Tu scis procedendi pro ageretur proximalis humerus fracturae?

Proximal humerus fracturae unum commune fracturae trauma orthopaedics et maxime proximalis humerus fracturae sunt humilis-navitas Osteoporotic fracturae in senibus.

Licet maioris proximalis humerus fracturae potest esse tractata conservatively, 10-15% of fracturae adhuc eget chirurgicam curatio, quae includit incisional reductionem laminam fixation, clausa reduction intramedullary clavus internum solidamentum, et iuncturam.

Et consilium of curatio indiget ut fundatur in patientes estote in corporalis conditio, aut sui sua perceptio, psychologicum spe, et fractura type.

1. Resetting et solidamentum de subitis fracturae

【Recommendation】 pro proximalis Humeral maiorem tuberosity (neer type II partialis fractura) Fracturae combined cum humero peccatibus, in chirurgicam ciue, repositioning et braking in traumatica humero, repositioning et braking in traumatica humero, repositioning et braking in traumatica humero, repositioning et braking in traumatica humero, repositioning et braking in traumatica humero, repositioning et braking in traumatica humero, repositioning et braking in chirurgicam clolae rate, repositioning et braking in traumatica, repositioning et braking in traumatica, repositioning et braking in traumatica, repositioning et braking in traumatica, repositioning et braking in Traumatica, repositioning et fractis et in aureaticorum rate, rate,% Cfromphi (% Cfmercation Rate:

II. Preoprative acuti dolor imperium

【Recommendation】 aegris cum proximalis humerus fractura non preference pro preoperative analgesia cum oris acetaminophen aut nsaids, et oris opioids potest addidit si effectus non est bonum (peritus commendaticiis rate: C%; fortis commendatione rate: 73.8%).

III. Preoperative Missionali Education

[Suam commendationem] preoperative educationem debet ferri ex diversificatur et multi-modalis modo. (Peritus commendationem rate: C%; fortis commendatione rate: 83.8%)

IV. Preopative nutritionis aestimationem et adminicula curatio

【Recommendation】 ad perficere nutritional protegendo de aegris in XXIV h de admissione et providere nutritionis interventus pro aegris cum nutritionis periculo. (Peritus commendaticiis rate: 98.5%; fortis commendationem rate: 55.9%)

V. Perioperative GLYCOSA amet et ordinacione in diabetic patientes estote

【Recommendation】 Suspendisse glycemic potestate target pro maxime diabetic aegris subeunda electiva surgery est 7,8 ad 10.0 MMOL / l.

VI. Management de mollis TEXTUS tumor in perioperative periodum

【Recommendation】 enim aegris subeunda electiva surgery ad proximal humerus fractura, multiple physica modi dantur ad redigendum tumor per perioperative tempus. (Peritus commendaticiis rate: 98.5%; fortis commendaticiis rate: 80,9%)

VII. Preopative puritate alimentorum Management

【Recommendation】 aegroti cum electiva surgery potest manducare liquet beverages II h ante surgery et starchy cibis et lacticiniis products VI h ante surgery. (Peritus commendationem rate: C%; fortis commendatione rate: 76.5%)

VIII. Perioperive urinariorum CATHETER Management

【Recommendations】 Routinis perioperative urinariorum Catheterization non suadetur pro proximalis humerus fractura surgery (Perito commendatione rate: C%; fortis commendatione rate: 78.6%)

IX. Prophylactic applicationem de perioperative antimicrobial medicinae

【Recommendations】 enim aegris cum proximal humerus Fracturae requiring endoprosthesis aut iuncturam replacement, in prophylactic usum primi et secundi-generation Cephalosporins commendatur ad infectio praeventionis in perioperative tempus. (Peritus commendaticiis rate: 97.1%; fortis commendaticiis rate: 73.5%)

X. Electio autem anesthesia

【Recommendation】 Anesthesia est suadetur ut adoptare modum regional obstructionum compositis generalis anesthesia, select medicinae ad vitare aggravans systemica organum didicit Monitoring ad vitare aegris, et stipendium operam ad confirma magna (peritus commendaticiis, C%,% C fortitude commendaticiis: 71.4%).

XI. Intraoperative sanguinem pressura contro

[Suadiam] moderari reducere sanguinem pressura debet solvit operam ad redigendum intraoperative sanguinem damnum pro proximalis humanioris fracturae, sed senes aegros et multiplicem comorbidities ut stipendium operam ad maintaenamic stabilitatem ad vitare ad sufficit operam ad maintaem stabilitatem ad vitare ad sufficiens operam ad maintaenamic stabilitatem ad vitare ad sufficiens ad attendendo et organorum (peritus commendaticiis rate: C%;

XII. Intraoperative Volubilis Management

[Suadetiam] effectum deducendi ad propositum-orientatur liquor administratione belli, et vasoactive medicinae potest datum prophylactically durante Generalis anesthesia ne fluido overload (peritis rate: C%, fortis commendatione rate: 69.1%).

