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1. Fractura Cuello Femoral Subgrupo # 5 Lucia Guarderas Fred Olvera Stephani Robinson Gema Vera Omar Zapata

2. ANATOMÍA 01

3. EXTREMIDAD PROXIMAL CABEZA FEMORAL Estructura esférica que se ubica superomedial y se proyecta anteriormente desde el cuello del fémur. Forma la articulación coxofemoral. Dentro de la cápsula articular.

4. EXTREMIDAD PROXIMAL CUELLO FEMORAL 5cm longitud. Porción basicervical . Porción mediocervical . Porción subcapital .

5. EXTREMIDAD PROXIMAL TROC Á NTERES FEMORALES TROCÁNTER MAYOR Cuadrangular y se extiende desde el aspecto superior de la unión del cuello y el cuerpo del fémur. TROCÁNTER MENOR Medial, pequeña, más cónica, y se extiende en el plano posteromedial.

6. EXTREMIDAD PROXIMAL C Á PSULA ARTICULAR Capa fibrosa externa adherida al acetábulo Se extiende lateralmente hasta el fémur proximal. Anterior  a la línea intertrocantérea. Superior  a la base del cuello del fémur. Posterior  cerca de 1 cm superomedial a la cresta intertrocantérea. Inferior  cerca del trocánter menor.

7. SISTEMAS TRABECULARES Fascículo Arciforme  parte inferior del trocánter mayor a la parte más baja de la cabeza. Fascículo Cefálico  desde la cabeza femoral hacia arriba Fascículo Trocantéreo  desde el trocánter mayor al menor. Triángulo de Ward  zona de menor resistencia

8. VASCULARIZACIÓN Arteria femoral profunda  Art. Circunfleja medial y lateral. Fractura a nivel del cuello  N ecrosis isquémica de la cabeza femoral. > grado de desplazamiento de los fragmentos, > será el riesgo de necrosis isquémica y más difícil que se produzca la consolidación de la fractura. Fractura en la región trocantérea no habrá riesgo de necrosis ya que recibe vascularización de las estructuras adyacentes.

9. DIAGNOSTICO HISTORIA CLÍNICA EXAMEN FÍSICO RADIOGRAFÍAS AP Y AXIAL TC RM EXÁMENES DE LABORATORIO

10. ELECCIÓN DEL TRATAMIENTO: Estado físico y mental del paciente Edad del paciente Tipo de fractura ( grado desplazamiento ) Circulación interósea Conminación posterior del cuello Osteoporosis y osteomalacia Enfermedad concurrente TRATAMIENTO DE LAS FX CERVICALES O DE CUELLO DE FEMUR Alivio del dolor a)Inmovilizacion b)Analgesicos Estabilizacion de la patología asociada HTA,EPOC,DM,cardiopatías,etc 3.Quirurgico : osteosíntesis,hemiartrosis,artroplastia total

11. Tratamiento conservador : Paciente terminal o con alta morbilidad quirúrgica Impactada en valgo no desplazada: Desplazamiento tardío 15- 30% Estabilizar para prevenir el desplazamiento Desplazamiento tardío 1-6% luego de la estabilización Desplazadas : Mal pronostico Paciente joven con trauma de alta energía se intenta OTS.

12. Comportamiento como fracturas laterales D.H.S. + tornillo anti- rotatorio NO DESPLAZADAS BASICERVICALES: DESPLAZADAS Lo mas importante para disminuir la no unión y osteonecrosis → reducción Joven / alta energía/paciente activo sin comorbilidad OTS→ intentar manejo como no desplazada

13. OSTEOSINTESIS: Es la unión de dos segmentos óseos fracturados con un elemento de fijación. Por ejemplo placas c l avos e n d o m e du l ares o tutores y t o r n il l os, externos. Objetivos: Reducción anatómica Fijación rígida Impactación de los fragmentos Tipos de osteosíntesis : Clavos multipes(knowls,tornillos AO) Clavos placas fijos(Jewet ) Clavos placas ensambladas(Smith Peterson) 4.Clavos placa telescopables (Richard) 5.Clavos flexibles a distancia(Enders) 6.Protesis parciales(Thompson,Moore )

14. PROTE S IS Parcial o total de cadera Después de todo, el mejor lugar para una prótesis es el armario del instrumental, así como el sitio ideal para una cabeza femoral viable es el cuello del fémur . REMPLAZO PROTESICO PRIMARIO VENTAJAS : Rápida movilización del paciente con soporte de peso del miembro Disminuye la morbilidad Elimina complicaciones tardías de las fracturas DESVENTAJAS La función del miembro aunque buena,nunca es igual al original Mayor trauma quirúrgico.

