tapa i frase - UAB Barcelona · Es de sentido común elegir un método y experimentarlo.! Si no...
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Transcript of tapa i frase - UAB Barcelona · Es de sentido común elegir un método y experimentarlo.! Si no...
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Es de sentido común elegir un método y experimentarlo. !
Si no resulta admitirlo sinceramente e intentar otro.
Pero sobre todo intentar algo.
Franklin D.Roosevelt
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Bibliografía
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Anexos
Evaluación Funcional de Gartland y Werley para
Fracturas Distales de Radio
DEFORMIDAD RESIDUAL (0 a 3 puntos)
Estiloides del radio prominente 1
Deformidad con desvio dorsal 2
Desvío radial de la mano 3
EVALUACIÓN SUBJETIVA (0 a 6 puntos)
EXCELENTE ausencia de dolor, sin limitación funcional 0
BUENO Dolor ocasional discreta limitación funcional 2
REGULAR dolor ocasional discreta limitación funcional a los movimientos, con discreta
restricción de las actividades 4
MALO dolor importante, limitación funcional con restricción importante de las actividades 6
EVALUACIÓN OBJETIVA (0 a 5 puntos)
Pérdida de extensión < 45 5
Pérdida de desvío ulnar < 15 3
Pérdida de supinación o pronación < 50 4
Pérdida de flexión < 30 1
Pérdida de desviación radial < 15 1
Pérdida de circunducción 1
Dolor en el radio y cúbito distal al movimiento 1
COMPLICACIONES (0 a 5 puntos)
Alteraciones artríticas
Mínima 1
Mínima con dolor 3
Moderada 2
Moderada con dolor 4
Severa 3
Severa con dolor 5
Complicaciones nerviosas 1 a 3
Función de los dedos limitada durante los movimientos 1 a 2
RESULTADOS
EXCELENTE 0 a 2
BUENO 3 a 8
REGULAR 9 a 20
MALO > a 21
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EVALUACIÓN RADIOLÓGICA
Parámetros Graduación Medidas Puntos
Ángulo Inclinación Excelente 18 a 23 0
radial Bueno 10 a 17 1
Malo < a 10 2
Ángulo inclinación Excelente 6 a 11 0
Volar Bueno 5 a 9 1
Malo negativo 2
Longitud radial Excelente 10 a 13 mm 0
Bueno 5 a 9 mm 1
Malo < a 5 mm 2
RESULTADO
Excelente 0 a 1
Bueno 2 a 3
Malo >a 3
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Tabla de datos
Nº
Pac
ien
te
Ed
ad
NH
C
Dat
a IQ
/dat
a fr
ac e
n e
ls
con
serv
ado
r
Lo
caliz
ació
n
Cla
sifi
caci
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Tra
tam
ien
to
Incl
inac
ión
ED
R (
AP
)
Incl
inac
ión
ED
R
(Vo
lar/
do
rsal
)
Lo
ng
itu
d r
adia
l
Fp
alm
ar/ F
do
rsal
DR
/DC
P/S
Seg
uim
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to (
mes
es)
tiem
po
co
nso
lidac
ión
(sem
anas
)
Co
mp
licac
ion
es
Eva
luac
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fu
nci
on
al
Gar
dtl
and
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y R
esu
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fun
cio
nal
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Eva
luac
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Gar
dtl
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ltad
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rad
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gic
