Traumatologie
Inhoud
Hoofdstuk 1: basisbegrippen................................................................................. 7
1. inleiding.......................................................................................................... 7
1.1. Basis begrippen........................................................................................ 7
2. wondheling..................................................................................................... 8
2.1. Fasen van wondheling.............................................................................. 8
2.2. Vertraagde wondheling............................................................................ 8
3. fractuur heling................................................................................................ 9
3.1. Inleiding.................................................................................................... 9
3.2. Biologie..................................................................................................... 9
3.3. Biomechanisch....................................................................................... 11
3.4. Methoden van fractuur fixatie................................................................12
4. basisprincipes van operatieve fractuurfixaties.............................................12
4.1. Gewrichtsfracturen................................................................................. 13
4.2. Schaftfracturen....................................................................................... 13
4.3. Metafysaire fracturen............................................................................. 13
5. polytrauma – basisprincipes van de patiënten opvang.................................13
5.1. Inleiding: patiënten opvang....................................................................13
5.2. Opvang................................................................................................... 14
5.3. Behandeling........................................................................................... 14
6. letsels van het bewegingsapparaat: open fracturen.....................................15
6.1. Gustilo-Anderson Classificatie................................................................15
Hoofdstuk 2: traumatische letsels van het BL......................................................16
1. clavicula fracturen........................................................................................ 16
1.1. Diagnose................................................................................................ 16
1.2. Classificatie............................................................................................ 16
1.3. Behandeling.......................................................................................... 16
1.4. Nabehandeling....................................................................................... 17
2. scapulafracturen........................................................................................... 17
2.1. Diagnose................................................................................................ 17
2.2. Behandeling.......................................................................................... 18
3. proxomale humerusfracturen.......................................................................18
3.1. Diagnose................................................................................................ 18
1
, 3.2. Classificatie............................................................................................ 18
3.3. Behandeling.......................................................................................... 18
3.4. Nabehandeling....................................................................................... 19
4. humerusschaftfracturen............................................................................... 19
4.1. Diagnose................................................................................................ 19
4.2. Behandeling........................................................................................... 20
4.3. Nabehandeling....................................................................................... 21
5. distale humerusfracturen............................................................................. 21
5.1. Diagnose................................................................................................ 21
5.2. Behandeling........................................................................................... 21
5.3. Nabehandeling....................................................................................... 21
6. olecranonfracturen....................................................................................... 22
6.1. Diagnose................................................................................................ 22
6.2. Behandeling.......................................................................................... 22
6.3. Nabehandeling....................................................................................... 22
7. radiuskopfracturen....................................................................................... 22
7.1. Diagnose................................................................................................ 23
7.2. Behandeling........................................................................................... 23
7.3. Nabehandeling....................................................................................... 23
8. distale bicepsruptuur.................................................................................... 23
8.1. Diagnose................................................................................................ 24
8.2. Behandeling.......................................................................................... 24
8.3. Nabehandeling....................................................................................... 24
9. fracturen van de radius en ulna schaft.........................................................24
9.1. Diagnose................................................................................................ 24
9.2. Behandeling.......................................................................................... 24
9.3. Nabehandeling....................................................................................... 25
10. distale radiusfracturen................................................................................25
10.1. Diagnose.............................................................................................. 25
10.2. Behandeling........................................................................................ 25
10.3. Nabehandeling..................................................................................... 25
Hoofdstuk 3: traumatische letsels van het OL.....................................................26
1. heupfracturen............................................................................................... 26
1.1. Diagnose................................................................................................ 26
1.2. Classificatie............................................................................................ 26
2
, 1.3. Behandeling........................................................................................... 27
1.4. Na behandeling...................................................................................... 28
2. fermurschaftfractuur.................................................................................... 29
2.1. Diagnose................................................................................................ 29
2.2. Behandeling........................................................................................... 29
2.3. Na behandeling..................................................................................... 29
3. distale femurfractuur.................................................................................... 29
3.1. Diagnose................................................................................................ 29
3.2. Behandeling........................................................................................... 30
3.3. Na behandeling..................................................................................... 30
4. quadricepspeesruptuur.................................................................................30
4.1. Diagnose................................................................................................ 30
4.2. Behandeling........................................................................................... 31
4.3. Na behandeling..................................................................................... 31
5. patellafractuur.............................................................................................. 31
5.1. Diagnose................................................................................................ 31
5.2. Behandeling........................................................................................... 31
5.3. Na behandeling..................................................................................... 32
6. patellapeesruptuur....................................................................................... 32
6.1. Diagnose................................................................................................ 32
6.2. Behandeling........................................................................................... 32
6.3. Na behandeling..................................................................................... 33
7. proximale tibiafractuur................................................................................33
7.1. Diagnose................................................................................................ 33
