Material de Apoio Orto I

Universidade Nove de Julho UNINOVE

2014

Apostila

Fisioterapia Ortopdica e Traumatolgica I

Prof. Andr Serra Bley

e-mail: [email protected]

mailto:[email protected]

Plano de Ensino: Prof. Andr Serra Bley

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Referncias Bibiliogrficas:

Bsica:

Hebert, S. Ortopedia e Traumatologia: princpios e prticas. Porto Alegre: Artmed. 2003

Browner, B. D. Traumatismos Do Sistema Msculo - Esqueltico: Fraturas, Luxaes, Leses e

Ligamentos. So Paulo: Manole, 2000. (volume I e II)

Souza, M. Z. Reabilitao Do Complexo Do Ombro. So Paulo: Manole 2001.

Apley, A. G. Ortopedia e fraturas em Medicina e Reabilitao. 6 ed. So Paulo: Atheneu, 2002

Gross, J. Exame Musculoesqueltico. Porto Alegre: Artmed, 2000.

Rockwood Jr., C. A. Fraturas em Adultos. So Paulo: Manole, 1994.

Boccolini, F. Reabilitao: amputados, amputaes, prteses. So Paulo. Robe, 2000.

Complementar:

Starkey, C; Ryan, J. Avaliao Das Leses Ortopdicas e Esportivas. So Paulo: Manole. 2001

Gabriel, M.R.S. Fisioterapia em traumatologia, ortopedia e reumatologia. Rio de Janeiro: Revinter. 2001

Magee, D. J. Avaliao Musculoesqueltica. 4 ed. So Paulo: Manole, 2005.

Andrews, J. R. Reabilitao Fsica das Leses Desportivas. Rio de Janeiro; Guanabara Koogan, 2000.

Observaes:

TERMINOLOGIAS ORTOPDICAS Prof. Andr Serra Bley

Tendinite:_____________________________________________________________________________

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Tendinose:____________________________________________________________________________

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Tenossinovite:_________________________________________________________________________

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Entesite:______________________________________________________________________________

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Osteoartrite:__________________________________________________________________________

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Osteomielite:__________________________________________________________________________

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Pioartrite:_____________________________________________________________________________

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Anquilose:____________________________________________________________________________

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Sinovite:______________________________________________________________________________

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Fratura:______________________________________________________________________________

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Luxao:______________________________________________________________________________

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Subluxao:___________________________________________________________________________

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Fratura-luxao:________________________________________________________________________

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Entorse:______________________________________________________________________________

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Consolidao Viciosa: ___________________________________________________________________

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Necrose Avascular: _____________________________________________________________________

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Pseudoartrose:________________________________________________________________________

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Tenotomia:____________________________________________________________________________

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Tenorrafia:____________________________________________________________________________

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Osteotomia:___________________________________________________________________________

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Osteossntese:_________________________________________________________________________

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Enxertos:_____________________________________________________________________________

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Artrodese:____________________________________________________________________________

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Artroplastia:___________________________________________________________________________

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Artroscopia:___________________________________________________________________________

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Sinovectomia:_________________________________________________________________________

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Obs.:

Avaliao Ortopdica Prof. Andr Serra Bley

Ficha de avaliao

1. Dados Pessoais:

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2. Queixa Principal:

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3. Histria da Molstia Atual (HMA):

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4. Intensidade da Dor

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5. Doenas Associadas e Familiares:

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6. Hbitos e Vcios:

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7. Medicamentos:

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8. Exames Complementares:

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9. Cirurgias:

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10. Exame Fsico:

Inspeo:______________________________________________________________________________

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Movimentao Ativa:____________________________________________________________________

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Palpao:______________________________________________________________________________

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Movimentao Passiva:__________________________________________________________________

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Sensao-final do movimento (end feel)___________________________________________________

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11. Testes:

Testes de flexibilidade:___________________________________________________________________

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Testes de fora para msculos especficos:___________________________________________________

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Testes especiais:________________________________________________________________________