XIII. Intraoperative sanguis Management

[Recommendations] Intraoperative imperium hypotension non suadetur pro proximalis humerali fracturae, praesertim in senibus aegros et intraoperative sanguis transfusio et tranexamic acidum potest applicari. Intraoperative Reprehendo de HGB <80G / L. commendat Transfusion de Allogeneic sanguis (Peritus commendatitias rate: C%; fortis commendatione rate: 73.8%).

XIV. Ne intraoprative hypothermia

[Recommendations] aegris cum proximalis Humeral Fracturae ut confirma intraoperative temperatus vigilantia et accipe variis mensuras ponere core temperatus supra XXXVI ° (perit, commendationem rate: C%;

XV. Chirurgicam electionis

(I) fracturam CHORAGIUM of proximalis humeri

[Commendationem] Neer scriptor CHORAGIUM est suadetur pro proximalis humerus fractura (peritus commendationem rate: C%; fortis commendatione rate: 83.3%).

(II) chirurgicam accessum

Et chirurgicam consilium sit electus secundum fracturam EREGUS, os qualis, patientes estote in physiologica et psychologicum statum et alia relevant factores.

[Suam commendaticiis] quod internum fixation materiam potest electus secundum fracturam type et os densitatem, ut laminam vel intramedullary clavus; Nam senes aegris cum Osteoporosis qui sunt difficile ad reset et fix, IV-part fractura (et fractura, cum severus, split et rate COLAPHIZO in injuriam (artificialem Rotoriam COLAPHIZO (% COLEPTICA RESTRIGER, C%.

Figura I A LXV annos femina cum a IV-pars fractura de proximal Humeral adductor insertion et in Allograft fibulare implantare laminam fixation cum incisum et repositioning.

XVI. Placement de vulnere INCILE TUBULUM

[Recommendations] indicia non ponere INCILE Tubes: ① minime Psidium operationem techniques (Mippo et Intramedullary Niling); ② humilis sanguinem. Indicia ad collocatione de INCILE fistulam: ① per pectoralis deltoid aditus, densis laminam solidamentum vel humero iuncturam replacement; ② significant sanguinem de vulnere superficiem (peritus commendationem rate: C%; fortis commendatione rate: 71.4%).

XVII. Vulnus Agricola

【Recommendations】 In Suspendisse incisum est clausa per simplex interrupta, layer-per-iacuit suturas (peritus commendaticiis rate, C%; fortis commendationem rate: 76.2%).

XVIII. Postoperative convaluisset victu

【Recommendation】 aegris potest ingest dregs-liberum bibit per os semel sunt expergiscimini post surgery, et resumere normalis victu post 1-2 h si non est adversa reactionem.

XIX. Postoperative positio lectio et mane operatio

【Recommendations】 aegros non opus est mendacium plana in cervical post surgery, possunt capere a semi-recumbent situ et potest movere in area post expergefactus. Traumatica humero arrue sit braked.

XX. Postoperative analgesic mensuras superiores

【Recommendations】 postoperative analgesia in aegris cum proximalis humeralis fracturae est suadetur utor regional obsidione combined cum iusto 'background doses Self-administratum analgesia Pumps (peritus Self-administratum Analgesia Pumps (peritis Self-administratum Analgesia Pumps (Perfolds Rate: C%: fortis commendatione Rate: 78.6%).

XXI. Praeventionis postoperative nauseam et vomitus

[Suam commendaticiis] omnes aegris dandum prophylactic antiemetic medication XXX min ante finem surgery. (Peritus commendationem rate: XCVII%; fortis commendationem rate: 47.8%)

XXII. Eget RESTITUTIO

【Recommendations】 aegros et firmum proximal humerus fracturae ut satus semper exercitiis ut mane fieri post surgery. RESTITUTIO exercitiis Auxilium ad meliorem restituere munus superioris (peritus commendationem rate: C%; fortis commendatione rate: 92.9%).

XXIII. Mission criteria sequi,

【Recommendations】 practical solvendis criteria debet esse statutum, et aegris debet sequi semper pro saltem VI mensibus (peritus commendatione rate: C%; fortis commendatione rate: 83.3%).

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