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Das
h
1 M 76 272711 09/10/12 I tipo III DVR 13 3 -5 50/80 40/35 90/90 18 8 No 5-Bueno 5-Malo 47
2 H 63 809575 28/10/12 D tipo I Ortopédico 9 -5 5 60/60 15/15 90/90 7 5 No 4-Bueno 5-Malo 50
3 H 38 265706 10/10/12 I tipo III DVR 16 7 6 70/30 20/30 90/90 24 4 No 7-Bueno 2-Bueno 40
4 H 42 213531 10/10/12 I tipo III DVR 15 8 7 60/60 40/10 90/90 17 6 No 0-Excelente 3-Bueno 28
5 H 36 282369 25/12/12 I tipo I Ortopédico 15 6 7 70/70 40/40 90/90 6 3 No 0-Excelente 3-Bueno 28
6 M 66 508648 18/11/12 I tipo I Agujas K 12 -6 0 30/30 10/0 90/90 4 8 Retraso de
consolidación 13-Regular 5-Malo 51
7 H 75 54158 17/11/12 I tipo I Ortopédico 10 9 4 60/60 30/30 90/90 6 2 No 4-Bueno 4-Malo 45
8 M 80 426114 12/12/12 D tipo I Ortopédico 21 5 7 45/45 15/15 90/90 7 3 No 7-Bueno 2-Bueno 55
9 M 26 347556 26/12/12 I tipo I Ortopédico 14 6 6 80/80 40/40 90/90 6 3 No 0-Excelente 2-Bueno 28
10 M 41 283065 30/12/12 D tipo I Ortopédico 18 4 7 80/90 35/50 90/90 15 5 No 0-Excelente 0-Excelente 29
11 H 63 22967 24/12/12 I tipo IV DVR 10 7 5.3 70/30 oct-34 90/90 24 15 Retraso de
consolidación 3-Bueno 2-Bueno 56
12 H 38 215180 24/12/12 I tipo III DVR 20 11 9 80/80 40/40 90/90 4 6 No 0-Excelente 1-Excelente 28
13 M 83 385946 29/01/13 D tipo III Agujas K 3 3 5 10/0 0/0 90/45 3 8 retraso consolidación
y rigidez 19-Regular 6-Malo 118
14 M 62 65058 14/02/13 I tipo II DVR 23 11 8.38 70/80 30/40 90/90 13 5 No 0-Excelente 1-Excelente 29
15 H 50 733798 06/03/13 I tipo III DVR 19 1 5.6 40/60 20/20 90/70 13 6 Hipoestesia cubital 7-Bueno 4-Malo 58
16 M 25 6076 16/02/13 I tipo I Ortopédico 13 6 6 70/70 30/30 90/90 3 6 No 1-Excelente 3-Bueno 30
17 M 31 663015 20/02/13 I tipo I Agujas K 20 10 7.95 80/80 30/20 90/90 13 5 No 0-Excelente 0-Excelente 29
18 M 23 47188 20/02/13 D tipo II DVR 16 10 8 70/70 20/20 70/80 14 6 Sdr. Tunel carpiano 5-Bueno 2-Bueno 47
19 H 26 14127 20/02/13 I tipo II DVR 17 8 8 40/10 20/20 70/70 12 8 Shudeck 20-Regular 3-Bueno 88
20 M 81 686253 20/02/13 I tipo I Ortopédico 11 3 1 45/45 15/15 70/70 4 7 desplazamiento 2 17-Regular 5-Malo 85
21 M 42 868811 27/02/13 D tipo III Agujas K 20 7 11 60/60 30/30 90/90 2 6 No 0-Excelente 0-Excelente 29
22 M 73 374471 26/02/13 I tipo III Agujas K 17 6 6.18 60/70 45/30 90/90 13 16 Retraso de 0-Excelente 2-Bueno 30
!"#$%&"#'("#)*+()*'%#,( ( ( ( ( ( ( ( -../0-.1.(
2345( ( ((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((677#(89*:&*,,+(;,#&"#)<(
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Nº P
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nte
Ed
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NH
C
Dat
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/dat
a fr
ac e
n e
ls
con
serv
ado
r
Lo
caliz
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Cla
sifi
caci
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Tra
tam
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inac
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AP
)
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inac
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ED
R
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lar/
