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    Discussion Tibial Fibula Fracture Rafael Gustillo Anderson

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    As'ad Pratama Putra
    The document discusses classifications of open fractures according to Gustilo & Anderson. It describes the different grades of open fractures from Grade I with a small wound size and minimal soft tissue damage to Grade III C which has massive soft tissue damage. The principles of managing open fractures include wound cleaning, debridement of dead tissue, repositioning and stabilizing the bone, wound closure, antibiotic administration, and tetanus prevention. Treatment options include conservative treatment with antibiotics and casting or surgical treatment with internal fixation using intramedullary nails or plates and screws.

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    Discussion Tibial Fibula Fracture Rafael Gustillo Anderson

    Uploaded by

    As'ad Pratama Putra
    750 views5 pages
    The document discusses classifications of open fractures according to Gustilo & Anderson. It describes the different grades of open fractures from Grade I with a small wound size and minimal soft tissue damage to Grade III C which has massive soft tissue damage. The principles of managing open fractures include wound cleaning, debridement of dead tissue, repositioning and stabilizing the bone, wound closure, antibiotic administration, and tetanus prevention. Treatment options include conservative treatment with antibiotics and casting or surgical treatment with internal fixation using intramedullary nails or plates and screws.

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    The document discusses classifications of open fractures according to Gustilo & Anderson. It describes the different grades of open fractures from Grade I with a small wound size and minimal soft tissue damage to Grade III C which has massive soft tissue damage. The principles of managing open fractures include wound cleaning, debridement of dead tissue, repositioning and stabilizing the bone, wound closure, antibiotic administration, and tetanus prevention. Treatment options include conservative treatment with antibiotics and casting or surgical treatment with internal fixation using intramedullary nails or plates and screws.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    750 views5 pages

    Discussion Tibial Fibula Fracture Rafael Gustillo Anderson

    Uploaded by

    As'ad Pratama Putra
    The document discusses classifications of open fractures according to Gustilo & Anderson. It describes the different grades of open fractures from Grade I with a small wound size and minimal soft tissue damage to Grade III C which has massive soft tissue damage. The principles of managing open fractures include wound cleaning, debridement of dead tissue, repositioning and stabilizing the bone, wound closure, antibiotic administration, and tetanus prevention. Treatment options include conservative treatment with antibiotics and casting or surgical treatment with internal fixation using intramedullary nails or plates and screws.

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    Klasifikasi fraktur terbuka menurut Gustilo & Anderson

    Grade I Ukuran luka <1cm kontamina si bersih Jaringan lunak Minimal Bentuk patahan Simpel/transversal/oblik

    II
    III A

    >1cm
    >10 cm

    Moderate
    Tinggi

    Moderate
    -kerusakan jaringan lunak luas, tapi masih bisa menutupi patahan tulang ketika dilakukan perbaikan -kerusakan jaringan lunak luas/hilang, sehingga tampak tulang (bone exposs) -kerusakan jaringan lunak disertai kerusakan pembuluh darah /saraf yang hebat

    -kominutive moderat (transverse, short oblique)


    -minimal periosteal stripping -soft tissue coverage of bone is possible

    III B

    >10 cm

    Masif

    -moderate to severe comminution -poor bone coverage -poor bone coverage -moderate to severe comminution

    III C

    >10cm

    Masif

    management
    Prinsip penanganan fraktur terbuka:
    Pembersihan luka Debridemen/pembuangan jaringan avital
    Membuang benda asing Membuang jaringan avital

    Reposisi dan stabilisasi tulang Penutupan luka Pemberian antibiotika Pencegahan tetanus

    - Konservatif dan operatif

    Treatment
    Conservative Antibiotic Operative Plan for ORIF

    Anti tetanus
    Debridement Stabilization with long leg back slab

    Using intramedullary nailing Using plates and screw

    Conservative
    A long leg cast with progressive weight bearing can be used for isolated, closed, low-energy fractures with minimal displacement and comminution. Cast with the knee in 0 to 5 degrees of flexion to allow for weight bearing with crutches as soon as tolerated by patient, with advancement to full weight bearing by the second to fourth week. After 4 to 6 weeks, the long leg cast may be exchanged for a patellabearing cast or fracture brace.

    Union rates as high as 97%, although with delayed weight bearing related to delayed union or non-union.

    Plates and Screws Plating is best for metaphyseal fracture that unsuitable for nailing. The disadvantages are: 1) Increase risk of infection, wound breakdown, mal-union, non-union 2) Need to expose the fracture site 3) Stripping of the soft tissue around the fracture 4) less secure fixation and delay weight bearing (usually after 6wk)

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