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“Guía básica para el diagnóstico de la patología traumática aguda de la extremidad superior mediante radiología simple !

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 Localización: Se divide la diáfisis de un hueso largo en tercios: -Proximal -Medio -Distal

Fractura del tercio distal

Fractura del tercio proximal

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

Transversal

Oblicua

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Conminuta: más de dos fragmentos

Impactación: Un fragmento queda introducido en el otro Intraarticular: Con afectación de la superficie articular

Conminuta

Intraarticular

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.

No desplazada

Desplazamiento lateral

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

Angulación lateral del fragmento distal

Angulación medial del fragmento distal

Angulación posterior del fragmento distal

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Tabla 3. Lesión de los ligamentos que fijan la escápula a la clavícula Grado de lesión

Lesión Hallazgos radiológicos Tratamiento habitual

I Elongación o rotura parcial del ligamento acromioclavicular (AC), pero los ligamentos coracoclaviculares intactos.

Normal o pequeño escalón en la articulación AC

Conservador

II Rotura del ligamento AC y elongación de los ligamentos coracoclaviculares

Escalón en la articulación AC: pueden requerirse proyecciones de estrés si es dudoso

Conservador o quirúrgico

III Rotura de los ligamentos acromioclaviculares y rotura de los ligamentos coracoclaviculares

Un escalón en la articulación AC. Distancia aumentada coracoclavicular (>1,3 mm). Pueden requerirse proyecciones de estrés para demostrar la extensión completa de las lesiones.

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!Tabla 4. Los centros de osificación del codo. Edad aproximada de aparición

Secuencia más habitual

Nacimiento 12 años

Cóndilo Cabeza radal Epictróclea Tróclea Olécranon Epicóndilo lateral

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Tabla 7. FRACTURAS FÁCILES DE RECONOCER Desplazamiento posterior del fragmento distal. Fractura de Colles

Desplazamiento anterior del fragmento distal. Fractura de Smith

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