SERI 1

1. Anatomi (bone + soft tissue)

- manus, Batas antara Hand dan Antebrachii

 Anatomi carpal hand

 Inervasi dari regio manus dan antebrachii
 Jumlah phalanges
 FDP FDS origo insersi
 Extensor digitorum, extensor policis, extensor digiti minimi

- shoulder, articulation shoulder dibentuk oleh? Rotator cuff?

- Elbow

- hip , articulation coxae dibentuk oleh? Hip otot utama apa aja?

2. Pediatri

1. Anak usia 1 tahun, demam 38.6°C setelah upper respiratori infeksi 3 hari lalu, pasien rewel, tidak mau
minum, menangis ketika sendi panggul kiri digerakkan( memasang popok)

-Kriteria diagnosis? DDnya apa?

-pemeriksaan fisik dan penunjang yang diperlukan apa?

-Gambaran radiologisnya bagaimana?

-hasil lab yang diharapkan apa?

-Jika aspirasi cairan sendi (-), diperiksa apa?

-penatalaksanaanya bagaimana? diberi antibiotik dahulu atau drainase dulu?

2. jelaskan mengenai septic arthritis (dx sampai tx).

- Diagnosis banding? Transcient Synovitis

- Edukasi keluarga

3. Shoulder Dislocation

- MOI, Jenis, Tatalaksana, cara closed reduction, komplikasi early and late, mengapa termasuk
kegawatan.

- Hill sach lesion, bony brankart

- Rotator cuff

- Lesi vascular dislokasi bahu, lesi nerve, pemeriksaan fisik

4. dr IMA

1. Tuliskan 20 diagnosis banding nyeri pada elbow? Anatomi? diantara DD itu mana yang sering
menyebabkan kompartemen sindrom? mengapa?

2. Komplikasi tersering fraktur supracondiler humerus yang merupakan kegawatan ortopedik? Kenapa?
Kompartement syndrome, karena kinking arteri brachialis
Complications
There are three main complications 2,3:
 malunion: resulting in cubitus varus (varus deformity of the elbow, also known as gunstock
deformity)
 ischemic contracture (Volkmann contracture) due to damage/occlusion to the brachial
artery and resulting in volar compartment syndrome
 damage to the ulnar nerve, median nerve, or radial nerve
o most commonly insured at the time of injury is the AIN, followed by the radial nerve and
then the ulnar nerve. Ulnar nerve injury is more common in flexion type fractures.  

3. .Pada pemasangan C-clamp/eksternal fiksasi sampai kapan dipertahankan? kpn c clamp sebagai
definitif dilepas?
A C-clamp is normally applied as an emergency in patients with pelvic and hemodynamic
instability. As soon as the causes of the hemodynamic instability have been addressed,
definitive fixation of the pelvis can be performed and the C-clamp removed.
If the patient is in a persistent shock category despite adequate fluid replacement, blood transfusions, and
medications over 2 hours, an external fixator or C-clamp should replace a pelvic sheet or binder

The C-clamp was removed 3.3±0.3 days after admission; definitive stabilization of

the pelvic ring was performed on day 3.5±0.5.
4. No man land itu apa? kenapa disebut seperti itu?

“no man's land” to describe zone 2 in the hand because at that time it was felt
that no man should attempt repair within this zone. 
Bunnell referred to this area as “no man’s land,” a place where no man should attempt to repair a flexor
tendon because the results were so poor. There was a period when these digital wounds were typically
closed and flexor tendon grafts were undertaken at a later stage.

5. sebutkan zona flexor dan extensor tendon manus

6. Pulled elbow

Pulled elbow

 A pulled elbow is a common injury among children under the age of five. It is also sometimes
called nursemaid’s elbow. A pulled elbow is a result of the lower arm (radius bone) becoming
partially dislocated (slipping out) of its normal position at the elbow joint.
A pulled elbow is caused by a sudden pull on a child's lower arm or wrist, for example when a child is
lifted up by one arm. It can also happen when a child falls. A pulled elbow will be put back into place by
a nurse practitioner or doctor. It will not cause any long-term damage to your child.

