997).
On bone, joint proximal long and the distal photo must participate. If there is doubt over the existence of broken bones or not, the image should be made members of the same movement for a healthy comparison. If not acquired certainty of aberration, such as fissure, should the image repeated after one week; cracked will become apparent as local hiperemia around the bone fracture that will appear as dekalsifikasi (Sjamsuhidajat & de Jong, 1997).
Special inspections such as CT scan is often required, such as broken bones in the vertebra with symptoms neurologist (Sjamsuhidajat & de Jong, 1997).