ARIEF YANDA

KONGENITAL
CTEV TORTICOLLIS SCOLIOSIS DDH (Developmental Dysplasia CALCANEOVAGUS PFFD (Proximal focal
(Congenital Talipes Equino Varus) (Sternomastoid tumor) of the Hip) FOOT femoral deficiency)
Muscular & bony Failure formation Dislokasi panggul 1 FLATFEET Femoral salah satu
Failure segmention sisi lebih pendek
• Plagiocephaly
• Facial asymmetry • Forward bending
• Decreased neck test (Adam test)
movement (jugular • Assessment of 2 FLEXIBLE
vein distention) maturity FLATFEET
 Tes dorsoflexi • Flexibility and
Balance
• Hemivetebra

3 CAVUS FOOT
• Charcot Marie
Tooth Disease
• Friedrich’s Ataxia
• Poliomyelitis
• Spina Bifida
+ Trandekenburg test

TL
Manual streaching

GIPS
TL
DENIS BROWN SPLINT
• Observation
• Bracing
Komplikasi :
• Surgery
1 rocker bottom foot
2 skin blister
(PAVLIK HARNESS)
 KONGENITAL
SYNDACTILY OSTEOGENESIS BLOUNT DISEASE
IMPERFECTA (BOW LEG)
(differensiasi) jari Kegagalan maturasi serat
kollagen

Ciri-ciri
– Herediter autosomal
– Dominan atau resesif
– Tulang osteoporotik dan
mudah patah
– Tulang bengkok
(bowing)
– Ligamen hyperlaxity
– Blue sclera
– Dentinogenesis

Arthrogryoposis Multiplex
Congenita
 HIP DISLOCATION / (DDH) Developmental Dysplasia of the HIP OPEN FRACTUR TIBIA FRACTUR
ACETABULUM + HEAD FEMUR TL Patofisiologi
Ligament  Golden period : 6 jam 1. Periosteal stripping
1. Ileofemoralis (lig teres, arteri tegang : necrosis) 2. Soft tissue destruction
2. Pubofemoralis  obtain congruen & stable hip 3. Skin tears (wound / debris)
3. Ischiofemoralis  Close Reduction
Arteri
1. Medial sircumflexa femoralis
2. Lateral sircumflexa femoralis
3. Ligamentum teres femoralis
4. Ascending servical
5. Obturator
ANTERIOR POSTERIOR
Eksternal Internal
rotation, rotation,
Abduction, Adduction, Tscherne classification
Flexi knee, Flexi knee, OA classification

*plg banyak TREATMENT

Dashboard 1. Antibiotik
injuri 2. Anti tetanus
Bigelow : supine 3. Debridement
Klasifikasi Klasifikasi
Epstein Thomson & Capten morgan 4. Irrigation of wound
Epstein Dis posterior : abd, external rot, 5. Fracture stabilisation
ekstensi 6. Closure soft tissue Compartment syndrome (pressure)
Steward- Anterior, lateral, deep & superfisial posterior
milford,
pipki, TL
brumback Fasciotomy (decompresi cmprtment)
Komplikasi Nails
AVN, Posttrauma OA, Plate
neurovascular injuri Exsternal fixation
Brace (Sarmiento)
 SHOULDER DISLOCATION RADIAL-ULNAR SHAFT FRACTUR BRACE & SPLINT
GLENOID + HEAD HUMERAL TL FRACTUR BRACE
TRAKSI SPINE :
Anterior (subcoracoid) (plg 1. Counter Traksi
COLLES 1 coolar brace
banyak) abd. , ext. rotation & (THOMAS) no
Jatuh di
extension C1&C2.
kamar mandi
(PHILADELPHIA)
lalu tangan
Antero-inferior (subglenoid)
menopang
Posterior 2. torak-lumbal
tubuh
Inferior (JEWET)
Superior
SHELTER
Bilateral 3. cervical-trorak-
HARIS
lumbal (milwauke)
CLASIFIKASI
DYNAMIC STABILIZERS
• ROTATOR CUFF MUSCLES SPLINT
• BICEPS TENDON Ulnar gutter splint
• CORACO-ACROMIAL ARCH Radial gutter splint

Thomas splint
Kocher teknik
Scapular manipulation
Spaso teknik
Milch teknik
Komplikasi TL 1. Approach ulna Stirrup splint
- Rotator cuff tear 1. Brace (orthosis)
2. Aproach radius
- Axillary erve injuri (imobilisasi)(stable)
- Vascular injuri 2. Implant - Anterior (HENDRY)
- Fracture (plate&screw or nail) - Posterolateral Dennis Brown splint
(THOMSON)
Komplikasi : Early : nerve palsy &compartment syndrome
Late :regional pain, synostis, refractur after implant
 SPONDILOLISIS SPONDILOLITESIS SPONDILITIS SPONDILODISITIS
TANPA PERPINDAHAN DENGAN PERPINDAHAN  RADANG DISCITIS + SPONDILITIS
Gejala Gejala  DEMAM Or
 Nyeri & hiperekstensi  Biasa di L4 atau L5  Sendi ankylosing (radang discus intervtbre) + (radang
 Muncul ADL, gang tidur  Atas lebih kedepan  Fusion (menyatu( vertebrae)
 Hiperlordotik (punggung  Bawah lebih kebelakang
bawah)  A Etio : stapilococus,ecoli,mtbc
patofisiologi  Gerak vetebre terbatas
 Hiperekstensi &rotasi trauma  Kaku otot hamstring Gejala
imaging  Tdk bisa flexi (ruku)  Nyeri punggung
 Biasa di L5-S1  Hiperlordosis lumbal-torak  ABSES (edema)
 Scoty dog (anjing2an)  Hiperkifosis lumal-sakro  DEMAM
 Patah leher pedikel di lamina  Sulit jalan  Gerak sakit
 Necrosis discus
*komplit : SPONDILOPTOSIS  Deformitas (GIBUS)
SPONDILITIS TB  Tes tuberculin
 Discus infection  Xray : Discus sempit
 Bone infection  MRI (gold standar) : erosi
 Bone collaps  CT scan : bengkak
 Pinched nerve root (terjepit)
 Pinched spinal cord
 DDH (Developmental Dysplasia of the HIP) AVN (avascular necrosis)
• Kaki panjang sebelah TL Necrosis caput femur
• lipatan paha asimetris  Circumflex artery
• jalannya tidak seimbang  Retinacular arctery
• Nyeri  Obturator artery

DX

Xray : Bone cystic & collaps of dead & arthritic change

TL : operated (no drug can restore blood supply),
DECOMRESI femoral head, or+ graft , or+ stemcell  weight bearing
Komplikasi 6week
1. AVN
SHENTON LINE 2. Subchondral fractur
HILGENREINER LINE 3. OA
 LESI MENISKUS (LUTUT) RUPTUR ACHILES TENDON
MEDIAL & LATERAL MRI
Normal Lesi meniskus

DX :
 plantar kaki flexi (terhambat)
 teraba jarak di area rupture
 kebiruan stlh 2 hari
 OSTEOMIELITIS ARTRITIS SUPURATIF AKUT TBC TULANG & SENDI
Akut Akibat Fractur Terbuka

Pasca Operasi

PP : +uji mantoux(+)

Hematogen SubAkut
Kronik

TB SENDI