fracture rt neck femur

8/19/2019 Fracture Rt Neck Femur

1/27

FRACTURE NECK OF FEMUR

FAUZIAH

Advisor :

dr. Ahmad Rizan

dr. Yohanes toban

Supervisor :

dr. M. Ruksal Saleh , Ph.D, Sp.OT(K)

Orthopaed! a"d Trau#atolo$%Depart#e"tMed!al Fa!ult% o& 'asa"udd"U"erst%Makassar

CASE RFERUAR


2/27

PAT/ENT /DENT/T*

• Name : Mr. MN

• Number Register : !"#$$

• Se% : Ma&e

• Age : #$ 'ears o&d

• (ate o) Admission : Februar' "*th + ,"$


3/27

-hie) -omp&ain : ain on the right groin

Suffered since 7 days before admitted to

UH hospital

Mechanism of Trauma : The patient was

slipped and fell down in sitting position

(with right side come first to the ground)

while he was walking on street

o history of headache! nausea! "omitingand unconsciousness prior to fall

#fter falling! patient only lying on the bed

at home and didn$t seek medical treatment

for % days

&efore fall patient still can walk by himself

'/STOR* TAK/N0('ETEROANAMNES/S)

'amily said the patient seems

when he was walking

History of isual impairment (

*ataracts)

History of +ementia (forgetfulnes

• o history of numbness! cra

weakness

• o history of backpain

• o history of chronic headache

• o history of HH+ and +M

• History of carcinoma of prostate

• History of prostate operation , ye

• -rior treatment : Salewangan hosp


4/27


5/27

R$ht Th$h Re$o"

;oo< : (e)ormit' 1=3+ s/e&&ing 1=3+ hemato1>3+ /ound 1>3

Fee& : enderness 1=3

Move : A0tive and pasive motion o) hip ?oin0annot be eva&uated due to pain

N@( : Sensibi&it' is good+ dorsa&is pedisarter' is pa&pab&e+ 0api&&ar' re&& timB ,C

1OCA1 RE0/ON


6/27

;D2 ;DN2H (IS-RDAN-Y

R ;

A;; 8! 0m 8$ 0m

;; 8 0m 8" 0m

;;( " 0m


7/27

ANTERIOR

C1/N/CA1 F/ND/N0S


8/27

LATERAL MEDIAL

C1/N/CA1 F/ND/N0S


9/27

Resu&t Norma& ;ev

E4- #+"# +>"+

R4- 6+! +!>$+!

H24 "+6 "+>"8+

H- 6"+*G +>!+

; 6,, "!>

- #+6 >"

4 6+ ">#

H4sAg Non Rea0tive Non Rea0t

1AORATOR* F/ND/N0


10/27

RAD/O1O0/CA1 /MA0/N• Pels AP (-65+5+-)

FRA-URD


11/27

RAD/O1O0/CA1 /MA0/N• R$ht Fe#ur AP51at (-65+5+-)

FRA-URD


12/27


13/27

•Male! 7/ years old! was admitted to Hospital because othe right groin! suffered since 7 days before admiss

patient was slipped and fell down in sitting position (w

side come first to the ground) while he was walking

• &ased on physical e0amination! deformity! swel

tenderness is present in the right hip region2 #cti"e and

motions of the hip 3oint 0annot be eva&uated due t

• 45 ray of pel"ic and right femur (ap and lateral "iews) s

fracture in the right femoral neck

RESUME


14/27

•Closed &ra!ture r$ht "e!k o& &e#u

D/A0NOS/S


15/27

• I@F( R;•Ana&gesi0

•App&' s


16/27


17/27

Fra!ture o& proks#a&e#ur, "tra!apsular&ra!ture

NECK FEMURFRACTURE


18/27

ARTER/ES

Netter -on0ise rthopedi0+ ,nd edition+ ,,

GERIATRIC PEOPLE PROBLEMS hi h i


19/27

GERIATRIC PEOPLE PROBLEMS which increasesfalls

• HEALTH PROBLEMS

1. Muskuloskeleal !ro"le#s$oseo!orosis% #uscle weakness&

'. I#!air#en of s!ecial senses $(isualan) au)ior* i#!air#en&

+. Car)io ,ascular )isease% !osuralh*!oension

-. ia"ees

/. C0S )isor)er% s*nco!e% e!ile!s*

. Cerain )ru2s $se)ai,es%h*!o2l*ce#ic )ru2s% ec&

• Ps*cholo2ical !ro"le#s

1. Suici)al en)enc*

'. Senile )e#enia

• E3TRI0SIC E0(IHA4ARS

1. !oor li2hin2

'. unsafe sairwa*s

+. irre2ular floor5 roa)

-. Sli!!er* floor5 roa)

/. sli!!er* shoes5 sli!


20/27

CLINICAL MANIFESTATION

• pain inmotion

• shortening o)e%tremit'

• de)ormit' o)rotation inrestingposition

• angu&ation

NRS : 4/10

right leg shortenedLLD = 1 cm

external rotation

varus

Robert et a&. Ro0


21/27

• Sub0apita&

• rans0ervi0a&

• 4asi0ervi0a&

Class8!ato" 9%

A"ato#! 1o!ato"

0arde" Cla

Pau:elsClass8!ato

"


22/27

anatomicalclassification

pauwelsclassification


23/27

Fra!ture o& R$ht Ne!k Fe#ur

E2/DENCES 1EAD/ND/A0NO

PAT/ENT E2A1UA

- Hip (e)ormit' K enderness at rightgroin- ain on movement

P'*S/CA1 E;AM/NAT/ON

-ain on &e)t groin-histor' o) )a&& onsitting position

-Ris< o) )a&& 1=3

'/STOR *

L> Ra)ra0to) )e

RAD/OE;AM


24/27


25/27

reatment

Surger'Initia& treatment

Apley’ s System of Orthopaedics and Fractures 9th Editio

'e#arthroplast%Sk" tra!to"

D&der&' patient /ith disp&a0ed)ra0ture

ain a&&eviation o minimize so)t tissuein?ur'

o ho&d )ra0turea&ignment


26/27

Dar&' -omp&i0ation :

- (@

- D

- U&0us de0ubitus

- rthosati0 pneumonia

;ate -omp&i0ation :

- steone0rosis Avas0u&ar Ne0rosis o) )emora& head

- Non union

- Se0ondar' steoarthritis

COMP1/CAT/ONS

Jova&+ Jenneth .9 Zu0


27/27

fracture rt neck femur

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