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LAPORAN REFLEKSI KASUS KOMUDA

RSUD MUNTILAN

 Nama / NIM : Evi Herdianti / 20100100!"

PENGALAMAN

Se#ran$ %a&ien 'a(i)'a(i 2* ta+,n datan$ &e#ran$ diri (e I-D %ada tan$$a' 2. Mei 201. %,(,'

0"0 I &ete'a+ (ee'a(aan 'a', 'inta&3 den$an (e',+an ',(a %ada (e%a'a 4a$ian %arieta'

de(&tra dan n5eri 4a+, (anan3 &adar 6783 %,&in$ 6)83 m,a' 6)83 m,nta+ 6)8 Pa&ien di4eri(an tera%i

 Na di('#9ena( 2;0 m$ < am#ii''in ;00 m$ < ATS I

Ha&i' %emeri(&aan men,n=,((an :

Keadaan ,m,m : 4ai( 

Ke&adaran : >#m%#& Menti&

Te(anan dara+ : 10/"0 mmH$

MASALAH YANG DIKAJI

Men$a%a tida( di4eri(an %enan$anan im#4i'i&a&i %ada &,&%e( 9ra(t,r ('avi(,'a &e4e',m

di'a(,(an %emeri(&aan %en,n=an$ ? A%a(a+ tinda(an ter&e4,t &,da+ te%at ?

ANALISA KRITIS

Fra(t,r  ('avi(,'a 6t,'an$ (#'ar8 mer,%a(an edera 5an$ &erin$ ter=adi a(i4at =at,+ ata, +antaman

'an$&,n$ (e 4a+,

Karena 'eta(n5a di4a@a+ (,'it3 ma(a clavicula  &an$at m,da+ %ata+ 4i'a ter=adi tra,ma3 dan

&erin$ (a'i %ata+ann5a teri&#'a&i Sa5an$n5a %ata+ t,'an$ &e'an$(a &erin$ 4er+,4,n$an den$an

high-energy injury ata, multiple traumatic, &e+in$$a &an$at %entin$ ,nt,( memeri(&a %enderita

&eara (e&e',r,+an a$ar edera 'ain5a &e%erti 9ra(t,r t,'an$ i$a3 9ra(t,r  scapular 3 (#nt,&i#

 %,'m#ner3 pneumothorax3 hematothorax da%at diidenti9i(a&i dan ditan$ani den$an &e$era

Unt,( men$identi9i(a&i 9ra(t,r t,'an$ &e'an$(a &an$at m,da+ (arena %#&i&in5a 5an$ de(at

den$an (,'it -e=a'a 5an$ tim4,' da%at 4er,%a n5eri ter,tama (eti(a 'en$an 4er,&a+a di$era(an3

 %em4en$(a(an %ada area &e(itar t,'an$ 5an$ %ata+3 &erta %#&i&i 'en$an a(an men=adi 'e4i+ de(at

den$an t,4,+ Nam,n #4&erva&i 5an$ te'iti teta% di%er',(an3 ter,tama men$enai &tat,&

ne,r#va&(,'arn5a 6&ara9 dan %em4,',+ dara+8 Pem4,',+ dara+ arteri  subclavicula  mer,%a(an

 %em4,',+ dara+ %entin$ 5an$ a(an men5,%'ai dara+ (e 'en$an dan 'eta(n5a di4a@a+ t,'an$

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&e'an$(a3 &e+in$$a &an$at rentan ter+ada% edera 4i'a ter=adi 9ra(t,r t,'an$ &e'an$(a Se'ain

 %em4,',+ dara+3 &era4,t &ara9 brachial 6 plexus bracialis8 5an$ 'eta(n5a de(at den$an arteri

&,4'avi,'a =,$a rentan edera %ada displaced clavicle fracture ata, 9ra(t,r t,'an$ &e'an$(a

5an$ %ata+ann5a ter%i&a+ K#ndi&i 5an$ %er', di@a&%adai a%a4i'a terda%at memar &e(itar t,'an$

&e'an$(a3 4er(,ran$n5a ata, +i'an$n5a den5,t nadi di 'en$an 5an$ edera3 t,'an$ i$a %ertama

 %ata+3 dan 4a$ian 4a@a+ tan$an tida( 4i&a di$era((an ata, ',m%,+

Serin$ (a'i3 9ra(t,r 'avi,'a dira@at &eara n#n)#%erati9 den$an ara &e'em%an$ 'en$an ata,

den$an men$$,na(an met#de  figure-of eight  Den$an met#de)met#de ini 4a+, di im#4i'i&a&i

&e+in$$a %en5at,an t,'an$ da%at e%at ter=adi Im#4i'i&a&i di'a(,(an &am%ai n5eri dan $era(an

di&e(itar &i&i 9ra(t,r tida( 'a$i dira&a(an

Penata'a(&anaan medi& men,r,t >+aer,ddin R#&=ad3 1"" Se4e',m men$$am4i' (e%,t,&an

,nt,( me'a(,(an %enata'a(&anaan de9initive Prin&i% %enata'a(&anaan 9ra(t,r ada . R 5ait, :

1 Recognition 

dia$n#&a dan %eni'aian 9ra(t,r

Prin&i% %ertama ada'a+ men$eta+,i dan meni'ai (eadaan 9ra(t,r den$an ananne&i&3

 %emeri(&aan ('ini& dan radi#'#$i Pada a@a' %en$#4atan %er', di%er+ati(an : '#(a&i

9ra(t,r3 4ent,( 9ra(t,r3 menent,(an te+ni( 5an$ &e&,ai ,nt,( %en$#4atan3 (#m%'i(a&i

