“Guía básica para el diagnóstico de la patología traumática aguda

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“Guía básica para el diagnóstico de la patología
traumática aguda de la extremidad superior mediante
radiología simple
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Iglesias Hidalgo, Gotzon; Carreras Aja, Magdalena; Iturre Salinas,
Begoña; Gil Martín, Ana Rosa; Cortazar Uribasterra, Oihane; Barredo
Parra, Jennifer.
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Tabla 2. COMO DESCRIBIR UNA FRACTURA
General
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Localización: Se
divide la diáfisis
de un hueso largo
en tercios:
-Proximal
-Medio
-Distal
Fractura del tercio distal
Línea de fractura:
-Transversal:
Perpendicular al
eje
longitudinal
del hueso
-Oblicua: Con un
ángulo de 90º
respecto al eje
longitudinal
-Espiroidea: Curva
y espiral a lo largo
del hueso
Conminuta: más
de dos fragmentos
Impactación: Un
fragmento queda
introducido en el
otro
Intraarticular:
Con afectación de
la
superficie
articular
Posición
Deformidad
-Ninguna
-Desplazamiento:
es
decir,
los
extremos óseos se
han desviado entre
sí, la dirección del
desplazamiento se
describe
con
referencia a la
posición
del
fragmentos distal.
Angulación
-Puede describirse
bien en referencia
a la dirección a la
que apunta el ápex
de la fractura o
indicando
la
dirección
de
angulación
del
fragmento distal
Fractura del tercio proximal
Transversal
Espiroidea
Oblicua
Conminuta
No desplazada
Intraarticular
Desplazamiento lateral
Angulación posterior del fragmento distal
Angulación lateral del fragmento distal
Angulación medial del fragmento distal
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Tabla 3. Lesión de los ligamentos que fijan la escápula a la clavícula
Grado
de Lesión
Hallazgos radiológicos
lesión
I
Elongación o rotura parcial Normal o pequeño escalón en
del
ligamento la articulación AC
acromioclavicular
(AC),
pero
los
ligamentos
coracoclaviculares intactos.
II
Rotura del ligamento AC y Escalón en la articulación
elongación
de
los AC:
pueden
requerirse
ligamentos
proyecciones de estrés si es
coracoclaviculares
dudoso
III
Rotura de los ligamentos Un escalón en la articulación
acromioclaviculares y rotura AC. Distancia aumentada
de
los
ligamentos coracoclavicular (>1,3 mm).
coracoclaviculares
Pueden
requerirse
proyecciones de estrés para
demostrar
la
extensión
completa de las lesiones.
Tratamiento habitual
Conservador
Conservador
quirúrgico
Quirúrgico
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Tabla 4. Los centros de osificación del codo.
Edad
aproximada
de Secuencia más habitual
aparición
Nacimiento
Cóndilo
Cabeza radal
Epictróclea
Tróclea
Olécranon
12 años
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Tabla 7. FRACTURAS
RECONOCER
FÁCILES
DE
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Fractura de Colles
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