Os aparelhos gessados são dispositivos rígidos de imobilização externa que envolvem uma região do corpo, de forma a mantê-la numa posição adequada. Estudo mecânico comparativo entre aparelhos gessados clássicos e de material sintético. JDMBA Rossi, FAS Caffali, TP Leivas, LA Menezes Filho, AA Quintela. Avaliação do aparelho gessado cruro-podálico articulado como complementação do tratamento cirúrgico do “genu valgum.” Front Cover. Hélio Lúcio de Souza.
|Published (Last):||26 March 2016|
|PDF File Size:||9.57 Mb|
|ePub File Size:||18.18 Mb|
|Price:||Free* [*Free Regsitration Required]|
Among its clinical manifestations, it may present pain and limitation of joint movement, heat, edema, and local flushing. Heterotopic ossification HO is a process of abnormal osteogenesis in non-skeletal tissues, due to an initial metaplastic and inflammatory process, through bone neoformation in soft tissues; it is apardlhos considered a neoplasia.
Pin by Marisa Martins on Enfermagem | Pinterest | Education, Medical and Med student
A clinical perspective on common forms of gessadso heterotopic ossification. None of these methods currently have a precise recommendation regarding dose, quantity, or well-established protocols.
Treatment of heterotopic ossification of the hip with use of a plaster cast: After the aggression, he evolved with TBI and was bedridden due to a bilateral hip contracture Fig.
Thus, surgical excision must be carefully and individually considered and reserved for fully matured HO cases in patients with severe functional joint impairment.
Treatment is based on resection of the ossification, with adjuvant measures such as non-steroidal anti-inflammatory drugs, bisphosphonate, radiotherapy, and physical therapy.
It is believed that recurrence is associated with the presence of osteoblastic activity at the HO site at the time of resection. It should only be performed in cases with hip movement restrictions, in order to release the ankylosed joints and entrapped nerves. Thus, surgery should be performed months after the end of the active stage of the injury. Exercises are recommended to maintain joint mobility.
Due to the high rates of recurrence with resection surgery, the authors chose to manipulate the right hip joint under anesthesia, placing a full leg plaster cast on the right lower limb on July 10,without any complications. Clin Orthop Relat Res. On physical examination, he was in good general condition and was afebrile. HO presents with elevated serum alkaline phosphatase AP levels, and a transient decrease in serum calcium levels preceding the first event.
The patient was able to improve the movements of extension, abduction, and adduction of the right hip, which allowed gait without the risks of resection surgery.
Jorge Joanfer Email & Phone# | técnico de aparelho gessado @ hospital semiu – ContactOut
It usually occurs in the large joints. Risk factors of heterotopic ossification in traumatic spinal cord injury. An anteroposterior view radiograph of the hip showed areas of periarticular hip ossification, bilaterally, and the diagnosis of HO was made Fig.
Leite NM, Faloppa F. This pathology usually has a benign course, but it can cause a reduction in the range of joint movement and hamper the rehabilitation process. Computed tomography CT can also be used. Two years after the manipulation, the following right hip ROM values were registered: It is important to note that HO treatment is often conservative, provided that differential diagnoses have been definitively ruled out deep vein thrombosis, osteosarcoma, and septic arthritis, among others.
In patients with spinal cord injury, early HO diagnosis is of utmost importance so that adequate treatment can be initiated and the chance of progression to ankylosis of the joint reduced. The etiology of HO is still uncertain.
The treatment of HO is often conservative and prevention is the most appropriate conduct; however, surgical intervention may be necessary. Immediately after the manipulation, in the operation room, the right hip’s range of motion ROM was measured: That is, remaining osteoblastic cells would be responsible for recurrence, similarly to what is observed in cases of incomplete neoplasia resection.
The diagnosis is made through conventional radiography. The cast was used for 9 months. The initial clinical manifestations of HO include pain and limitation of joint movement, heat, edema, local flushing, and, in some cases, moderate fever and severe spasticity.
Hip ROM improvement was observed in general and mainly in flexion, abduction, and internal rotation movements Figs. Increased AP is also observed in the presence of fractures and liver diseases. In some cases, it can present moderate fever, severe spasticity, and even ankylosis in more advanced stages of the disease.
TEC.APARELHO GESSADO E VENDEDOR AUTONOMO DE LATICINIOS.
Shortly after its removal, the patient began walking with crutches for short distances and later, after several physical therapy sessions, without crutches. Appearance 2 years after treatment. Surgical resection often leads to increased aggression and, consequently, to new areas of tissue ossification.
Hip contracture before treatment, more significant on aparehos right; the hip is in flexion, abduction, and external rotation. After 2 weeks, the patient returned to the outpatient clinic to change the cast; and had no complaints.
Rev Col Bras Cir. Rehabilitation medicine plays an important role in approaching these patients by addressing the symptoms and improving the function of the affected body areas, allowing family, social, and occupational reintegration of these patients. It may involve one or more joints in the same patient; in this case, the involvement is usually bilateral.
The objective of this report is to describe a case of heterotopic ossification in the hip after traumatic brain injury, presenting the clinical manifestations and discussing the treatment instituted with a long leg plaster cast.
Furthermore, resection can cause excessive bleeding particularly in the femurand lead to increased morbidity and mortality, and if it is performed before bone maturity, there are high chances of gessdos.
Patient 2 years after treatment, now able to walk.