15. MANIOBRAS DE REDUCCIÓN

16. Table of contents 01 04 02 05 03 06 The disease and its symptoms People at risk Risk factors Available treatments Disease prevention and control Conclusion

17. Introduction to the disease On the first part of the presentation, it’s important to give an overview of the disease you’re going to speak about. This helps your audience understand: The context The health risks Likelihood of developing it Prevalence

18. Environmental factors Who is at risk? When an environmental factor puts a person at risk of developing an illness, it means that exposure to certain substances, conditions or situations in the environment can increase the likelihood of developing that illness When a genetic factor puts a person at risk of developing an illness, it means that there is a hereditary component to that illness. This can be due to specific genetic mutations or variations that increase a person's susceptibility to developing the illness Genetic factors

19. Types of diseases Types Spread Diseases vary based on transmission, like communicable (spreadable) and non-communicable (non-spreadable). They can also differ in duration: acute (short-term) or chronic (long-lasting) Diseases spread as communicable or stem from genetics/lifestyle as non-communicable. Recognizing how diseases transmit informs preventive measures, while understanding non-communicable causes aids in lifestyle adjustments Diseases range from acute, with sudden symptoms and short span, to chronic, with prolonged effects. Managing acute cases requires swift action, while chronic conditions demand continuous care to alleviate lasting impact Duration

20. This involves the use of medications, surgery, radiation therapy, chemotherapy or other medical procedures to treat a particular illness Behavioral therapies involve various techniques that are used to treat mental health conditions, such as depression, anxiety and addiction Alternative therapies include a range of treatments that are not considered part of conventional medical practice Lifestyle changes involve making modifications to an individual's diet, exercise habits or other behaviors Four main types of treatments Medical treatment Alternative therapies Behavioral therapy Lifestyle changes

21. Patients treated 85% Success rate 10,000 1,000 Suffered secondary effects

22. Investment in disease research is crucial for improving public health outcomes, advancing medicine and improving quality of life for patients, which in turn has the potential for significant economic growth and global health benefits $1 billion

23. Disease prevalence Follow the link in the map to modify its data and then paste the new one here. For more info, click here 15-30% of the population in these regions are affected by the disease 6-14% of the population in these regions are affected by the disease 0-5% of the population in these regions are affected by the disease

24. Symptoms and diagnosis Follow the link in the graph to modify its data and then paste the new one here. For more info, click here Most common symptoms Use this slide to display the most common symptoms of the disease being discussed. Include a graph with a clear title and labels for each axis. You can also explain how the disease is diagnosed, including the types of tests or procedures used, to help your audience understand how it is identified and treated

25. Risk factors Description Prevalence Contributing factors Complications Severity Enter the risk factors here In this part, include a brief description 80% of cases Enter the contributing factors here In this part, enter the complications of the disease High Enter the risk factors here In this part, include a brief description 30% of cases Enter the contributing factors here In this part, enter the complications of the disease Moderate Enter the risk factors here In this part, include a brief description 40% of cases Enter the contributing factors here In this part, enter the complications of the disease High Enter the risk factors here In this part, include a brief description 10% of cases Enter the contributing factors here In this part, enter the complications of the disease Moderate Risk factors and complications

26. Disease history Discovery of the disease Early research First treatment Milestone discoveries Breakthrough treatment Epidemic outbreak Current research Future directions

27. Diagnosis and treatment flowchart Start Diagnostic test Patient symptoms Diagnosis confirmed List the symptoms that the patient is experiencing: Enter the symptoms of the patient Enter the symptoms of the patient Enter the symptoms of the patient List the diagnostic tests that were performed: Enter the diagnostic test performed Enter the diagnostic test performed Enter the diagnostic test performed Prescribe treatment List the recommended treatment options Enter the treatment options Enter the treatment options Enter the treatment options End This step represents the confirmation or ruling out of a specific disease diagnosis based on the results of the diagnostic tests

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29. Region Number of cases Percentage of cases North 1,000 20% South 2,500 50% East 1,200 24% Disease management Number of cases of the disease over time Follow the link in the graph to modify its data and then paste the new one here. For more info, click here Describe the trend of the disease cases over time Provide key insights or observations about the graph Explain any significant changes or patterns in the graph List the regions or areas that are relevant for the disease Enter the number of cases for each region, area or country Describe any notable variations or trends among the regions Provide additional details or observations about the table

30. Disease overview and conclusions Information Causes Enter in this section specific information about causes Symptoms Enter in this section specific information about symptoms Diagnosis Enter in this section specific information about the diagnosis Treatment Enter in this section specific information about the treatment Prevention Enter in this section specific information about prevention Key findings Summarize the most important or relevant aspects of the disease Use bullet points to present the key findings in a clear and organized manner Conclusions In this section, summarize the key findings from the disease study Provide an overview of the implications for the current diagnosis and treatment plan 1 2

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