{"id":29652,"date":"2012-08-20T03:05:52","date_gmt":"2012-08-20T02:05:52","guid":{"rendered":"http:\/\/www.cirurgiavet.com\/web\/?p=29652"},"modified":"2019-01-20T03:21:45","modified_gmt":"2019-01-20T03:21:45","slug":"fratura-cominutiva-do-umero","status":"publish","type":"post","link":"http:\/\/www.cirurgiavet.com\/web\/fratura-cominutiva-do-umero\/","title":{"rendered":"Fratura cominutiva do \u00famero"},"content":{"rendered":"<p>[et_pb_section bb_built=&#8221;1&#8243; _builder_version=&#8221;3.0.47&#8243; custom_padding=&#8221;0px|0px|20.6563px|0px&#8221; next_background_color=&#8221;#000000&#8243;][et_pb_row admin_label=&#8221;row&#8221; custom_padding=&#8221;40px|||&#8221; column_padding_mobile=&#8221;on&#8221; background_position_1=&#8221;top_left&#8221; background_repeat_1=&#8221;no-repeat&#8221; _builder_version=&#8221;3.0.51&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_cta admin_label=&#8221;CASOS CL\u00cdNICOS &#8211; TRAUMATOLOGIA (n\u00e3o editar)&#8221; title=&#8221;CASOS CL\u00cdNICOS &#8211; TRAUMATOLOGIA&#8221; _builder_version=&#8221;3.19.4&#8243; use_background_color=&#8221;off&#8221; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; background_layout=&#8221;light&#8221; saved_tabs=&#8221;all&#8221; button_text_size__hover_enabled=&#8221;off&#8221; button_text_size__hover=&#8221;null&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_one_text_size__hover=&#8221;null&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover=&#8221;null&#8221; button_text_color__hover_enabled=&#8221;off&#8221; button_text_color__hover=&#8221;null&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_one_text_color__hover=&#8221;null&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover=&#8221;null&#8221; button_border_width__hover_enabled=&#8221;off&#8221; button_border_width__hover=&#8221;null&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_one_border_width__hover=&#8221;null&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover=&#8221;null&#8221; button_border_color__hover_enabled=&#8221;off&#8221; button_border_color__hover=&#8221;null&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_one_border_color__hover=&#8221;null&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover=&#8221;null&#8221; button_border_radius__hover_enabled=&#8221;off&#8221; button_border_radius__hover=&#8221;null&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover=&#8221;null&#8221; button_two_border_radius__hover_enabled=&#8221;off&#8221; button_two_border_radius__hover=&#8221;null&#8221; button_letter_spacing__hover_enabled=&#8221;off&#8221; button_letter_spacing__hover=&#8221;null&#8221; button_one_letter_spacing__hover_enabled=&#8221;off&#8221; button_one_letter_spacing__hover=&#8221;null&#8221; button_two_letter_spacing__hover_enabled=&#8221;off&#8221; button_two_letter_spacing__hover=&#8221;null&#8221; button_bg_color__hover_enabled=&#8221;off&#8221; button_bg_color__hover=&#8221;null&#8221; button_one_bg_color__hover_enabled=&#8221;off&#8221; button_one_bg_color__hover=&#8221;null&#8221; button_two_bg_color__hover_enabled=&#8221;off&#8221; button_two_bg_color__hover=&#8221;null&#8221; \/][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section bb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; _builder_version=&#8221;3.19.4&#8243; custom_padding=&#8221;0px|50px|50px|50px&#8221; prev_background_color=&#8221;#000000&#8243; next_background_color=&#8221;#000000&#8243;][et_pb_fullwidth_post_title admin_label=&#8221;T\u00cdTULO (n\u00e3o editar)&#8221; author=&#8221;off&#8221; categories=&#8221;off&#8221; comments=&#8221;off&#8221; featured_image=&#8221;off&#8221; _builder_version=&#8221;3.19.4&#8243; title_font_size=&#8221;36px&#8221; title_all_caps=&#8221;off&#8221; custom_margin=&#8221;0px||0px|&#8221; custom_padding=&#8221;0px|||&#8221; \/][\/et_pb_section][et_pb_section bb_built=&#8221;1&#8243; admin_label=&#8221;section&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; _builder_version=&#8221;3.0.74&#8243; custom_padding=&#8221;0px|0px|50.5167px|0px&#8221; custom_padding_tablet=&#8221;50px|0|50px|0&#8243; padding_mobile=&#8221;off&#8221; prev_background_color=&#8221;#000000&#8243; next_background_color=&#8221;#000000&#8243;][et_pb_row][et_pb_column type=&#8221;4_4&#8243;][et_pb_text admin_label=&#8221;FOTO E APRESENTA\u00c7\u00c3O&#8221; _builder_version=&#8221;3.19.4&#8243;]<\/p>\n<div class=\"text-headers-3\"><span class=\"Azul IL\" style=\"color: #1e73be;\"><strong><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-29662 alignleft\" src=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau_id.jpg\" alt=\"\" width=\"100\" height=\"133\" \/>&#8220;Mingau&#8221;<\/strong><\/span><br \/><span class=\"Azul IL\" style=\"color: #1e73be;\"><em><span class=\"text-headers-4\">Gato macho com 14 anos de idade<\/span><\/em><\/span><\/div>\n<p>Fratura cominutiva do \u00famero; causa desconhecida; gato com acesso ao exterior.