surgical: fracture 8 complications

Complications that can occur often or in the case fracture open include:

a. Dislocated Infection / Osteomyelitis
Fracture infection can prevent the bone fusion. This mainly occurred in the fracture with shifting fragments fracture. Infection is rarely found on fracture on fracture closed. Infection often occurs in the open or on the fracture handling fracture with internal fixation (Mc Rae & Esser, 2002).
Infections caused by bacteria from an open wound or from the blood circulation. Difficult to diagnose osteomyelitis based on clinical signs and patient age. Standard that is used to establish the diagnosis is with culture microbiologist taken from the center of infection or drainage of fluid (Armis, 2001).

b. Tetanus
Most cases of tetanus occurred after the hair cuts, and trauma laserasi dish. Organism responsible (Clostridium tetani) is a gram positive rod, spore anaerobic the form, which are spread everywhere in the environment.
Injuries tend to be tetanus necrosis by a network is with a heavy environmental contamination. Moreover, therapy can delay placing a wound in this category. The biggest risk of such injuries cause tetanus, but it must be emphasized that the injury was small pin or needle puncture has become precursor of this disease.
Early phases of therapy include the destruction of organisms debrideman with surgery and antibiotics and provision of antitoxin for the toxin sirkulated not fiksation (Sabiston, 1995).

c. Union delayed
That is not a fragment fracture ignites but still showed activity biologic (Armis, 2001).
This is a clinical terminology which means that there is no signs of a union in the average bone continuation in general. When a student or a doctor establish the diagnosis has been delayed union then need to consider the appropriate treatment for these complications. Conservative therapy in the sense to wait until union occurs, or when 6 months operative not have the development of a union such as fracture tibia with the fibula intact, fraktur kruris and fibula with the union earlier, the necessary action osteotomi on the fibula (Armis, 1994).

d. Nonunion
That is not fracture ignites without any signs recover after 6-9 months in both clinical and radiologist. kinds of types :
- Atrophy nonunion: the narrow end of the fragment, such as the tip of the pencil, avaskular, and lack the capacity to recover biology.
- Hypertrophic nonunion: hipervaskularisasi happen and the high capacity for the healed, but the lack of mechanical stability. Hypertrophy end of the fragment.
- Oligotrophic nonunion
- Infected nonunion: the process of nonunion associated with chronic infection of the bone.
Causes of nonunion are:
- Infection in the bone
- Blood vessel damage to the bones
- Movement for the fixation is not adequate
- The loss of fragments, such as apposition distracts so that there gaps between the fragment-fragment fracture
- Corrosion implant
- Interposes, network software means is between muscle or fragment fragment-fracture
- The process of bone pathologies called fracture pathologies

e. Nerve trauma
Perifer nerve trauma can cause contuse, voltage, or lost. Neuropraxia described as small trauma that cause physiological block and recovery occurred in a few weeks. Axonotmesis is damage and axon degeneration perifer will occur. Axon regeneration will be approximately 1 mm per day so that recovery will occur until many months depending on the length of nerve distal from the trauma. The dissolution is neurotmesis whole nerve, the result happens to the other end of the fibrosis. To lesi is cutting edge and need to do repair (Armis, 1994).
Lesi nerve on open fracture always mean that the nerve is lost and the need for exploration were identified, while sewing the fourth week after the post-trauma. When the nerve is intact and injury leave are closed. Nerve can be due to recessive calus called nerve trauma secondary (Armis, 1994).

f. Trauma vena
Trauma can be a blood vessel contuse, laserasi or damaged. Thrombus or aggravate spasm will iskhemi incident. Arterial Spasme not have any correlation to the damage to the network (Armis, 1994)
Indications iskhemi after trauma:
- Extreme pain (Pain)
- pulse lost (Pulseless)
- Priesthood
- Pale because the blood does not go back there (Pale)
- fingers can not do extension (Paralyse)