Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients

Detalhes bibliográficos
Autor(a) principal: Gonzalez, Vinícius Leite
Data de Publicação: 2009
Outros Autores: Santin, Edgar, Arsego, Felipe Véras, Silva, Gustavo da Rosa, Zimmermann Júnior, José Mauro, de Vasconcellos, Luiz Felipe Teer, Costa, Matheus Brun, Ledur, Tiago Ribeiro
Tipo de documento: Artigo
Idioma: por
Título da fonte: Clinical and Biomedical Research
Texto Completo: https://seer.ufrgs.br/index.php/hcpa/article/view/2984
Resumo: As soon as the initial assesment is completed, with performance of the basic manouvers from ATLS® (Advanced Trauma Life Support), the management of exposed fractures stands among the priorities in the orthopaedic care of the multiple injured pacient. Vigorous washing, proper debrising, antitetanic vaccine and early broad-spectrum antibiotic therapy are cornerstones for their suitable management. Pelvis and hip fractures, often related to high energy trauma, are the only ones that can cause early mortality because of retroperitoneal bleeding, meaning emergency in Traumatology. Lower limb fractures presents with high mortality rates, and the tibia’s are known as the most frequent among those exposed and those in long bones. Despite the femur fractures are less frequent, they use to leave more severe sequelae. Unlike these, scapula, clavicle, radius and ulna fractures receive simple reduction and immobilization, requiring surgical intervention only in particular cases. The radiologic evaluation in multiple trauma pacients should never intefere or postpone the reanimation manouvers. Two orthogonal radiographic incidences are usually enough to visualize most of the orthopaedic injuries. Additional imaging modalities are usually save for later evaluation of more complex injuries and anatomic structures.
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spelling Diagnosis and Management of Orthopaedic Injuries in Politraumatized PatientsDiagnóstico e Manejo das Lesões Ortopédicas em Pacientes PolitraumatizadosOrtopediaFraturasPolitraumatizadosortopediaAs soon as the initial assesment is completed, with performance of the basic manouvers from ATLS® (Advanced Trauma Life Support), the management of exposed fractures stands among the priorities in the orthopaedic care of the multiple injured pacient. Vigorous washing, proper debrising, antitetanic vaccine and early broad-spectrum antibiotic therapy are cornerstones for their suitable management. Pelvis and hip fractures, often related to high energy trauma, are the only ones that can cause early mortality because of retroperitoneal bleeding, meaning emergency in Traumatology. Lower limb fractures presents with high mortality rates, and the tibia’s are known as the most frequent among those exposed and those in long bones. Despite the femur fractures are less frequent, they use to leave more severe sequelae. Unlike these, scapula, clavicle, radius and ulna fractures receive simple reduction and immobilization, requiring surgical intervention only in particular cases. The radiologic evaluation in multiple trauma pacients should never intefere or postpone the reanimation manouvers. Two orthogonal radiographic incidences are usually enough to visualize most of the orthopaedic injuries. Additional imaging modalities are usually save for later evaluation of more complex injuries and anatomic structures.Concluído o atendimento inicial com a realização das manobras básicas preconizadas pelo ATLS® (Advanced Trauma Life Support), o manejo das fraturas expostas figura entre as prioridades no atendimento inicial ortopédico em politraumatizados. Lavagem abundante, desbridamento adequado, profilaxia antitetânica e antibioticoterapia intravenosa precoce e de amplo espectro são fundamentais para o adequado manejo das mesmas. Fraturas da pelve e do quadril, francamente relacionadas a traumas de alta energia, são as únicas que, por estarem ligadas a grandes sangramentos retroperitoniais, podem levar ao óbito logo após o trauma, configurando emergências traumatológicas. As fraturas em membro inferior apresentam alta morbidade, sendo as de tíbia as consideradas mais frequentes dentre as expostas e em ossos longos. Embora as de fêmur se apresentem com menor frequência, acabam por deixar sequelas mais importantes. Diferentemente destas, as fraturas de escápula, clavícula, rádio e ulna podem receber um manejo simples de redução e contenção, requerendo apenas em casos particulares de intervenções cirúrgicas. A avaliação radiológica no politraumatizado jamais deve interromper as manobras de reanimação. Duas incidências radiográficas ortogonais costumam ser suficientes para a visualização de lesões ortopédicas. Outros exames normalmente ficam reservados para um segundo tempo do atendimento na avaliação de estruturas e lesões de maior complexidade.HCPA/FAMED/UFRGS2009-08-26info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-reviewed