Fratura do quadril
Summary
Definição
História e exame físico
Principais fatores diagnósticos
- história de queda ou trauma
- dor no quadril, virilha ou coxa afetados
- incapacidade de suportar peso ou mover o quadril
- perna encurtada e rotacionada externamente
- fatores de risco
Fatores de risco
- osteoporose/osteopenia
- idade avançada
- quedas
- índice de massa corporal (IMC) baixo
- sexo feminino
- trauma de alta energia
- medicações
- demência
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- radiografias simples
- hemograma completo
- ureia e eletrólitos
- glicose
- tipagem e reserva de sangue
- coagulograma
- eletrocardiograma (ECG)
Investigações a serem consideradas
- ressonância nuclear magnética (RNM) da pelve
- tomografia computadorizada (TC) da pelve
- cintilografia óssea com tecnécio
Algoritmo de tratamento
adequado para cirurgia
atualmente não é adequado para cirurgia: não está recebendo cuidados no final da vida
atualmente não é adequado para cirurgia: recebendo cuidados no final da vida
Pós-cirurgia
Colaboradores
Consultores especialistas
Michael Barrett, MBChB, FRCS (Tr & Orth), PG Cert Med Ed
Consultant Trauma and Orthopaedic Surgeon
Cambridge University Hospitals NHS Foundation Trust
Cambridge
UK
Declarações
MB is a director of Orthohub.xyz, an online education platform for orthopaedic surgeons. Orthohub.xyz receives sponsorship from the healthcare industry.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:
Zoe Little
ST6 in Trauma and Orthopaedics
Epsom and St Helier University Hospitals
Epsom
UK
Brett Griffiths
Specialist Registrar
Norfolk and Norwich University Hospitals
Norwich
UK
Hiba Khan
ST4 in Trauma and Orthopaedics
Croydon University Hospital
London
UK
Disclosures
ZL, BG, and HK declare that they have no competing interests.
Peer reviewers
Antony Johansen, MB BChir
Consultant Orthogeriatrician
University Hospital of Wales
Cardiff
UK
Biography
AJ is clinical lead for the National Hip Fracture Database, Royal College of Physicians, London, UK.
Disclosures
AJ has been a co-applicant or collaborator in successful applications for non-commercial grants from the NIHR Health Technology Assessment Programme, Physiotherapy Research Foundation, and Versus Arthritis.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
National Institute for Health and Care Excellence. Hip fracture: management. January 2023 [internet publication].Full text
Public Health Scotland. Scottish standards of care for hip fracture patients. May 2024 [internet publication].Full text
British Orthopaedic Association. BOAST: the care of the older or frail orthopaedic trauma patient. May 2019 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Fratura do acetábulo
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