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Avaliao sensitiva (nervos e dermtomos): __________________________________________________

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Avaliao motora (mitomo): _____________________________________________________________

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Avaliao de reflexos: ___________________________________________________________________

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Mensuraes:__________________________________________________________________________

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12. Amplitude de movimento: _____________________________________________________________

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13. Grau de Fora Muscular (grupos): _______________________________________________________

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14. Avaliao Postural: ___________________________________________________________________

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15. Avaliao da Marcha: _________________________________________________________________

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16. Diagnstico Fisioteraputico:

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17. Objetivos de tratamento:

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18. Condutas de tratamento:

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Obs.:

Reviso:

DERMTOMOS e MITOMOS:

Tabela ASIA: Imagem retirada da internet

Estabilizadores Estticos e Dinmicos:

Propriocepo:

FRATURAS Prof. Andr Serra Bley

Definio:

Estrutura:

Imagem retirada da internet

Composio:

Parte Orgnica

Parte Inorgnica

Balano sseo / Resposta ao Estresse:

Classificao das fraturas:

1. Mecanismo de trauma:

2. Localizao:

3. Extenso:

4. Configurao:

- transversa

- dupla ou segmentar

- oblqua

- espiral

- em cunha

- cominutiva

- avulso

- achatamento

5. Relao com o meio externo:

6. Relao dos fragmentos / desvio:

- angular

- rodada

- distase

- impactada

- cavalgada

Imagens retiradas da internet

Oblqua Trasnversa Espiral Cominutiva Dupla Avulso Achatamento

Classifique a fratura abaixo:

Consolidao das fraturas:

Estabilidade x Vascularizao

Tipos: Direta (Intramembranosa/Primria)

Indireta (Endocondral/Secundria) esboo cartilaginoso

Tratamento:

objetivo: reduo anatmica + estabilidade + atraumtica possvel + mobilidade ativa e indolor

- Incruento

- Cruento

Compartilhamento de estresse e sem compartilhamento de estresse:

Placa e Parafusos Haste Intramedular Placa e Parafusos Artrodese

Fixador Externo Fixador Externo Ilizarov Ilizarov Parafuso e Fios de Kirshner

imagens retiradas da internet

Trao Esqueltica Trao Cutnea

Prognstico no tratamento das fraturas: idade, gravidade, local, reabilitao, ao hormonal, solicitao

mecnica

Consequncias da imobilizao:

Retraes Artrognicas X Retraes Miognicas

Consideraes:

- Fraturas em crianas:

Fratura em Galho Verde Leso da epfise de crescimento

- Fratura Intra-articular:

Complicaes das fraturas:

Princpios do tratamento fisioteraputico:

Obs.:

Cintilografia ssea

COMPLEXO ARTICULAR DO OMBRO Prof. Andr Serra Bley

1. Reviso Anatmica e Biomecnica

- osso / articulaes / ligamentos

Imagens retiradas da internet

- msculos

- movimentos e ADMs

- Biomecnica (imagens retiradas KAPANDJI, 2000)

2. Patologias

- Sndrome do Impacto

Def.:

Plano escapular

Movimentos da escpula

Movimentos da art. esternoclavicular

Etiologia/ Predisposio:

Patologias decorrentes da Sd. do Impacto:

Estgios da Sd. do Impacto:

Quadro Clnico:

Testes Especiais:

Exames Complementares:

Tratamento Mdico:

Tratamento Fisioteraputico:

- Capsulite Adesiva

Definio:

Fases da capsulite:

Etiologia:

Quadro Clnico:


Tratamento Mdico:


- Instabilidades do Ombro (Luxaes):

Def.:

Instabilidade x Frouxido ligamentar

Classificao das Instabilidades: (Mecanismo de Leso/quadro clnico/epidemiologia)

T

U

B

S

A

M

B

R

I

A

I

O

S

Leso de Bankart e Hill-Sachs

leso SLAP


Testes Especiais:

