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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 Epicóndilo lateral

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