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2020 > 7 - Fx colo fêmur > Flashcards

7 - Fx colo fêmur Flashcards

1
Q

Anatomia vascular?

A

A femoral -> A circunflexa femoral medial -> Vasos capsulares

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2
Q

Angulação cervico-diafisária?

A

135 graus

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3
Q

Fatores de risco?

A

Comprimento do eixo quadril aumentado
Inserções musculares fracas
Osteoporose

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4
Q

Angulação da anteversão femoral?

A

15 graus

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5
Q

Epidemiologia: _% são desviadas

A

85% (alto risco NAV)

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6
Q

Radiografias?

A

AP bacia

Perfil coxofemural

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7
Q

Garden 1?

A

Incompleta

Impactada em valgo (estável)

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8
Q

Garden 2?

A 
Completa
Sem desvio (estável)
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9
Q

Garden 3?

A

Completa
Cabeça mantém contato com colo
Desvio em varo (instável)

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10
Q

Garden 4?

A

Completa
Cabeça sem contato com colo
Desviada (translação proximal da diáfise)

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11
Q

AO 31B1?

A

Subcapital

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12
Q

AO 31B2?

A

Transcervical

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13
Q

AO 31B3?

A

Basocervical (prognóstico melhor, irrigação arterial)

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14
Q

Tto: Garden 1/2?

A

Parafusos canulados / DHS

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15
Q

Tto: Garden 3/4, <60a, ativo, jovem?

A

Redução em forma S + Fixação percutânea

  • AP 160 graus (preferência valgo)
  • Perfil 180 graus
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16
Q

Tto: Garden 3/4, 40-60a, independente, osteoporose/comorbidades?

A

ATQ

17
Q

Tto: Garden 3/4, 40-60a, abuso álcool, osteoporose, mais debilitado?

A

Hemiartroplastia bipolar

18
Q

Tto: Garden 3/4, >60a, independente, sem deficit cognitivo?

A

ATQ

19
Q

Tto: Garden 3/4, >60a, independente, pouco deficit cognitivo?

A

Hemiartroplastia bipolar

20
Q

Vias de acesso para artroplastias do quadril?

A

Anterior (Smith Peterson)
Anterolateral (Watson Jones)
Lateral (Hardinger)
Posterior (Kocher Langenbach)

21
Q

Nuances da via posterior?

A

Acesso mais fácil

Maior chance de lx posterior

22
Q

Nuances da via anterior?

A

Acesso mais difícil

Menor chance de lx posterior

23
Q

Passos da via posterior?

A

Decúbito lateral, RI
Palpar TM, dividir em 3 terços
Fáscia lata -> mm rotadores internos, tenotomia
Cápsula articular

24
Q

Complicações?

A 
Mortalidade (50% em 1 ano)
Pseudoartrose (7-50%, na ausência intervenção)
NAV (24%)
Lx prótese
Infecção

2020 (14 decks)

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