Dislocation Lusi
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Transcript of Dislocation Lusi
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DISLOCATION
Lecturer :
dr. Erwien Isparnadi, Sp.OT
Author :
Lusiana Ayu Lestari
201210401011027
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Definition
JOINT
Is a relationship between two or more bones are
connected through the connective tissue wrapping onthe outside and on the inside there is a joint cavitywith the bone surface covered by cartilage.
Dislocation A condition in which the bones that form the joint is
no longer connected anatomically (off the bone ofjoints).
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clasification
Congenital
Patoligik Traumatik
Paralitic
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Clinical manifestasion
acute
chronic
recurent
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Etiology
Falls
patologist
Trauma
notrelated to
sports
Sportinjury
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ANATOMI
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Repositioning immediately
Dislocation reduction: restored to its originalplace, it is necessary to use anesthesia ifsevere dislocation.
Head of bone dislocation manipulated andreturned into the joint cavity
Imobillized casts, splints, traction Several days to weeks after the reduction
carried out mobilization smooth 3-4x a day.
Management
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ANATOMI
Shoulder dislocation
Sternoklavikularjoin
Akromioklavikularjoin
Humeroskalpulerjoin
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Adult >>
Arms are usually forced to abduction,
external rotation, and extensionHumerus is
pushed forward, tearing the capsule or
causing avulsi the edge of the glenoid
Bankart lesion
Anterior shoulder dislocation
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Arm injuries sustained by other hand
Deformity
Position tilted to the position of the sick
Painful
Palpable bumps on clavicle
Unable to move his arm
On palpation palpable under the acromion isempty
Clinical manifestasion
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Overlap between the humeral head and
glenoid fossa, caput usually in below and
medial to the joint bowl
X- RAY
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repositioning immediately
With the indication:
no fracture
absence of neurological deficits1. axilarry sensory nerves in m.deltoideus
2. n.radialis hand extension
3. a.brachialisradial pulse
Treatment
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Close reduction
STIMPSON
This method is simple and
does not require
anesthesia.
Patients in prone position
and sleep on the table,hanging downward. Arm
were given a weight 5-7 kg.
At the time of the shoulder
muscles in a state ofrelaxation, is expected to
occur due to therepositioning of heavy arms
that hung beside the bed.
Applied 15 to 20 minutes
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When Stimson failed
patient supine
grasps the affected side at thehand and forearm and abduksi
foot pressed into axiila(tilting the humeral head to
the lateral and posterior)
Shoulder position maintainedendorotasi by a buffer chest
min 3 weeks
HIPPOCRATES
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After reposition shoulder joints were fixed with chest, with verband and
forearm suspended by slings. 3-6 weeks of immobilization enough.27/07/2013 22
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operation
bristow-helfet
Brankartprosedur
putti-plat
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Rarely Indirect force that causes internal rotation and
strong adduction.
Clinical features The arm was swollen and deformity locked in
position adduction and internal rotation,
protrusion of the posterior humeral head, the
blank subakromion Limited adduction can not be rotated to
external
Posterior shoulder dislocation
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caput humeris looks abnormal (such as light
bulbs), away from the glenoid fossa (glenoid
sign blank)
Radiological examination
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The humeral head trapped under the cavities
glenoidale locked in position abduction.
Treatmen like anterior dislocation
Inferior shoulder dislocation
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Adult >>
Common in traumatic35 years
Congenital dislocation of about 2-4 casesper 1000 live births, 80-85% in women
HIP DISLOCATION
DefinitionA situation where the femur head out
of the acetabulum
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Posterior hip dislocation
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supine
Assistant pressing the crista
iliaca to the table
Operators do traction of the
femur one way direction of
the axis
endorotasi
eksorotasi
Ekstensi hip join
treatment
THE BIGELOW MANEUVER
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supine
Fixation crista iliaca to the
operating table
Traction direction axis of the
femur + endorotasi femur
Immobilized with skin
traction with minimal
flexion of the hip joint
Endorotasi for 2-3 weeks
Non-weight bearing
mobilization2-3 weeks
METODE ALLIS
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Early lesions n. Ischiadicus
Lately nekrosis avaskuler
artrosis degeneratif
COMPLICATION
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fell from a high place and rub the head femur in front of the
acetabulum
Anterior HIP DISLOCATION
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Leg is be laid Eksorotasi, in a abductionposition
patient can not move Flexion actively when
in a state of dislocation. Kaput femur in
front of the femoral triangle.
sinar x
clinical manifestation
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Pattien supine
Fixation crista iliaca to
the operating table
Traction in the direction
of the axis of the femur
Endorotasi and adduksi
femur
management
REVERSE BIGELOW
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excessive abduction of the pelvis trochanter
major moves agains pelvis to tilting kaput
femur out of the acetabulum.
clinical symptoms and examination
abduction and can not in normal position
trochanter and pelvic region pain
Can do a limp movements
Central hip dislocation
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Treatment
Changing thesedislocations into
anterior / posteriorhip dislocation
reduced with true
appropriate
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