surgical: fracture 5 handling

Fracture is usually attached to the trauma. Therefore, it is very important to conduct the examination of the way the breath (Airway), the process of respiration (breathing) and circulation (circulation), whether the shock occurs or not. When you have stated there is no longer a problem, do a new anamnesis and physical examination in detail. Time of accident it is important to know asked how long the hospital, given the golden period 1-6 hours. When more than 6 hours, complications of the infection. Make anamnesis and physical examination in a rapid, concise and complete. Then, do a photo radiologist. Installation of splint made to reduce pain and prevent the occurrence of more serious damage on the network software in addition to facilitate the process of making images (Mansjoer et al., 2000)
Management of fracture in general follow the principle of medical treatment in general, namely the first and primary is not injury patient (primum non nocere). Iatrogenic additional injury to the patient occurred due to a wrong action and / or excessive action. The second, treatment was based on the diagnosis and the right prognosis. Third, in cooperation with the laws of nature, and the fourth, select the correct treatment of each patient individually (Sjamsuhidajat & de Jong, 1997).
To fracture itself, is a principle to restore the position of the bones to fracture the position (repositioning) and maintain that position during the healing of broken bones (immobilises). Repositioning the situation does not need to achieve as fully as the bones have the ability to adjust the shape of the back like (remodeling / swapugar). The feasibility of repositioning a dislocation is determined by the fragment and the dislocation aksim ad, ad peripheriam, and KUM kontraktione the form of rotation, or digest. In general, angulasi in the field of joint movement until about 20-30 degrees will be may swapugar, while angulasi that is not in the field of movement joints will not be through. However, the rotation between the two fragments are never corrected by the process swapugar. There is no rotation can not be known fragment of the image rays, but must be known from the clinical examination. The easiest way to check this rotation is to compare the rotation member of the fracture with a healthy rotation members. Abridgment members caused by a broken towing muscle tonus fracture fragments so that the bones are on both sides. Abridgment members on the adults and abridgment members up and down on the child usually does not cause problems (Sjamsuhidajat & de Jong, 1997).

Mansjoer et al. (2000) mentioned that in fracture treatment can be either closed or conservative operative:
1. Conservative therapy, consisting of:
a. Protection only, for example mitela for fracture collum chirurgicum humeri with a good position.
b. Immobilises without any repositioning, such as the plaster cast on the fracture incomplete and fracture with good position.
c. Closed repositioning and fixation with plaster cast, for example, on the fracture suprakondilus, fracture Colles, Smith fracture. Repositioning may be in local or general anesthesia.
d. Traksi, for repositioning slowly. In the children used traksi skin (traksi Hamilton Russel, traksi Bryant). Traksi skin for 4 weeks, and the burden of < 5kg. To traksi adult / definitive traksi must traksi skeletal form balanced traction. 2. Operatif therapy, consisting of:
a. Open repositioning, fixation Interna.
b. Closed repositioning with fixation control radiologis followed eksterna.
Therapy operatif with anatomical repositioning followed by the Interna fixation (open reduction and internal fixation), artroplasti eksisional, eksisi fragments, and the endoprostesis.