do
rsal
)
Lo
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itu
d r
adia
l
Fp
alm
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rsal
DR
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P/S
Seg
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to (
mes
es)
tiem
po
co
nso
lidac
ión
(sem
anas
)
Co
mp
licac
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es
Eva
luac
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dtl
and
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fun
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ltad
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rad
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gic
os
Das
h
consolidación
23 M 78 49314 27/02/13 I tipo III Agujas K 14 1 6.30 60/50 20/20 90/90 13 7 No 5-Bueno 4-Malo 59
24 M 50 5595 28/02/13 I tipo II DVR 25 10 9.58 60/50 20/40 90/90 11 8 Shudeck 6-Bueno 0-Excelente 69
25 M 31 383577 05/03/13 I tipo II DVR 17 8 6 45/15 20/20 9090 12 6 Protusión tornillo pendiente RMO
11-Regular 2-Bueno 36
26 H 48 430787 06/03/13 I tipo III DVR 16 0 10,2 70/70 20/50 90/90 12 7 No 0-Excelente 2-Bueno 29
27 M 65 402047 07/03/13 I tipo I Agujas K 15 -2 4,22 60/60 20/30 90/90 12 9 Osteopenia 0-Excelente 5-Malo 29
28 M 56 546023 17/03/13 I tipo I Agujas K 12 -3 5 70/70 40/40 90/90 5 7 No 1-Excelente 4-Malo 28
29 M 71 275774 21/03/13 I tipo III Agujas K 16 1 5 60/70 30/40 90/90 12 8 No 0-Excelente 4-Malo 29
30 H 18 36970 20/03/13 I tipo I Ortopédico 19 7 13 90/90 40/30 90/90 12 5 No 0-Excelente 0-Excelente 29
31 M 16 871576 27/03/13 D tipo II DVR 14 11 9 80/80 30/30 90/90 4 6 No 2-Excelente 2-Bueno 31
32 M 62 669542 02/04/13 E tipo III DVR 12 7 2 50/45 30/20 90/90 3 5 No 4-Bueno 4-Malo 34
33 M 71 29182 30/03/13 D tipo I Agujas K 20 8 9 60/70 45/30 90/90 12 9 Osteoporosis
epifisaria 0-Excelente 1-Excelente 32
34 M 77 45730 30/03/13 I tipo II Ortopédico 14 3 5 35/40 15/15 70/70 13 8 desplazamiento 2 17-Regular 4-Malo 87
35 M 59 69334 17/04/13 E tipo III DVR 14 14 7.28 70/65 40/30 90/90 11 8 No 0-Excelente 2-Bueno 28
36 M 59 391328 23/04/13 D tipo III DVR 17 7 10 60/60 30/30 90/90 15 7 No 1-Excelente 1-Excelente 29
37 M 73 621691 23/04/13 D tipo I Agujas K 14 5 6 45/30 20/20 90/90 3 7 osteopenia 3-Bueno 3-Bueno 31
38 M 66 PR6246 15/04/13 D tipo III DVR 21 9 11 80/60 30/40 90/90 4 6 No 1-Excelente 1-Excelente 29
39 M 74 364088 24/04/13 D tipo III DVR 18 9 8 90/90 45/45 90/90 6 7 No 1-Excelente 1-Excelente 28
40 H 43 827600 07/05/13 D tipo III DVR 15 7 9 70/70 30/25 90/90 11 8 No 0-Excelente 2-Bueno 30
41 M 53 875785 01/05/13 D tipo II DVR 21 14 9,7 50/50 10/20 90/90 11 6 No 4-Bueno 0-Excelente 57
42 M 36 642150 07/05/13 E tipo II DVR 20 5 11 90/90 40/40 90/90 11 6 No 0-Excelente 1-Excelente 28
43 H 29 516376 05/05/13 D tipo II Ortopédico 8 -10 7 30/10 15/15 90/90 2 8 desplazamiento 2 11-Regular 5-Malo 70
44 M 45 555700 08/05/13 D tipo II DVR 17 6 6 75/75 30/40 90/90 7 5 Protusión tornillo 1-Excelente 2-Bueno 29
45 H 63 80714 14/05/13 D tipo IV DVR 9 -7 0 5/5 0/0 45/45 14 8 colapso
radial+protusión 27-Malo 6-Malo 105
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Nº P
acie