Tratamento Mdico:


- Luxao Acromioclavicular:

- Fraturas de mero proximal

- Fraturas da difise do mero

- Fraturas de Clavcula

COTOVELO Prof. Andr Serra Bley

3. Reviso Anatmica e Biomecnica


Ligamento Colateral Ulnar (feixes) Ligamento Colateral Radial (feixes + ligamento anular)

- msculos

- movimentos e ADMs

4. Patologias

- Epicondilite Medial e Lateral

Def.:

Etiologia/ Predisposio - Epidemiologia:

Quadro Clnico:

Testes Especiais:


Tratamento Mdico:


- Bursite Olecraniana

Definio:

Etiologia:

Quadro Clnico:

Tratamento:

- Sndromes Compressivas:

Def.:

rea sensitiva e motora:

Nervo mediano

Nervo Ulnar

Nervo Radial

Sd. do Pronador:

Sd. do Tnel Cubital:

Sd. do Supinador:

Tratamento:

FRATURAS DO COTOVELO:

Fratura Supracondiliana:

- epidemiologia:

- mecanismo de trauma:

- Tratamento:

Fratura de olcrano:

- mecanismo de trauma:

- Tratamento:

- Fratura da cabea do rdio:

- mecanismo de trauma / epidemiologia:

- tratamento:

- Fratura-luxao de Monteggia

- Fratura de Galeazzi

LUXAES DO COTOVELO

- mecanismo de trauma/epidemiologia:

- tratamento:

Complicaes das fraturas e luxaes do cotovelo:

obs.: proximidade de nervos e artrias

osteoartrite do cotovelo

Punho e Mo Prof. Andr Serra Bley

Reviso Anatmica e Biomecnica


Tnel do Carpo Tnel dos Extensores

Biomecnica / movimentos e ADM:

- msculos

Distribuio Sensitiva da Mo: Distribuio Motora da Mo:

Patologias

- Sndrome do Tnel do carpo

Def.:

Etiologia/ Predisposio:

Quadro Clnico:

Testes Especiais:

Teste de Phalen


Tratamento Mdico:


- Sndrome do Canal de Guyon

Def.:

Quadro Clnico:

- Tenossinovite de Quervain

Def.:

Etiologia:

Quadro Clnico:

Testes Especiais: Exames complementares / diagnstico diferencial:

Teste de Finkelstein

Tratamento Mdico:


- Tenossinovite do Flexores e Extensores do Punho

Obs.:

- Cisto Sinovial

Obs.:

- Contratura de Dupuytren

Def.:

Etiologia:

Quadro Clnico:

Tratamento Mdico e Fisioteraputico:

Obs.:

Deformidades (doenas reumticas):

Ndulos de Bouchard (A) e Heberden (B)

DISFUNES TRAUMTICAS DO PUNHO E DA MO:

- Fratura de Colles

- Fratura de Smith

Mecanismo de trauma:

Quadro Clnico:

Tratamento Mdico:

Complicaes:

Sinostose Distrofia Simptico-Reflexa

- Fratura do escafide:

Mecanismo de trauma:

Complicaes:


Tratamento mdico e fisioteraputico:

- Doena de Kienbck

Tratamento mdico e fisioteraputico:

Carpectomia Artrodese

- Fratura-luxao de Bennett

- Luxao do Semilunar Instabilidade Escafo-semilunar (tratamento)

- Fraturas dos Metatarsos:

Tratamento:

Observaes:

Complicaes:

Normal Consolidao Viciosa:

- Luxao Interfalangiana / Fraturas de falanges:

Obs.:

Deformidades decorrentes de leses traumticas dos quirodctolos:

- dedo em pescoo de cisne

- dedo em botoeira

- dedo em martelo

Deformidades das mos decorrentes de leses nervosas:

Mo em garra mo cada mo em garra ulnar

Leses Musculares Prof. Andr Serra Bley

Leses

Regenerao Muscular

Documents

Material de Apoio Orto I