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=&#8221;row&#8221; custom_padding=&#8221;0px|0px|27px|0px&#8221; padding_mobile=&#8221;off&#8221; column_padding_mobile=&#8221;on&#8221; _builder_version=&#8221;3.19.4&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_text admin_label=&#8221;TEXTO DO CASO CL\u00cdNICO&#8221; disabled=&#8221;off&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; background_size=&#8221;initial&#8221; _builder_version=&#8221;3.19.4&#8243;]<\/p>\n<hr \/>\n<h3><span class=\"Azul IL\" style=\"color: #1e73be;\">1 &#8211; Imagem lateral<br \/><\/span><\/h3>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-29660\" src=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau1.jpg\" alt=\"\" width=\"347\" height=\"500\" srcset=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau1.jpg 347w, http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau1-208x300.jpg 208w\" sizes=\"(max-width: 347px) 100vw, 347px\" \/><em>Fratura cominutiva do \u00famero.<\/em><\/p>\n<hr \/>\n<h3><span class=\"Azul IL\" style=\"color: #1e73be;\">2 &#8211; Imagem VD<br \/><\/span><\/h3>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-29659\" src=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau2.jpg\" alt=\"\" width=\"195\" height=\"500\" srcset=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau2.jpg 195w, http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau2-117x300.jpg 117w\" sizes=\"(max-width: 195px) 100vw, 195px\" \/><em>Fratura cominutiva.<\/em><\/p>\n<hr \/>\n<h3><span class=\"Azul IL\" style=\"color: #1e73be;\">3 &#8211; Imagem p\u00f3s-cir\u00fargica<br \/><\/span><\/h3>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-29658\" src=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau3.jpg\" alt=\"\" width=\"396\" height=\"500\" srcset=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau3.jpg 396w, http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau3-238x300.jpg 238w\" sizes=\"(max-width: 396px) 100vw, 396px\" \/><em>Devido \u00e0 idade do paciente e \u00e0 gravidade da fratura (o que pressup\u00f5e grande traumatismo dos tecidos envolventes), foi decidida redu\u00e7\u00e3o fechada por forma a minimizar a perda de c\u00e9lulas pluripotenciais e a perda de recursos vasculares. Uma das cavilhas (central) apenas melhora a aproxima\u00e7\u00e3o de um dos fragmentos secund\u00e1rios ao foco de fractura para que incorpore o calo. Esta cavilha foi removida passadas 2 semanas.<\/em><\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-29657\" src=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau4.jpg\" alt=\"\" width=\"309\" height=\"500\" srcset=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau4.jpg 309w, http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau4-185x300.jpg 185w\" sizes=\"(max-width: 309px) 100vw, 309px\" \/><em>Nesta imagem vemos 2 grandes fragmentos na zona de cominu\u00e7\u00e3o. A posi\u00e7\u00e3o dos fragmentos principais respeita o alinhamento articular enquanto no foco de fratura o espa\u00e7o entre os v\u00e1rios fragmentos testa os limites da capacidade de cicatriza\u00e7\u00e3o com este m\u00e9todo e neste paciente. Apesar deste posicionamento n\u00e3o ser totalmente satisfat\u00f3rio foi decidido que n\u00e3o haveria mais manipula\u00e7\u00e3o cir\u00fargica.<\/em><\/p>\n<hr \/>\n<h3><span class=\"Azul IL\" style=\"color: #1e73be;\">4\u00a0&#8211; 12 semanas ap\u00f3s a cirurgia<br \/><\/span><\/h3>\n<p style=\"text-align: center;\"><em><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-29656\" src=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau5.jpg\" alt=\"\" width=\"309\" height=\"500\" srcset=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau5.jpg 309w, http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau5-185x300.jpg 185w\" sizes=\"(max-width: 309px) 100vw, 309px\" \/>Observamos forma\u00e7\u00e3o de calo \u00f3sseo com incorpora\u00e7\u00e3o de todos os fragmentos. <br \/>O uso do membro permitiu uma vida normal com poucas limita\u00e7\u00f5es funcionais durante a cicatriza\u00e7\u00e3o. <\/em><\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"\/\/www.youtube.com\/embed\/fjYyInAWBqM\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<hr \/>\n<h3><span class=\"Azul IL\" style=\"color: #1e73be;\">5\u00a0&#8211; 17 semanas ap\u00f3s a cirurgia<br \/><\/span><\/h3>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-29655\" src=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau6.jpg\" alt=\"\" width=\"286\" height=\"500\" srcset=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau6.jpg 286w, http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau6-172x300.jpg 172w\" sizes=\"(max-width: 286px) 100vw, 286px\" \/><em>Foi removido o fixador externo. No centro da zona de calo \u00f3sseo e deste ponto de observa\u00e7\u00e3o (imagem lateral) observa-se aus\u00eancia de tecido mineralizado. Decidimos n\u00e3o efectuar enxerto \u00f3sseo perante a robustez do calo que ir\u00e1 aumentar durante a fase de remodela\u00e7\u00e3o.