Lyrics of 'Fractura De Escafoides Tarsiano Derecho' by Jorge Drexler
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FRACTURA DE ESCAFOIDES TARSIANO DERECHO
Bilbao, 14 de mayo del 2007
HISTORIA CLÍNICA:
Paciente de 42 años, sin antecedentes personales a destacar, que acude a consulta para valoración de dolor y limitación funcional a nivel de pie derecho luego de traumatismo durante un concierto.
EXPLORACIÓN FÍSICA
No deformidad. No hematoma. Leve tumefacción en región dorsal del pie derecho con dolor intenso a la palpación a nivel de la articulación astragaloescafoidea. Tobillo estable.
Movilidad conservada. Movilidad dedos conservada no dolorosa. Fuerza conservada. No alteraciones de la sensibilidad. Pulsos distales presentes.
PARA CLÍNICA
Tomografía axial computarizada del tobillo derecho:
fractura compleja de escafoides tarisiano derecho sin desplazamiento, impactación, ni angulación de los fragmentos, ni ablación del tubérculo interno.
JUICIO - DIAGNÓSTICO
(este es el momento donde la medicina llega al cenit de su quehacer profesional):
Fractura de Escafoides tarsiano derecho (5)
Tratamiento:
1. En agudo: pierna elevada, anti-inflamatorios no esteroideos por boca y bolsa de hielo.
2. Caminará con ayuda de bastones.
3. Carga parcial progresiva.
4. Ibuprofeno 600 mg por v/o cada 8 horas hasta remisión sintomática.
5. Heparina IBOR 3500 unidades subcutáneas cada 24 horas hasta comenzar apoyo.
6. Fisioterapia tutelada en centro especializado.
7. Vigilancia evolutiva y revisión en 6 a 8 semanas.
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