deformitas muskuloskeletal dalam tinjauan bedah.pptx
TRANSCRIPT
DEFORMITAS MUSKULOSKELETAL DALAM TINJAUAN BEDAH
VALGUS DEFOEMITY
VARUS DEFOEMITY
13 to 18SKOLIOSIS a. Skoliosis postural hilang pada saat fleksi b. Skoliosis tungkai pendek hilang pada saat duduk
SKOLIOSIS
SKOLIOSIS
SKOLIOSIS Cobbs angle
Kifosis
Scheuermanns disease
a.b. Scheurmanns disease pada orang tuad.e. gibbus kecil pada spondilitis tuberkulosa
Pemeriksaan ekstremitas inferior dan tulang belakangTulang belakangGejala :Nyeri punggungKekakuandeformitasLook : sikatriks, bentuk dan postur tubuh ( dari depan & samping)Feel : keempukan (struktur tulang, jaringan intervetebra, otot paravetebra)Move : fleksi depan, ekstensi, fleksi lateral, rotasi
18.1 Examination With the patient standing upright (a), look at his general posture and note particularly the presence of any asymmetry or frank deformity of the spine. Then ask him to lean backwards (extension) (b), forwards to touch his toes (flexion) (c) and then sideways as far as possible (d), comparing his level of reach on the two sides. Finally, hold the pelvis stable and ask the patient to twist first to one side and then to the other (rotation). Note that rotation occurs almost entirely in the thoracic spine (e) and not in the lumbar spine.SCOLIOSISSkoliosis : vertebra tampak jelas membentuk curvatura ke lateral.Bentuk yg plg umum dari skoliosis -> triplanar deformity pd komponen lateral, anteroposterior dan rotasional.
Klinis skoliosis di bedakan :Skoliosis posturalSkoliosis struktural
SKOLIOSIS a. Skoliosis postural hilang pada saat fleksi b. Skoliosis tungkai pendek hilang pada saat duduk
SKOLIOSIS
SKOLIOSIS Cobbs angle
Deformitas Panggul :
coxa valgus SubluksasiTarikan otot abnormal fleksi panggul, adduksi & rotasi interna femur coxa valgus, malformasi kepala femur, asetabulum dangkal subluksasi
KEKUATAN OTOTDiperiksa dg Manual Muscle Testing (MMT)Merupakan pemeriksaan yg subyektif Reliabilitas & validitas baik utk penggunaan klinis
GRADING MMTNUMBERWORKDEFINITION5 NORMALComplete joint ROM against gravity with full resistance 4 GOODComplete joint ROM against gravity with moderate resistance3FAIRFull joint ROM against gravity2POORFull joint ROM with gravity eliminated1TRACEVisible palpable or muscle contraction0ZERONo visible or palpable muscle contractionPERSYARATAN MMTPasien kooperatifMengerti prosedur pemeriksaanTidak ada nyeri gerakPemeriksa menguasai teknik pemeriksaan dilakukan pd posisi yg benar, dg stabilisasi /fiksasi yg tepatTRUNK FLEXION( m. rectus abdominis)
TRUNK EXTENSION( m. sacrospinalis)
HIP FLEXION( m.iliopsoas )
HIP EXTENSION( m. gluteus max,semitendinosus,semimembranosus,biceps femoris)
HIP ABDUCTION( m. gluteus medius)
SPECIAL TEST MUSCULOSKELETALSMF REHABILITASI MEDIKRS ORTOPEDI PROF DR R SOEHARSO SURAKARTASPINE - INSPEKSI
SPINE - PALPASI
SPINE-MOVEMENT
TRUE LLD
GALEAZZI TEST
APPARENT LLD
THOMAS TEST
OBER TEST