Fracturi Mb. Sup. 2012

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1 FRACTURILE MEMBRULUI FRACTURILE MEMBRULUI SUPERIOR SUPERIOR DR. CODRIN HUSZAR Spitalul Universitar Bucuresti

Transcript of Fracturi Mb. Sup. 2012

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FRACTURILE MEMBRULUI FRACTURILE MEMBRULUI SUPERIORSUPERIOR

DR. CODRIN HUSZAR

Spitalul Universitar Bucuresti

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FRACTURILE DIAFIZARE ALE OASELOR ANTEBRATULUI

Epidemiologie : 0.9% din totalul fracturilor 40.1 ani ♂ : ♀ = 73 / 27 Incidenta 11.7 / 105 / an Fracturi deschise : 11.7% Cadere simpla - 28.3%

Impact direct (agresiune) - 21.6%

Sport - 18.3%

Accidente rutiere - 13.3%

Fractures of the femurFractures of the femur 2

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FRACTURILE DIAFIZARE ALE OASELOR ANTEBRATULUI

MECANISM DE PRODUCERE : Traumatisme energie joasa /

medie

Mecanism indirect

Mecanism direct (fracturi de aparare)

Traumatisme de energie inalta

Fractures of the femurFractures of the femur 3

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FRACTURILE DIAFIZARE ALE OASELOR ANTEBRATULUI

Fractures of the femurFractures of the femur 4

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FRACTURILE DIAFIZARE ALE OASELOR ANTEBRATULUI

Fractures of the femurFractures of the femur 5

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Fractures of the femurFractures of the femur 6

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Fractures of the femurFractures of the femur 7

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Fractures of the femurFractures of the femur 8

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Fractures of the femurFractures of the femur 9

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FRACTURILE DIAFIZARE ALE OASELOR ANTEBRATULUI

CLINIC : Inspectie : Deformare regionala Echimoze / escoriatii Fracturi deschise

Palpare : Semne de certitudine ! Cot / Pumn

Semne suferinta neuro / vasculara

! Sdr. De compartiment

Fractures of the femurFractures of the femur 10

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FRACTURILE DIAFIZARE ALE OASELOR ANTEBRATULUI

Investigatii paraclinice: Rx. antebrat F + P (! Cot + Pumn)

Fractures of the femurFractures of the femur 11

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TRATAMENT :

Refacerea raportului de lungime

Refacerea formei

! Reducere anatomica

Fractures of the femurFractures of the femur 12

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Fractures of the femurFractures of the femur 13

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Fractures of the femurFractures of the femur 14

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Fractures of the femurFractures of the femur 15

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Fractures of the femurFractures of the femur 16

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Fractures of the femurFractures of the femur 17

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Fractures of the femurFractures of the femur 18

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Fractures of the femurFractures of the femur 19

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FRACTURILE DIAFIZARE ALE OASELOR ANTEBRATULUI

Complicatii immediate : Fractura deschisa Leziuni neuro – vasculare Interpozitia musculara

Fractures of the femurFractures of the femur 20

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Fractures of the femurFractures of the femur 21

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FRACTURILE DIAFIZARE ALE OASELOR ANTEBRATULUI

Complicatii precoce : Sindromul de compartiment Osteita

Fractures of the femurFractures of the femur 22

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Fractures of the femurFractures of the femur 23

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Fractures of the femurFractures of the femur 24

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Fractures of the femurFractures of the femur 25

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FRACTURILE DIAFIZARE ALE OASELOR ANTEBRATULUI

Complicatii tardive : Pseudartroza Calusul vicios Sinostoza radio – ulnara Sdr. Volkmann Fracturile iterative

Fractures of the femurFractures of the femur 26

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Fractures of the femurFractures of the femur 27

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Fractures of the femurFractures of the femur 28

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Fractures of the femurFractures of the femur 29

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Sinostoza radio - ulnara

Fractures of the femurFractures of the femur 30

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Fractures of the femurFractures of the femur 31

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FRACTURI OLECRAN

Fractures of the femurFractures of the femur 32

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FRACTURI OLECRAN

Fractures of the femurFractures of the femur 33

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FRACTURI OLECRAN

CLINIC : ! Extensie activa cot ! Nv. ulnar

Fractures of the femurFractures of the femur 34

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FRACTURI OLECRAN

Fractures of the femurFractures of the femur 35

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FRACTURI OLECRAN

Fractures of the femurFractures of the femur 36

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FRACTURI OLECRAN

Fractures of the femurFractures of the femur 37

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FRACTURI CAP RADIAL

Fractures of the femurFractures of the femur 38

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Fractures of the femurFractures of the femur 39

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FRACTURI CAP RADIAL

CLINIC : Stabilitate cot ! (valgus) Mobilitate cot

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FRACTURI CAP RADIAL

Fractures of the femurFractures of the femur 41

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Fractures of the femurFractures of the femur 42

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FRACTURA EXTREMITATII DISTALE A RADIUSULUI

Epidemiologie : Cea mai frecventa fractura 2008 : 644985 3 varfuri de incidenta

Fractures of the femurFractures of the femur 43

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Fractures of the femurFractures of the femur 44

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Fracturi extraarticulare :

Colles Goyrand - Smiths

Fractures of the femurFractures of the femur 45

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FRACTURA EXTREMITATII DISTALE A RADIUSULUI

Fracturi partial articulare : fracturile marginale volara / dorsala fractura stiloidei radiale

Fractures of the femurFractures of the femur 46

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Fracturi articulare :

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Fracturi complexe / cominutive :

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Examen radiologic :

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Examen radiologic :

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Fractures of the femurFractures of the femur 51

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Clinic

Fractures of the femurFractures of the femur 53

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Fractures of the femurFractures of the femur 54

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Fractures of the femurFractures of the femur 55

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Fractures of the femurFractures of the femur 56

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Fractures of the femurFractures of the femur 57

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Fractures of the femurFractures of the femur 58

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Complicatii immediate : Fractura deschisa (rar) Leziuni neurologice (rar, Goyrand Smiths)

Fractures of the femurFractures of the femur 59

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FRACTURA EXTREMITATII DISTALE A RADIUSULUI

Complicatii precoce : !!! Sdr. de compartiment Deplasarea secundara sub ap. gipsat

Fractures of the femurFractures of the femur 60

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FRACTURA EXTREMITATII DISTALE A RADIUSULUI

Complicatii tardive : CALUSUL VICIOS Artroza radio - carpiana Redori articulare DISTROFIA REFLEXA SIMPATICA Rupturi tendinoase Pareze in “doi timp” (nv. median – fr. GS)

Fractures of the femurFractures of the femur 61