<\/em><\/p>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-29654\" src=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau7.jpg\" alt=\"\" width=\"233\" height=\"500\" srcset=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau7.jpg 233w, http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau7-140x300.jpg 140w\" sizes=\"(max-width: 233px) 100vw, 233px\" \/><em>O tempo de cicatriza\u00e7\u00e3o foi afectado pela idade do paciente, gravidade do traumatismo e dist\u00e2ncia entre fragmentos sub-\u00f3tima. O conforto do paciente foi excelente durante todo o periodo de tratamento. As filosofias de osteoss\u00edntese biol\u00f3gica s\u00e3o muito eficazes contra complica\u00e7\u00f5es graves das fraturas como a n\u00e3o-uni\u00e3o e as infec\u00e7\u00f5es.<\/em><\/p>\n<hr \/>\n<h3><span class=\"Azul IL\" style=\"color: #1e73be;\">6\u00a0&#8211; Sete meses ap\u00f3s a cirurgia <br \/><\/span><\/h3>\n<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-29653\" src=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau8.jpg\" alt=\"\" width=\"284\" height=\"500\" srcset=\"http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau8.jpg 284w, http:\/\/www.cirurgiavet.com\/web\/wp-content\/uploads\/2019\/01\/mingau8-170x300.jpg 170w\" sizes=\"(max-width: 284px) 100vw, 284px\" \/><em>A fase de remodela\u00e7\u00e3o consolida as regi\u00f5es de carga.<\/em><\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"\/\/www.youtube.com\/embed\/O86rKlGAEuY\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>\u00a0\u00a0<\/p>\n<hr \/>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section bb_built=&#8221;1&#8243; _builder_version=&#8221;3.0.47&#8243; prev_background_color=&#8221;#000000&#8243;][et_pb_row _builder_version=&#8221;3.0.48&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_button admin_label=&#8221;BOT\u00c3O VOLTAR TRAUMATOLOGIA (n\u00e3o editar)&#8221; button_url=&#8221;http:\/\/www.cirurgiavet.com\/web\/casos-clinicos-traumatologia\/&#8221; button_text=&#8221;MAIS CASOS DE TRAUMATOLOGIA&#8221; button_alignment=&#8221;center&#8221; _builder_version=&#8221;3.19.4&#8243; custom_button=&#8221;on&#8221; button_text_size=&#8221;14px&#8221; button_bg_color=&#8221;#629fca&#8221; button_border_width=&#8221;0px&#8221; button_icon=&#8221;%%197%%&#8221; button_icon_placement=&#8221;left&#8221; button_on_hover=&#8221;off&#8221; background_layout=&#8221;dark&#8221; button_letter_spacing_hover=&#8221;0&#8243; button_bg_color_hover=&#8221;#14647c&#8221; button_text_size__hover_enabled=&#8221;off&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_text_color__hover_enabled=&#8221;off&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_border_width__hover_enabled=&#8221;off&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_border_color__hover_enabled=&#8221;off&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_border_radius__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; button_two_border_radius__hover_enabled=&#8221;off&#8221; button_letter_spacing__hover_enabled=&#8221;on&#8221; button_letter_spacing__hover=&#8221;0&#8243; button_one_letter_spacing__hover_enabled=&#8221;off&#8221; button_two_letter_spacing__hover_enabled=&#8221;off&#8221; button_bg_color__hover_enabled=&#8221;on&#8221; button_bg_color__hover=&#8221;#14647c&#8221; button_one_bg_color__hover_enabled=&#8221;off&#8221; button_two_bg_color__hover_enabled=&#8221;off&#8221; \/][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"text-headers-3\"><strong><span style=\"color: #1e73be;\">&#8220;Mingau&#8221;<\/span><\/strong><br \/>\n<em><span class=\"text-headers-4\" style=\"color: #1e73be;\">Gato macho com 14 anos de idade<\/span><\/em><\/div>\n<p>Fratura cominutiva do \u00famero; causa desconhecida; gato com acesso ao exterior.<\/p>\n","protected":false},"author":1,"featured_media":29662,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[24],"tags":[196,29,38,27,28,134,32,30,197,39,33,35,199,37,34,31,198,36],"_links":{"self":[{"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/posts\/29652"}],"collection":[{"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/comments?post=29652"}],"version-history":[{"count":1,"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/posts\/29652\/revisions"}],"predecessor-version":[{"id":29663,"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/posts\/29652\/revisions\/29663"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/media\/29662"}],"wp:attachment":[{"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/media?parent=29652"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/categories?post=29652"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.cirurgiavet.com\/web\/wp-json\/wp\/v2\/tags?post=29652"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}