Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- história de trauma
- presença de fatores de risco
- dor
- dispneia
Outros fatores diagnósticos
- sinais de oxigenação comprometida
- contratilidade paradoxal da parede torácica
Fatores de risco
- traumatismo torácico contuso
- ressuscitação cardiopulmonar (RCP)
- abuso físico em crianças
- osteoporose
- idade >65 anos
- participação em esportes
- tumores ósseos primários
- tumores ósseos metastáticos
- tosse intensa
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- radiografia torácica
- radiografia pélvica
Investigações a serem consideradas
- tomografia computadorizada (TC) do tórax
- ultrassonografia do tórax
- angiografia
- TC do crânio, coluna cervical, tórax, abdome e pelve
- radiografia de esqueleto (crianças)
Algoritmo de tratamento
todos os pacientes
Colaboradores
Autores
Garth H. Utter, MD, MSc
Professor of Surgery
University of California
Davis
California
CA
Declarações
GHU has been paid as a consultant by the US Agency for Healthcare Research and Quality (AHRQ) for their Healthcare Cost and Utilization Project (HCUP) Tools Program. His organisation has received contract funding on his behalf from the US Centers for Medicare and Medicaid Services, and AHRQ for their Quality Indicators programs and AHRQ's Patient Safety Network program.
Agradecimentos
Dr Garth H. Utter would like to gratefully acknowledge Dr Peter Cundy, Dr Nicole Williams, Dr Paul Novakovich and Dr Brent Ponce, previous contributors to this topic.
Declarações
PC is on the boards of MIGA (medical indemnity insurance) and Orthopaedics SA. He owns stock though a personal superannuation fund. PC’s hospital, the Women's and Children's Hospital, Adelaide, receives institutional support from medical supply companies for salary of research scientists. PC received payment from a medical supplier for two lectures on wound dressings in 2017. PC declares that none of the above are relevant to the Rib Fractures topic and that he receives no other money from suppliers. NW’s hospital, the Women's and Children's Hospital, Adelaide, receives institutional research support from medical supply companies and BioMarin Pharmaceutical Inc. PN and BP declare that they have no competing interests.
Revisores
Gino Kerkhoffs, MD, PhD
Orthopaedic Surgeon
Department of Orthopaedic Surgery & Orthopaedic Research Center
Academic Medical Center
Meibergdreef
Amsterdam
The Netherlands
Declarações
GK declares that he has no competing interests.
James Puffer, MD
President and Chief Executive Officer
American Board of Family Medicine
Lexington
KY
Declarações
JP declares that he has no competing interests.
Diagnósticos diferenciais
- Contusão da parede torácica
Mais Diagnósticos diferenciaisDiretrizes
- ACR Appropriateness Criteria: rib fractures
- Western Trauma Association critical decisions in trauma: management of rib fractures
Mais DiretrizesVideos
Inserção de dreno intercostal, técnica aberta: vídeo de demonstração
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