Diagnosis and Management of Orthopaedic Injuries in Politraumatized Patients
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Outros Autores: | , , , , , , |
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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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 |
status_str |
publishedVersion |
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) instacron:UFRGS |
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) |
repository.mail.fl_str_mv |
||cbr@hcpa.edu.br |
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1799767051258036224 |