nte
Ed
ad
NH
C
Dat
a IQ
/dat
a fr
ac e
n e
ls
con
serv
ado
r
Lo
caliz
ació
n
Cla
sifi
caci
ón
Tra
tam
ien
to
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inac
ión
ED
R (
AP
)
Incl
inac
ión
ED
R
(Vo
lar/
do
rsal
)
Lo
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l
Fp
alm
ar/ F
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rsal
DR
/DC
P/S
Seg
uim
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to (
mes
es)
tiem
po
co
nso
lidac
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anas
)
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mp
licac
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es
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luac
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fu
nci
on
al
Gar
dtl
and
y W
erle
y R
esu
ltad
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fun
cio
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Eva
luac
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Gar
dtl
and
y W
erle
y R
esu
ltad
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Das
h
intraacticular tornillo
46 M 71 230149 16/05/13 D tipo III DVR 11 -7 8 15/40 20/20 90/65 11 6 STC + pseudoartrosis
estoloides cubital 15-Regular 4-Malo 64
47 H 30 6401 15/05/13 E tipo III DVR 14 10 6 60/60 40/30 90/90 12 6 No 0-Excelente 2-Bueno 28
48 M 58 395398 15/05/13 E tipo IV DVR 8 6 3 20/0 0/0 20/10 12 9 Retraso
consolidación+rigidez+desplazamiento 2
29-Malo 5-Malo 82
49 M 54 PR3548 03/01/13 I tipo I Agujas K 16 -3 6 70/70 40/40 90/90 4 6 osteopenia 3-Bueno 3-Bueno 29
50 M 74 211963 22/05/13 D tipo I Agujas K 12 11 7 70/70 40/40 90/90 4 7 No 0-Excelente 2-Bueno 29
51 M 75 PR7379 30/05/13 I tipo III DVR 12 5 4 70/70 30/30 90/90 4 6 No 7-Bueno 3-Bueno 38
52 M 73 28646 18/06/13 D tipo I Agujas K 18 7 7 70/70 40/40 90/90 8 3 No 0-Excelente 1-Excelente 29
53 M 67 533593 20/01/13 D tipo II Ortopédico 19 6 5 50/60 15/15 90/90 5 6 No 4-Bueno 1-Excelente 35
54 M 72 238278 02/07/13 I tipo III DVR 19 0 3 60/60 30/30 80/80 8 8 No 5-Bueno 4-Malo 45
55 H 27 882593 26/06/13 I tipo II DVR 18 7 8 40/60 30/30 90/90 4 7 No 4-Bueno 1-Excelente 33
56 M 77 2010 28/06/13 D tipo I Agujas K 15 0 2 50/60 15/15 70/70 3 8 desplazamiento 2 8-Bueno 5-Malo 40
57 M 71 238278 02/07/13 I tipo III DVR 20 2 4 60/60 20/20 90/90 8 6 No 5-Bueno 4-Malo 40
58 M 17 54763 04/07/13 I tipo I Agujas K 20 6 8 90/90 40/40 90/90 5 5 No 1-Excelente 2-Bueno 30
59 M 85 60123 06/07/13 D tipo I Ortopédico 22 10 6 60/60 20/20 90/90 3 8 No 3-Bueno 1-Excelente 67
60 M 65 PR9519 22/07/13 I tipo II DVR 16 7 3 50/40 20/20 90/90 2 5 No 5-Bueno 4-Malo 47
61 M 62 30399 11/08/13 I tipo III DVR 15 11 6 80/80 30/30 90/90 3 6 No 1-Excelente 2-Bueno 28
62 M 58 116 08/08/13 I tipo II DVR 18 5 4 50/60 20/20 90/90 5 6 No 3-Bueno 3-Bueno 36
63 M 51 662848 15/08/13 D tipo III DVR 14 8 7 50/60 20/20 90/90 4 6 No 2-Excelente 3-Bueno 46
64 M 51 662848 15/08/13 I tipo III DVR 15 7 5 50/50 20/20 90/90 4 6 No 3-Bueno 3-Bueno 40
65 H 55 891709 14/08/13 I tipo IV DVR 14 6 5 50/80 40/40 90/90 4 8 No 2-Excelente 3-Bueno 35
66 M 79 32141 10/08/13 I tipo I Ortopédico 12 -5 4 30/30 15/15 70/70 3 6 desplazamiento 2 9-Regular 5-Malo 80