7. Fraktur condilus lateral, early and late complication

Complications

 Stiffness

o incidence

 most common complication

o risk factors

 stiffness may be an early sign of a non-union or delayed union

o treatment

 usually self-resolving

 by 24 weeks 90% of motion returns and full motion is present by 48 weeks

 Delayed Union

o fracture that does not heal with 6 weeks of immobilization

o risk factors

 fracture that is seen more than 2 weeks after injury

o treatment

 may be treated with immobilization if minimally displaced

 surgical treatment if displaced

 must be followed until radiographic union as nonunion is common in this scenario

 Nonunion   

o incidence

 higher rate of nonunion than other elbow fractures

o risk factors

 nonsurgical management

o mechanism - theoretical

 constant motion at fracture site from pull of the wrist extensors

  intra-articular (synovial fluid impede fracture healing)

 poor metaphyseal circulation to distal fragment

o prevent nonunion by

 preserving soft tissue attachments to lateral condyle

 stable internal fixation

o treatment

 goal is to obtain union of metaphyseal fragment, not restore joint surface

 may require bone graft

 ORIF with screw

 Cubitus Valgus ± tardy ulnar nerve palsy             

o due to lateral physeal arrest or more commonly a nonunion

o slow, progressive ulnar nerve palsy caused by stretch

o incidence

 10%

 less common than cubitus varus

o risk factors

 significant deformities that cause physeal arrest 

o treatment

 supracondylar osteotomy after skeletal maturity and ulnar nerve transposition

 AVN

o incidence

 occurs 1-3 years after fracture

o risk factors

 posterior dissection can result in lateral condyle osteonecrosis (may also occur in the trochlea)

 Fishtail deformity

o area between medial ossification center and lateral condyle ossification center resorbs or fails to develop

o does NOT predispose to arthritis

o treatment
  supracondylar osteotomy

 Lateral overgrowth/prominence (spurring)     

o incidence

 up to 50% regardless of treatment, families should be counseled in advance

o risk factors

 result of displacement of the metaphyseal fragment in addition to disruption of the periosteal en

 lateral periosteal realignment will prevent this from occurring

 spurring is correlated with greater initial fracture displacement

 Growth arrest

o incidence

 rare complication

o risk factors

 varus or valgus deformity

o treatment

 young patients may be treated with bar resection or osteotomy

 older patients best treated with completion of the epiphysiodesis and osteotomy

 Unsatisfactory appearance of surgical scar

8. Manuver close reduction dislokasi hip, valpeau bandage berapa lama berdasarkan umur
5. Cervical Injury

1. Datang pasien dg seorang supir taksi. Di igd saya sendiri tidak ada siapa2. Apa yang anda lakukan?

Call for help. Kita dari belakang log roll pasien, masukin board dari belakang.

 Sekarang team igd sudah datang. Apa yang kamu lakukan?

 Protab ATLS. : didapatkan nadi turun, tensi juga turun. TD 80, nadi 60.
 Problem ada di Circulation.  pasang IV line & kateter.
 Rontgen evaluasi cervical & pelvis. Trus pasien sesak nafas  reevaluasi ABC

2. Pemeriksaan penunjang pada pasien dicurigai cidera cervical apa?

3. Cara membaca x-ray cervical bagaimana?

4. Cara pemberian metilprednisolon pada SCI bagaimana? kontraindikasinya apa?

Jawaban saya dilakukan primary survey, ternyata salah pak.

yang benar, dibawa ke triage dulu, dengan minta bantuan supir taxi, dengan scope stacher pak

5. pasien datang curiga trauma cervical, apa yang kamu lakukan? Jelaskan mulai definisi sampai
rehabilitasi nya

- pemeriksaan BGA pada trauma cervical menunjukkan apa? Asidosis respiratorik

- jelaskan patofisiologi terjadinya asidosis repiratorik

- Bagaiman tatalaksana asidosis respiratorik

- jika ada gangguan napas bisa dibantu dengan apa? Ventilator

- bagaimana prinsip kerja ventilator?

- mode apa saja yang ada di ventilator?

- jelaskan salah satu mode ventilator, prinsip kerja mode tersebut, dan apa proses yang terjadi di organ
napas dengan mode ventilator tersebut

- gambarkan spinal cord lengkap, jelaskan bagian-bagiannya

- apa perbedaan SCI komplit dan inkomplit?

- ada berapa macam SCI inkomplit? Jelaskan dengan gambar bagian yang terkena lesi

6. Osteosynthesis
- jenis plat, fungsi plat, fungsi lag screw, cara pasang

7. Spine

- laki laki datang ke IGD dg paraplegia, jelaskan apa yg akan kamu lakukan (anamnesa, pmrx klinis,
penunjang, cara baca rontgen, tx)

8. Hand

- case (greenstick fr radius + buckle fr ulna) anmnesa, klinis, xray, tx, komplikasi

- case (fr. Phalanx prox digiti IV manus) anamnesa, klinis, xray, tx, komplikasi

- Traumatic amputatum, tatalaksana, kapan replantasi, syarat,