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Fraturas do punho

Last reviewed: 11 Jun 2025
Last updated: 04 Jun 2024

Summary

Definition

History and exam

Key diagnostic factors

  • história de trauma ou de osteoporose
  • dor no punho
  • sensibilidade sobre o rádio distal
  • edema
Full details

Other diagnostic factors

  • deformidade
  • sensibilidade na tabaqueira anatômica
  • dormência nos dedos
  • hipoestesia
  • ferida aberta
  • ausência de pulso
Full details

Risk factors

  • trauma
  • osteoporose
Full details

Diagnostic tests

1st tests to order

  • radiografias simples do punho
Full details

Tests to consider

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

Treatment algorithm

INITIAL

fechada

exposta

ACUTE

fratura isolada do rádio distal

fratura isolada do escafoide

fraturas concomitantes do rádio distal e do escafoide

ONGOING

fratura do punho confirmada

Contributors

Authors

Niels W.L. Schep, MD

Trauma, Hand and Wrist Surgeon

Department of Trauma and Hand Surgery

Maasstad Hospital

Rotterdam

Netherlands

Disclosures

NS declares that he has no competing interests.

Acknowledgements

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.

Disclosures

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.

Peer reviewers

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

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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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    • ACR appropriateness criteria: chronic hand and wrist pain
    • Prevention of surgical site infections after major extremity trauma
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  • Patient information

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