67 M 66 18718 08/08/13 D tipo IV DVR 16 25 3 80/60 20/20 90/90 11 8 desplazamiento 2 9-Regular 5-Malo 50
68 H 37 536325 26/08/13 I tipo II DVR 18 5 8 30/0 20/20 70/70 8 6 Protusión tornillo 16-Regular 2-Bueno 49
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Nº P
acie
nte
Ed
ad
NH
C
Dat
a IQ
/dat
a fr
ac e
n e
ls
con
serv
ado
r
Lo
caliz
ació
n
Cla
sifi
caci
ón
Tra
tam
ien
to
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inac
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ED
R (
AP
)
Incl
inac
ión
ED
R
(Vo
lar/
do
rsal
)
Lo
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adia
l
Fp
alm
ar/ F
do
rsal
DR
/DC
P/S
Seg
uim
ien
to (
mes
es)
tiem
po
co
nso
lidac
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luac
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and
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luac
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on
al
Gar
dtl
and
y W
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y R
esu
ltad
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rad
ioló
gic
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Das
h
69 H 45 54957 19/08/13 I tipo II DVR 15 6 7 80/80 30/40 90/90 3 6 No 0-Excelente 3-Bueno 28
70 M 36 24748 24/08/13 I tipo I Agujas K 12 8 5 70/70 40/40 90/90 7 8 No 0-Excelente 2-Bueno 28
71 H 27 371864 31/08/13 D tipo III DVR 16 5 8 70/70 30/30 90/90 11 5 No 2-Excelente 3-Bueno 29
72 M 66 36778 23/08/13 D tipo II Ortopédico 16 5 6 70/70 30/30 90/90 4 8 No 7-Bueno 2-Bueno 48
73 H 58 45275 25/08/13 I tipo III DVR 17 5 7 60/60 30/30 90/90 5 9 Retraso
consolidación 5-Bueno 2-Bueno 32
74 M 41 350193 16/09/13 D tipo II DVR 13 5 6 70/45 30/30 90/90 6 8 No 5-Bueno 3-Bueno 33
75 M 73 418202 07/09/13 D tipo I Ortopédico 15 2 5 30/30 10/10 90/90 3 7 No 12-Regular 4-Malo 68
76 M 71 90108 15/04/13 D tipo II DVR 20 8 8 70/60 20/40 90/90 6 3 No 2-Excelente 2-Bueno 32
77 M 86 360514 24/09/13 I tipo III Agujas K 16 -3 3 20/45 15/15 70/70 2 8 retraso consolidación
y rigidez 15-Regular 5-Malo 102
78 H 59 624578 11/07/2208 I tipo I Agujas K 18 6 5 40/50 30/30 75/90 14 8 Dolor residual y
rigidez 9-Regular 2-Bueno 46
79 H 79 262644 24/09/13 D tipo II Ortopédico 17 2 6 30/30 10/10 70/70 3 8 desplazamiento 2 16-Regular 4-Malo 85
80 M 65 285790 27/09/13 D Tipo II Agujas K 16 -3 5 70/70 40/40 90/90 4 7 No 3-Bueno 4-Malo 35
81 M 65 18890 28/09/13 D tipo I Agujas K 16 1 4 60/60 30/30 90/90 4 7 No 7-Bueno 5-Malo 42
82 H 29 516376 05/05/13 D tipo II Ortopédico 13 10 6 45/60 20/20 70/70 3 8 No 7-Bueno 2-Bueno 42
83 H 17 910098 11/12/13 D tipo III DVR 21 6 8 80/80 30/50 90/90 4 5 No 1-Excelente 2-Bueno 32
84 M 64 388301 03/01/14 D tipo I Agujas K 17 10 4 70/70 40/40 90/90 3 6 No 10-Regular 3-Bueno 37
85 M 77 247428 05/01/14 I tipo I Agujas K 14 5 2 60/40 20/30 90/90 6 8 No 5-Bueno 4-Malo 30
86 H 22 865356 05/01/13 I tipo I Ortopédico 19 7 7 40/60 30/30 90/90 2 7 No 5-Bueno 1-Excelente 35
87 H 55 65660 06/01/14 D tipo III DVR 21 2 10 70/50 20/20 90/90 3 6 No 3-Bueno 2-Bueno 33
88 M 50 10252 07/01/14 D tipo II DVR 23 6 9 70/70 30/30 90/90 5 5 No 1-Excelente 2-Bueno 31
