problem you can find in humerus orthopedic .pptx

problem you can find in humerus orthopedic

1. Humerus

2. Fracture of proximal humerus Mekanisme tersering FOOSH pada geriatri 4 lokasi anatomis Greater tuberosity Lesser tuberosity Anatomical neck Surgical neck Displacement = more than 1 cm displacement, 45 degree rotation Klasifikasi : Neer x part (1-4) 1 part: minimally displaced 2 part: displacement 3 part: 4 part: Tatalaksana U slab, ORIF, arthroplasty Komplikasi : AVN Hertel criteria Engsel periosteal terganggu Medial metdiaphyseal extension less than 8mm Increasing fracture complexity Displacement greater than 1cm Angulation more than 45 degree Komp : axillary injury, hardware failure, nonunion Approach: Trandeltoid , deltopectoral approach

3. Fraktur Shaft humerus Fraktur dengan tingkat non-union tertinggi (-20%) Rentan cedera saraf n.radialis , terutama fraktur midshaft condong ke distal (Holstein-Lewis Fracture) Selalu cek kondisi NVD Dapat ditatalaksana dengan konservatif (U-slab, functional brace), indikasi; less than 20 degrees of anterior angulation, less than 30 degrees of valgus/varus angulation, or less than 3 cm of shortening; contraindicated in patients with associated brachial plexus palsy Opsi lain: Plate and screw, IM nail (complication rate higher) Approach: Posterior, anterolateral

4. Fraktur distal humerus Klasifikasi : AO-OTA type 1: fraktur suprakondilus ekstraartikular type 2: fraktur unikondilar intra-articular type 3: fraktur bikondiler dengan derajat bervariasi Risenborough-radin (fraktur intercondyle ) type 1: nondisplaced fracture antara capitellum dan troclea type 2: pemisahan capitelum dan troclea tanpa rotasi fragmen type 3: pemisahan fragmen dengan rotational deformity type 4: severe comminition dari permukaan articular disertai separasi luas dari humeral condyle Yang terpenting : Approach operasi , preservasi ulnar nerve, teknik fiksasi Opsi : ORIF