7.2. Behandeling........................................................................................... 33
7.3. Na behandeling..................................................................................... 33
8. tibiaschaftfractuur........................................................................................ 34
8.1. Diagnose................................................................................................ 34
8.2. Behandeling........................................................................................... 34
8.3. Na behandeling..................................................................................... 34
9. diatale tibiafractuur...................................................................................... 34
9.1. Diagnose................................................................................................ 34
9.2. Behandeling........................................................................................... 35
9.3. Na behandeling..................................................................................... 35
10. enkel fractuur............................................................................................. 35
3
, 10.1. Diagnose.............................................................................................. 35
10.2. Classificatie.......................................................................................... 35
10.3. Behandeling......................................................................................... 36
10.4. Na behandeling................................................................................... 36
11. ruptuur van de syndesmosis tibiofibularis..................................................36
11.1. Diagnose.............................................................................................. 36
11.2. Behandeling......................................................................................... 37
11.3. Na behandeling................................................................................... 37
12. achillespeesruptuur................................................................................... 37
12.1. Diagnose.............................................................................................. 37
12.2. Behandeling......................................................................................... 37
12.3. Na behandeling................................................................................... 38
13. fratuur van de talus.................................................................................... 38
13.1. Diagnose.............................................................................................. 38
13.2. Behandeling......................................................................................... 38
13.3. Na behandeling................................................................................... 38
14. fractuur van de calcaneus..........................................................................39
14.1. Diagnose.............................................................................................. 39
14.2. Behandeling......................................................................................... 39
14.3. Na behandeling................................................................................... 39
15. fractuur van de metatarsalen.....................................................................39
15.1. Diagnose.............................................................................................. 39
15.2. Behandeling......................................................................................... 40
15.3. Na behandeling................................................................................... 40
Hoofdstuk 4: bekkenfracturen............................................................................. 40
1. patiënten profiel........................................................................................... 40
2. ligamentaire stabiliteit bekken.....................................................................40
2.1. Anatomische kenmerken........................................................................40
2.2. Krachten op de bekkenring.....................................................................41
3. classificatie................................................................................................... 41
4. bekkenringfracturen..................................................................................... 41
4.1. Classificatie............................................................................................ 41
4.2. Behandeling – hoog energetische fracturen...........................................41
5. heupkomfracturen........................................................................................ 42
5.1. Behandeling........................................................................................... 42
4
Inhoud
Hoofdstuk 1: basisbegrippen................................................................................. 7
1. inleiding.......................................................................................................... 7
1.1. Basis begrippen........................................................................................ 7
2. wondheling..................................................................................................... 8
2.1. Fasen van wondheling.............................................................................. 8
2.2. Vertraagde wondheling............................................................................ 8
3. fractuur heling................................................................................................ 9
3.1. Inleiding.................................................................................................... 9
3.2. Biologie..................................................................................................... 9
3.3. Biomechanisch....................................................................................... 11
3.4. Methoden van fractuur fixatie................................................................12
4. basisprincipes van operatieve fractuurfixaties.............................................12
4.1. Gewrichtsfracturen................................................................................. 13
4.2. Schaftfracturen....................................................................................... 13
4.3. Metafysaire fracturen............................................................................. 13
5. polytrauma – basisprincipes van de patiënten opvang.................................13
5.1. Inleiding: patiënten opvang....................................................................13
5.2. Opvang................................................................................................... 14
5.3. Behandeling........................................................................................... 14
6. letsels van het bewegingsapparaat: open fracturen.....................................15
6.1. Gustilo-Anderson Classificatie................................................................15
Hoofdstuk 2: traumatische letsels van het BL......................................................16
1. clavicula fracturen........................................................................................ 16
1.1. Diagnose................................................................................................ 16
1.2. Classificatie............................................................................................ 16
1.3. Behandeling.......................................................................................... 16
1.4. Nabehandeling....................................................................................... 17
2. scapulafracturen........................................................................................... 17
2.1. Diagnose................................................................................................ 17
2.2. Behandeling.......................................................................................... 18
3. proxomale humerusfracturen.......................................................................18
3.1. Diagnose................................................................................................ 18
1
, 3.2. Classificatie............................................................................................ 18
3.3. Behandeling.......................................................................................... 18
3.4. Nabehandeling....................................................................................... 19
4. humerusschaftfracturen............................................................................... 19
4.1. Diagnose................................................................................................ 19
4.2. Behandeling........................................................................................... 20
4.3. Nabehandeling....................................................................................... 21
5. distale humerusfracturen............................................................................. 21
5.1. Diagnose................................................................................................ 21
5.2. Behandeling........................................................................................... 21
5.3. Nabehandeling....................................................................................... 21
6. olecranonfracturen....................................................................................... 22
6.1. Diagnose................................................................................................ 22
6.2. Behandeling.......................................................................................... 22