ArticleAvaliados por Paresapplication/pdfhttps://seer.ufrgs.br/index.php/hcpa/article/view/2984Clinical & Biomedical Research; Vol. 29 No. 2 (2009): Revista HCPAClinical and Biomedical Research; v. 29 n. 2 (2009): Revista HCPA2357-9730reponame:Clinical and Biomedical Researchinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSporhttps://seer.ufrgs.br/index.php/hcpa/article/view/2984/5806Gonzalez, Vinícius LeiteSantin, EdgarArsego, Felipe VérasSilva, Gustavo da RosaZimmermann Júnior, José Maurode Vasconcellos, Luiz Felipe TeerCosta, Matheus BrunLedur, Tiago Ribeiroinfo:eu-repo/semantics/openAccess2020-01-16T16:20:25Zoai:seer.ufrgs.br:article/2984Revistahttps://www.seer.ufrgs.br/index.php/hcpaPUBhttps://seer.ufrgs.br/index.php/hcpa/oai||cbr@hcpa.edu.br2357-97302357-9730opendoar:2020-01-16T16:20:25Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)false
dc.title.none.fl_str_mv Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients
Diagnóstico e Manejo das Lesões Ortopédicas em Pacientes Politraumatizados
title Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients
spellingShingle Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients
Gonzalez, Vinícius Leite
Ortopedia
Fraturas
Politraumatizados
ortopedia
title_short Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients
title_full Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients
title_fullStr Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients
title_full_unstemmed Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients
title_sort Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients
author Gonzalez, Vinícius Leite
author_facet Gonzalez, Vinícius Leite
Santin, Edgar
Arsego, Felipe Véras
Silva, Gustavo da Rosa
Zimmermann Júnior, José Mauro
de Vasconcellos, Luiz Felipe Teer
Costa, Matheus Brun
Ledur, Tiago Ribeiro
author_role author
author2 Santin, Edgar
Arsego, Felipe Véras
Silva, Gustavo da Rosa
Zimmermann Júnior, José Mauro
de Vasconcellos, Luiz Felipe Teer
Costa, Matheus Brun
Ledur, Tiago Ribeiro
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Gonzalez, Vinícius Leite
Santin, Edgar
Arsego, Felipe Véras
Silva, Gustavo da Rosa
Zimmermann Júnior, José Mauro
de Vasconcellos, Luiz Felipe Teer
Costa, Matheus Brun
Ledur, Tiago Ribeiro
dc.subject.por.fl_str_mv Ortopedia
Fraturas
Politraumatizados
ortopedia
topic Ortopedia
Fraturas
Politraumatizados
ortopedia
description As soon as the initial assesment is completed, with performance of the basic manouvers from ATLS® (Advanced Trauma Life Support), the management of exposed fractures stands among the priorities in the orthopaedic care of the multiple injured pacient. Vigorous washing, proper debrising, antitetanic vaccine and early broad-spectrum antibiotic therapy are cornerstones for their suitable management. Pelvis and hip fractures, often related to high energy trauma, are the only ones that can cause early mortality because of retroperitoneal bleeding, meaning emergency in Traumatology. Lower limb fractures presents with high mortality rates, and the tibia’s are known as the most frequent among those exposed and those in long bones. Despite the femur fractures are less frequent, they use to leave more severe sequelae. Unlike these, scapula, clavicle, radius and ulna fractures receive simple reduction and immobilization, requiring surgical intervention only in particular cases. The radiologic evaluation in multiple trauma pacients should never intefere or postpone the reanimation manouvers. Two orthogonal radiographic incidences are usually enough to visualize most of the orthopaedic injuries. Additional imaging modalities are usually save for later evaluation of more complex injuries and anatomic structures.
publishDate 2009
dc.date.none.fl_str_mv 2009-08-26
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-reviewed Article
Avaliados por Pares
format article
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dc.identifier.uri.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/2984
url https://seer.ufrgs.br/index.php/hcpa/article/view/2984
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/2984/5806
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv HCPA/FAMED/UFRGS
publisher.none.fl_str_mv HCPA/FAMED/UFRGS
dc.source.none.fl_str_mv Clinical & Biomedical Research; Vol. 29 No. 2 (2009): Revista HCPA
Clinical and Biomedical Research; v. 29 n. 2 (2009): Revista HCPA
2357-9730
reponame:Clinical and Biomedical Research
instname:Universidade Federal do Rio Grande do Sul (UFRGS)
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instname_str Universidade Federal do Rio Grande do Sul (UFRGS)
instacron_str UFRGS
institution UFRGS
reponame_str Clinical and Biomedical Research
collection Clinical and Biomedical Research
repository.name.fl_str_mv Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)
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