Mendrisio Medical Meeting 2015_La giornata ortopedica
-
Upload
dr-med-ivan-tami -
Category
Health & Medicine
-
view
102 -
download
1
Transcript of Mendrisio Medical Meeting 2015_La giornata ortopedica
![Page 1: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/1.jpg)
Ivan TamiCentro manoegomito
Clinica Ars Medica – Gravesano
![Page 2: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/2.jpg)
LE FRATTURE DELLO SCAFOIDE CARPALE E LE
LORO CONSEGUENZE
La Giornata OrtopedicaMendrisio Medical Meeting 11.06.2015
![Page 3: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/3.jpg)
Introduzione
Fratture scafoide carpale70%
di tutte le fratture del carpo
![Page 4: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/4.jpg)
Caso clinico
- Paziente 16 anni
- Trauma febbraio 2015
- Immobilizzazione dp trauma per 3 settimane
- Dolori polso sx
![Page 5: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/5.jpg)
Anamnesi
![Page 6: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/6.jpg)
Anamnesi
![Page 7: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/7.jpg)
Anamnesi
![Page 8: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/8.jpg)
- Dolenzia tabacchiera anatomica
- Dolenzia tubercolo scafoide
- Dolenzia tra scafoide e semilunare
- Mobilità ridotta di pollice e polso
Esame clinicoTabacchiera anatomica
Tubercolo scafoide
![Page 9: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/9.jpg)
Diagnostica: radiografie
- PA o AP
- Laterale
- Obliqua
- PA o AP in deviazione ulnare
![Page 10: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/10.jpg)
Diagnostica: radiografie
- PA o AP
- Laterale
- Obliqua
- PA o AP in deviazione ulnare
![Page 11: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/11.jpg)
Diagnostica: radiografie
![Page 12: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/12.jpg)
Diagnostica
![Page 13: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/13.jpg)
Diagnostica: artroscopia
![Page 14: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/14.jpg)
Terapia
![Page 15: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/15.jpg)
• Terapia conservativa:– 1/3 distale +/- 1/3 prossimale– buon allineamento– diastasi < 2mm
Immobilizzazione
per 6-8 settimane
Terapia
![Page 16: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/16.jpg)
• Terapia conservativa:– 1/3 distale +/- 1/3 prossimale– buon allineamento– diastasi < 2mm
Immobilizzazione
per 6-8 settimane
Terapia
![Page 17: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/17.jpg)
Terapia
• Indicazione chirurgica:– malallineamento– diastasi > 2mm– fratture 1/3 centrale e
polo prossimale– frattura con lesioni
associate
(radio, leg. SL, …)
![Page 18: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/18.jpg)
• Tecnica chirurgica:– mini incisione
palmare o dorsale– vite canulata
Terapia
![Page 19: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/19.jpg)
• Riabilitazione:– tutore amovibile– terapia funzionale– fisio-/ergoterapia
Terapia
![Page 20: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/20.jpg)
Ricostruzione scafoide carpale
- Pseudoartrosi
- Delayed union
- Non union
- Mal union
![Page 21: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/21.jpg)
Ricostruzione: innesto osseo da…
- metafisi radio- cresta iliaca
![Page 22: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/22.jpg)
Ricostruzione: innesto osseo da…
- metafisi radio- cresta iliaca
![Page 23: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/23.jpg)
Ricostruzione: innesto osseo da…
- metafisi radio- cresta iliaca
![Page 24: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/24.jpg)
Ricostruzione: innesto vascolarizzato da…
- metafisi radio- condilo femore- cresta iliaca
![Page 25: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/25.jpg)
Ricostruzione: innesto vascolarizzato da…
- metafisi radio- condilo femore- cresta iliaca
![Page 26: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/26.jpg)
Ricostruzione: necrosi polo prossimale
![Page 27: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/27.jpg)
Ricostruzione: necrosi polo prossimale
![Page 28: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/28.jpg)
Ricostruzione: protesi polo prossimale
![Page 29: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/29.jpg)
Ricostruzione: protesi polo prossimale
![Page 30: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/30.jpg)
SNACSNAC
Procedure di salvataggio
Scaphoid Nonunion Advance Collapse
![Page 31: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/31.jpg)
Procedure di salvataggio
![Page 32: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/32.jpg)
Procedure di salvataggio: SNAC ILl
llllll
llllll
l
- Denervazione
- Stiloidectomia radio
![Page 33: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/33.jpg)
Procedure di salvataggio: denervazione
![Page 34: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/34.jpg)
Procedure di salvataggio: stiloidectomia
![Page 35: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/35.jpg)
Procedure di salvataggio: SNAC IILl
llllll
llllll
l
- Denervazione
- Resezione I filiera
- A’desi 4 angoli
![Page 36: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/36.jpg)
DenervazioneProcedure di salvataggio: resezione I filiera
![Page 37: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/37.jpg)
DenervazioneProcedure di salvataggio: artrodesi 4 angoli
![Page 38: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/38.jpg)
Procedure di salvataggio: SNAC IIILl
llllll
llllll
l
- Denervazione
- A’desi luno capitata
- A’desi 4 angoli
![Page 39: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/39.jpg)
Procedure di salvataggio: SNAC IVLl
llllll
llllll
l
- Denervazione
- Panartrodesi polso
- Protesi polso
![Page 40: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/40.jpg)
DenervazioneProcedure di salvataggio: panartrodesi
![Page 41: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/41.jpg)
DenervazioneProcedure di salvataggio: panartrodesi
![Page 42: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/42.jpg)
DenervazioneProcedure di salvataggio: protesi
![Page 43: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/43.jpg)
Caso clinico
- Paziente 16 anni
- Trauma febbraio 2015
- Immobilizzazione dp trauma per 3 settimane
- Dolori polso sx
Come procedere?
![Page 44: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/44.jpg)
Conclusione
![Page 45: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/45.jpg)
Grazie per l'attenzione!
![Page 46: Mendrisio Medical Meeting 2015_La giornata ortopedica](https://reader038.fdocument.pub/reader038/viewer/2022102816/55be6b6fbb61eb7c5a8b470c/html5/thumbnails/46.jpg)
www.manoegomito.ch