Fraturas do punho
Summary
Definition
History and exam
Key diagnostic factors
- história de trauma ou de osteoporose
- dor no punho
- sensibilidade sobre o rádio distal
- edema
Other diagnostic factors
- deformidade
- sensibilidade na tabaqueira anatômica
- dormência nos dedos
- hipoestesia
- ferida aberta
- ausência de pulso
Risk factors
- trauma
- osteoporose
Diagnostic tests
1st tests to order
- radiografias simples do punho
Tests to consider
- tomografia computadorizada (TC) do punho
- ressonância nuclear magnética (RNM; sem contraste) do punho
- absorciometria por dupla emissão de raios X (DEXA)
Algoritmo de tratamiento
fechada
exposta
fratura isolada do rádio distal
fratura isolada do escafoide
fraturas concomitantes do rádio distal e do escafoide ou do processo estiloide da ulna
fratura do punho confirmada
Colaboradores
Autores
Niels W.L. Schep, MD
Trauma, Hand and Wrist Surgeon
Department of Trauma and Hand Surgery
Maasstad Hospital
Rotterdam
Netherlands
Divulgaciones
NS declares that he has no competing interests.
Agradecimientos
Dr Niels W.L. Schep would like to gratefully acknowledge Dr Jeffrey N. Lawton, Dr John R. Lien, Dr Gregory D. Byrda, Dr Tamara D. Rozental, and Dr Chaitanya S. Mudgal, previous contributors to this topic.
Divulgaciones
JNL is a consultant for Innomed Inc, has received honoraria from The AO Foundation for teaching courses, and has been sponsored for research by DePuy Synthes. JRL and GDB declare that they have no competing interests. TDR is an author of several references cited in this topic. CSM has been reimbursed by AO North America and Asia Pacific for being a faculty member during educational conferences.
Revisores por pares
Asif Ilyas, MD
Program Director of Hand and Upper Extremity Surgery
Rothman Institute
Associate Professor of Orthopaedic Surgery
Thomas Jefferson University
Philadelphia
PA
Divulgaciones
AI declares that he has no competing interests.
Isam Atroshi, MD, PhD
Associate Professor of Orthopaedics
Lund University
Chief
Hand Surgery Section
Department of Orthopaedics
Hässleholm and Kristianstad Hospitals
Sweden
Divulgaciones
Not disclosed.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Torabi M, Lenchik L, Beaman FD, et al; Expert Panel on Musculoskeletal Imaging. ACR appropriateness criteria: acute hand and wrist trauma. J Am Coll Radiol. 2019 May;16(5s):S7-17.Texto completo Resumen
American Academy of Orthopaedic Surgeons. Management of distal radius fractures: evidence-based clinical practice guideline. Dec 2020 [internet publication].Texto completo
American Academy of Orthopaedic Surgeons. Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline. Mar 2022 [internet publication].Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Torção do punho
- Lesão ligamentar do carpo
- Ruptura do complexo da fibrocartilagem triangular (CFCT)
Más DiferencialesGuías de práctica clínica
- ACR appropriateness criteria: chronic hand and wrist pain
- Prevention of surgical site infections after major extremity trauma
Más Guías de práctica clínicaFolletos para el paciente
Síndrome do túnel do carpo
Sintomas de menopausa: quais são as opções de tratamento?
Más Folletos para el paciente
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