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