5an$ m,n$(in ter=adi &e'ama %en$#4atan

2 Reduction 

t,=,ann5a ,nt,( men$em4a'i(an %an=an$ B (e&e$ari&an t,'an$ Da%at dia%ai 5an$

mani%,'a&i tert,t,%/red,(&i ter4,(a %r#$re&i Red,(&i tert,t,% terdiri dari %en$$,naan

tra(&im#va' ,nt,( menari( 9ra(t,r (em,dian meman,%,'a&i ,nt,( men$em4a'i(an

(e&e$ari&an n#rma'/den$an tra(&i me(ani& Red,(&i ter4,(a diindi(a&i(an =i(a red,(&i

tert,t,% $a$a'/tida( mem,a&(an Red,(&i ter4,(a mer,%a(an a'at 9r,&a&i interna' 5an$

di$,na(an it, mem%erta+an(an da'am %#&i&in5a &am%ai %en5em4,+an t,'an$ 5an$ &#'id

&e%erti %en3 (a@at3 &(r,% dan %'at Red,ti#n interna 9iati#n 6#ri98 5ait, den$an

 %em4eda+an ter4,(a (an men$im#4i'i&a&i 9ra(t,r 5an$ 4er9,n$&i %em4eda+an ,nt,(

mema&,((an &(r,%/%en (eda'am 9ra(t,r 5an$ 4er9,n$&i ,nt,( men9i(&a&i 4a$ian)4a$ian

t,'an$ 5an$ 9ra(t,r &eara 4er&amaan

Retention

im#4i'i&a&i 9ra(t,r t,=,ann5a mene$a+ %en$e&eran 9re$men dan mene$a+ %er$era(an

5an$ da%at men$anam ,ni#n Unt,( mem%erta+an(an red,(&i 6e(trimita& 5an$

men$a'ami 9ra(t,r8 ada'a+ den$an tra(&i Tra(&i mer,%a(an &a'a+ &at, %en$#4atan

den$an ara menari(/tari(an %ada 4a$ian t,'an$)t,'an$ &e4a$ai (e(,atan dn$an (#ntr#'

dan ta+anan 4e4an (ed,an5a ,nt,( men5#(#n$ t,'an$ den$an t,=,an mene$a+ re%#&i&i

de9#rmita&3 men$,ran$i 9ra(t,r dan di&'#(a&i3 mem%erta+an(an 'i$amen

t,4,+/men$,ran$i &%a&me #t#t3 men$,ran$i n5eri3 mem%erta+an(an anat#mi t,4,+ dan

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men$im#4i'i&a&i area &%e&i9i( t,4,+ Ada 2 %ema&an$an tra(&i 5ait, : &(in tra(&i dan

&(e'eta' tra(&i

. Rehabilitation

men$em4a'i(an a(ti9ta& 9,n$&i#na' &e#%tima' m,n$(in

erda&ar(an ta+a%an %enata'a(&anaan medi& ,nt,( 9ra(t,r ('avi(,'a di ata&3 ma(a tinda(an 5an$

di4eri(an di I-D den$an tida( men$im#4i'i&a&i &,&%e( 9ra(t,r ('avi(,'a ter'e4i+ da+,', &e4e',m

di'a(,(an %emeri(&aan %en,n=an$ ada'a+ &,da+ te%at Karena %ada ta+a% %ertama da'am .R 

5ait, re#$niti#n3 %rin&i% %ertama ada'a+ men$eta+,i dan meni'ai (eadaan 9ra(t,r den$an

ananne&i&3 %emeri(&aan ('ini& dan radi#'#$i3 &e+in$$a +ar,& di%a&ti(an ter'e4i+ da+,', men$enai

'#(a&i3 =eni& dan 4ent,( dari 9ra(t,r ter&e4,t a$ar 4i&a di4eri(an %enan$anan 5an$ di4eri(an

&e&,ai Ha' ini di'a(,(an =,$a (arena 9ra(t,r 5an$ ter=adi %ada %a&ien di ata& ada'a+ 9ra(t,r 

tert,t,%3 &e+in$$a di%er',(an %emeri(&aan &e4a$ai %en,n=an$ ,nt,( mene$a((an dia$n#&i& %a&ti

dan %enan$anan 5an$ te%at

DOKMENTASI

Pemeri(&aan Pen,n=an$ :

- R# &+#,'der 

- R# 'avi,'a

Dia$n#&i& : CL 'avi,'a

Ke&an :

1 Fra(t,r 'avi,'a &ini&tra %#&i&i &e$men 4ai( 

2 >a%,t +,meri dan &a%,'a &ini&tra inta( 

RE!ERENSI

Prie SA and i'&#n LM3 200*3 Pat#9i&i#'#$i K#n&e% K'ini& Pr#&e&)Pr#&e& Pen5a(it3 6Edi&i *83

,(, II3 a(arta: E->

R,4in#3 #&e%+ L Clavicle Fracture Med&a%e 2011 Avai'a4'e at

+tt%://emediinemed&a%e#m/arti'e/12*0"; 

E&te%+an3 Amir Clavicle Fracture in Emergency Medicine Med&a%e 2010 Avai'a4'e at

+tt%://emediinemed&a%e#m/arti'e/2.;*. 

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>',ett3 #nat+an Broken Collarbone Ort+#%edi& 2011 Avai'a4'e at

+tt%://#rt+#%edi&a4#,t#m/&/4r#(en4#ne&/a/#''ar4#ne+tm'

Do"en Pe#bi#bing Re$le%"i Ka"u"

&d'( Ma'ia l$a) MMR*