Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- 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
- abuso físico em crianças
- osteoporose
- idade >45 anos
- atividades atléticas
- tumores ósseos primários
- tumores ósseos metastáticos
- ressuscitação cardiopulmonar (RCP)
- 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
Peter Cundy, MBBS, FRACS
Associate Professor
Discipline of Orthopaedics & Trauma
University of Adelaide
Paediatric Orthopaedic Surgeon
Women's and Children's Hospital
Adelaide
Australia
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 & 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.
Nicole Williams, BMedSc (hons I), BMed, Grad Cert Sports Med, FRACS (Ortho)
Associate Professor
Orthopaedics and Trauma
University of Adelaide
Head of Orthopaedic Surgery and Major Trauma Service Co-Director
Women's and Children's Hospital
Adelaide
Australia
Declarações
NW’s hospital, the Women's & Children's Hospital, Adelaide, receives institutional research support from medical supply companies and BioMarin Pharmaceutical Inc.
Agradecimentos
Dr Peter Cundy and Dr Nicole Williams would like to gratefully acknowledge Dr Paul Novakovich and Dr Brent Ponce, previous contributors to this topic. 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: vídeo de demonstração da técnica aberta
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