6.3. Nabehandeling....................................................................................... 22
7. radiuskopfracturen....................................................................................... 22
7.1. Diagnose................................................................................................ 23
7.2. Behandeling........................................................................................... 23
7.3. Nabehandeling....................................................................................... 23
8. distale bicepsruptuur.................................................................................... 23
8.1. Diagnose................................................................................................ 24
8.2. Behandeling.......................................................................................... 24
8.3. Nabehandeling....................................................................................... 24
9. fracturen van de radius en ulna schaft.........................................................24
9.1. Diagnose................................................................................................ 24
9.2. Behandeling.......................................................................................... 24
9.3. Nabehandeling....................................................................................... 25
10. distale radiusfracturen................................................................................25
10.1. Diagnose.............................................................................................. 25
10.2. Behandeling........................................................................................ 25
10.3. Nabehandeling..................................................................................... 25
Hoofdstuk 3: traumatische letsels van het OL.....................................................26
1. heupfracturen............................................................................................... 26
1.1. Diagnose................................................................................................ 26
1.2. Classificatie............................................................................................ 26
2
, 1.3. Behandeling........................................................................................... 27
1.4. Na behandeling...................................................................................... 28
2. fermurschaftfractuur.................................................................................... 29
2.1. Diagnose................................................................................................ 29
2.2. Behandeling........................................................................................... 29
2.3. Na behandeling..................................................................................... 29
3. distale femurfractuur.................................................................................... 29
3.1. Diagnose................................................................................................ 29
3.2. Behandeling........................................................................................... 30
3.3. Na behandeling..................................................................................... 30
4. quadricepspeesruptuur.................................................................................30
4.1. Diagnose................................................................................................ 30
4.2. Behandeling........................................................................................... 31
4.3. Na behandeling..................................................................................... 31
5. patellafractuur.............................................................................................. 31
5.1. Diagnose................................................................................................ 31
5.2. Behandeling........................................................................................... 31
5.3. Na behandeling..................................................................................... 32
6. patellapeesruptuur....................................................................................... 32
6.1. Diagnose................................................................................................ 32
6.2. Behandeling........................................................................................... 32
6.3. Na behandeling..................................................................................... 33
7. proximale tibiafractuur................................................................................33
7.1. Diagnose................................................................................................ 33
7.2. Behandeling........................................................................................... 33
7.3. Na behandeling..................................................................................... 33
8. tibiaschaftfractuur........................................................................................ 34
8.1. Diagnose................................................................................................ 34
8.2. Behandeling........................................................................................... 34
8.3. Na behandeling..................................................................................... 34
9. diatale tibiafractuur...................................................................................... 34
9.1. Diagnose................................................................................................ 34
9.2. Behandeling........................................................................................... 35
9.3. Na behandeling..................................................................................... 35
10. enkel fractuur............................................................................................. 35
3
, 10.1. Diagnose.............................................................................................. 35
10.2. Classificatie.......................................................................................... 35
10.3. Behandeling......................................................................................... 36
10.4. Na behandeling................................................................................... 36
11. ruptuur van de syndesmosis tibiofibularis..................................................36
11.1. Diagnose.............................................................................................. 36
11.2. Behandeling......................................................................................... 37
11.3. Na behandeling................................................................................... 37
12. achillespeesruptuur................................................................................... 37
12.1. Diagnose.............................................................................................. 37
12.2. Behandeling......................................................................................... 37
12.3. Na behandeling................................................................................... 38
13. fratuur van de talus.................................................................................... 38
13.1. Diagnose.............................................................................................. 38
13.2. Behandeling......................................................................................... 38
13.3. Na behandeling................................................................................... 38
14. fractuur van de calcaneus..........................................................................39
14.1. Diagnose.............................................................................................. 39
14.2. Behandeling......................................................................................... 39
14.3. Na behandeling................................................................................... 39
15. fractuur van de metatarsalen.....................................................................39
15.1. Diagnose.............................................................................................. 39
15.2. Behandeling......................................................................................... 40
15.3. Na behandeling................................................................................... 40
Hoofdstuk 4: bekkenfracturen............................................................................. 40
1. patiënten profiel........................................................................................... 40
2. ligamentaire stabiliteit bekken.....................................................................40
2.1. Anatomische kenmerken........................................................................40
2.2. Krachten op de bekkenring.....................................................................41
3. classificatie................................................................................................... 41
4. bekkenringfracturen..................................................................................... 41
4.1. Classificatie............................................................................................ 41
4.2. Behandeling – hoog energetische fracturen...........................................41
5. heupkomfracturen........................................................................................ 42
5.1. Behandeling........................................................................................... 42
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