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Fraturas do punho

Última revisão: 18 Jun 2025
Última atualização: 04 Jun 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • história de trauma ou de osteoporose
  • dor no punho
  • sensibilidade sobre o rádio distal
  • edema
Detalhes completos

Outros fatores diagnósticos

  • deformidade
  • sensibilidade na tabaqueira anatômica
  • dormência nos dedos
  • hipoestesia
  • ferida aberta
  • ausência de pulso
Detalhes completos

Fatores de risco

  • trauma
  • osteoporose
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • radiografias simples do punho
Detalhes completos

Investigações a serem consideradas

  • tomografia computadorizada (TC) do punho
  • ressonância nuclear magnética (RNM; sem contraste) do punho
  • absorciometria por dupla emissão de raios X (DEXA)
Detalhes completos

Algoritmo de tratamento

Inicial

fechada

exposta

AGUDA

fratura isolada do rádio distal

fratura isolada do escafoide

fraturas concomitantes do rádio distal e do escafoide

CONTÍNUA

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

Declarações

NS declares that he has no competing interests.

Agradecimentos

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.

Declarações

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

Asif Ilyas, MD

Program Director of Hand and Upper Extremity Surgery

Rothman Institute

Associate Professor of Orthopaedic Surgery

Thomas Jefferson University

Philadelphia

PA

Disclosures

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

Disclosures

Not disclosed.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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.Full text  Abstract

American Academy of Orthopaedic Surgeons. Management of distal radius fractures: evidence-based clinical practice guideline. Dec 2020 [internet publication].Full text

American Academy of Orthopaedic Surgeons. Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline. Mar 2022 [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.
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    • Prevention of surgical site infections after major extremity trauma
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