89 H 31 613843 14/01/14 D tipo II DVR 21 8 8 80/80 30/30 90/90 3 5 No 0-Excelente 1-Excelente 29
90 M 88 828136 12/01/14 D tipo III Agujas K 5 -7 2 30/40 15/15 90/90 6 8 desplazamiento 2 16-Regular 6-Malo 95
91 H 47 296883 19/01/14 D tipo II DVR 16 6 8 70/45 20/30 90/80 4 6 No 2-Excelente 3-Bueno 31
92 M 53 53248 28/01/14 D tipo III DVR 14 2 5 80/80 30/30 90/90 3.5 6 No 0-Excelente 4-Malo 32
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Nº P
acie
nte
Ed
ad
NH
C
Dat
a IQ
/dat
a fr
ac e
n e
ls
con
serv
ado
r
Lo
caliz
ació
n
Cla
sifi
caci
ón
Tra
tam
ien
to
Incl
inac
ión
ED
R (
AP
)
Incl
inac
ión
ED
R
(Vo
lar/
do
rsal
)
Lo
ng
itu
d r
adia
l
Fp
alm
ar/ F
do
rsal
DR
/DC
P/S
Seg
uim
ien
to (
mes
es)
tiem
po
co
nso
lidac
ión
(sem
anas
)
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mp
licac
ion
es
Eva
luac
ión
fu
nci
on
al
Gar
dtl
and
y W
erle
y R
esu
ltad
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fun
cio
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luac
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fu
nci
on
al
Gar
dtl
and
y W
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y R
esu
ltad
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rad
ioló
gic
os
Das
h
93 H 37 235259 04/02/14 I tipo IV DVR 18 4 8 60/70 30/30 90/90 3 6 Disestesias
eminencia tenar 3-Bueno 3-Bueno 35
94 M 69 233020 04/02/14 I tipo III DVR 17 6 9 60/40 25/20 90/90 4 7 desplazamiento 2 11-Regular 3-Bueno 41
95 M 79 396204 11/12/13 I tipo II Ortopédico 20 6 2 45/60 20/20 70/70 4.5 8 No 7-Bueno 3-Bueno 41
96 M 76 381661 04/03/14 I tipo III Agujas K 13 5 4 40/45 15/15 90/90 2 6 No 7-Bueno 4-Malo 46
97 M 67 768928 05/03/14 I tipo II Agujas K 7 7 2 45/45 15/15 90/90 5 6 Desplazamiento 2 8-Bueno 4-Malo 61
98 M 38 252986 05/03/14 I tipo I Ortopédico 17 10 7 90/90 40/40 90/90 2 6 No 0-Excelente 2-Bueno 29
99 H 49 595838 13/03/14 D tipo III Agujas K 13 3 4 45/45 15/15 90/90 3 6 No 7-Bueno 5-Malo 57
100 M 39 17427 19/03/14 D tipo III DVR 20 6 5 70/70 30/30 90/90 3 6 No 4-Bueno 2-Bueno 33
101 M 30 279513 01/04/14 I tipo IV DVR 23 3 8 70/60 20/40 90/90 4 4 No 1-Excelente 3-Bueno 31
102 M 66 2854 04/04/14 I tipo II DVR 21 8 7 60/60 30/30 90/90 5 7 No 4-Bueno 2-Bueno 32
103 M 69 54312 08/04/14 I tipo II DVR 19 5 4 60/60 20/20 90/90 3 6 No 4-Bueno 3-Bueno 39
104 M 94 23168 09/04/14 I tipo I Ortopédico 20 8 7 45/45 15/15 70/70 2 8 No 8-Regular 2-Bueno 76
105 M 67 22684 14/04/14 I tipo III DVR 10 4 4 50/50 20/20 80/80 3 6 No 7-Bueno 5-Malo 43
106 H 65 PR18520 23/04/14 I tipo II Agujas K 21 10 6 30/30 15/15 80/80 2 8 No 7-Bueno 0-Excelente 45
107 M 50 853520 23/04/14 D tipo I Agujas K 15 6 8 45/45 15/15 90/90 2 7 No 7-Bueno 2-Bueno 56
108 M 71 450503 21/04/14 I tipo I Agujas K 22 3 5 30/30 15/15 90/90 2 6 No 12-Regular 3-Bueno 57
109 H 23 2131 06/05/14 I tipo III DVR 23 3 8 45/45 15/15 80/80 2 5 No 7-Bueno 3-Bueno 44
110 M 77 308094 05/05/14 I tipo II Agujas K 18 1 7 30/30 11-oct 75/75 2 8 Osteopenia, colapso
cubital 16-Regular 3-Bueno 67
111 H 43 235337 14/05/14 D tipo II DVR 20 10 8 80/80 30/30 90/90 2 4 No 0-Excelente 1-Excelente 34
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