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Informasi Paien

• Nama : Tn. M.W.


• Usia : 30 tahun
• Alamat : DSN POLOSIRI
• Jenis Kelamin : Laki-laki
Anamnesis
• KU : Nyeri pada tungkai kiri dan kanan
• Riwayat Penyakit Sekarang :
Nyeri pada tungkai kiri dan kanan dirasakan
sejak 2 hari yang lalu setelah pasien jatuh dari
ketinggian sekitar 5 meter saat pasien bekerja.
Posisi terjatuh dalam posisi berdiri.
Tidak ada nyeri kepala, muntah dan pingsan.
Tidak ada riwayat hipertensi dan diabetes.
Pemeriksaan Fisik
• Compos mentis GCS 15
• TD : 120/80
• Pernafasan : 20x/m
• Nadi : 80x/m
• Suhu : 36.7 c
• NPRS : 4
Foto Cruris Bilateral posisi AP/Lateral
• Alignment genu joint dan ankle joint bilateral
baik, tidak tampak dislokasi
• Tampak fraktur komunitif pada 1/3 distal os
tibia sinistra
• Densitas tulang baik
• Celah sendi yang tervisualisasi kesan baik
• Jaringan lunak sekitar kesan baik
Kesan : Fraktur Komunitif 1/3 distal os tibia
sinistra
Foto Ankle Joint Bilateral AP/Lateral/Mortise View
• Alignment Ankle Joint bilateral berubah
• Tampak fraktur pada aspek anteroinferior et
posteroinferior os calcaneus dextra
• Tampak fraktur komunitis pada 1/3 distal os tibia
sinistra
• Tibiofibular overlap 1cm, medial clear space
0.1cm, total clear space 0.2 pedis dextra
• Tibiofibular overlap 1cm, medial clear space 0.3
cm, total clear space 0.3 pedis
• Densitas tulang baik
• Jaringan lunak disekitar kesan swelling
Kesan :
• Fraktur pada aspek anteroinferior et
posteroinferior os calcanesius dextra
• Fraktur komunitis pada 1/3 distal os tibia
sinistra
• Tibiofibular overlap 1cm, medial clear space
0.1cm, total clear space 0.2cm pedis dextra
• Tibiofibular overlap 1cm, medial clear space
0.3 cm, total clear space 0.3cm pedis sinistra
Pembahasan
When imaging the ankle obtain 3 views to
appropriately evaluate the joint: AP, Lateral
and the Mortise study.
sumber : https://www2.aofoundation.org
Radiographic Evaluation
• Begin with the AP and Lateral views. Trace the entire length
of the tibia and fibula.
• the mortise view. evaluate for joint space (clear space). The
ring structure of the ankle is made up of three bones (tibia,
fibula and talus) and three ligaments (medial and lateral
collateral ligaments and interosseous ligament) if there is one
break in the ring, look for a second.

To evaluate the integrity of the syndesmosis


use the following measurements:
•Tibiofibular overlap < 1mm
•Increased medial clear space: less than or
equal to 4 mm
•Increased Tibiofibular clear space: < 6 mm
• The medial clear space should
not exceed 4 mm and is usually
equal to the distance between
the tibial plafond and the
talus. Widening of the medial
joint space requires disruption of
the medial collateral ligament
• The lateral clear space is
measured from the medial
border of the fibula to the lateral
border of the posterior tibia 1cm
above the tibial plafond.
• Tibiofibular
overlap should be at
least 6 mm on an AP
image and usually at
least 1 mm on a mortise
view. Reduced overlap is
a sign of syndesmotic
widening/injury
Pembahasan
• A fracture is described as a disruption in the
continuity of all or part of the cortex of a
bone.
Radiologic features of acute fractures
• Abrupt disruption of all or part of the cortex
• Acute changes in the smooth contour of a
normal bone
• Fracture lines are black and linear
• Fracture fragments are jagged and rough
How fractures are describe