hsp-gu-190c-026 manejo de fracturas de diafisis de tibia

8/2/2019 HSP-GU-190C-026 Manejo de Fracturas de Diafisis de Tibia

1/16

Ro{~d2c9 5

FECOIA MO B[EN]_[E^ MO N2mdga9 L^P&G_&540N&MDEBD^D^ MO ]DKDE 0;2

La~pd}ehdf2c Kahdre{ LA^PD] EHdYENDAC

A[]APOMDE

]EKHE MONAC]OCDMA

5# I_^]DBDNENDAC;# AKIO]DRA^

># P[ABO^DACEHO^ E U_DOCO^ RE MD[DGDMA=# PAKHENDAC MDECE D O\NOPNDACO^?# FO]AMAHAGDE2# EN]DRDMEMO^ 0P[ANOMDFDOC]A^7# EHGA[D]FA MO EN]_ENDAC


2/16


La~pd}ehdfac Kahdre{

EHNED#h$,EFETA[s&&&&&&&& (Q s ssEsssddse9:E}:::LA^PD]EHDYENDAC

A[]APOMDE Ro{~d2c9 5

5# I_^]DBDNENDACHe~ b{en}{e~ mo he Mhebd~d~ mo he ]dkde oc emh}a~ o~ ce mo he~ p{dcndpeho~ne~e~ mo dcnependmem t fa}dra mo nac~h}e e ha~ ~o{rdnda~ mo _{gocnde~ moNahafkde#

;# AKIO]DRA^Md~oce{ ce gde mo fecoia nhdcdna ke~eme oc he foia{ ordmocnde md~pacdkho~ak{o oh fecoia mo B{en}{e~ mo he he Mdebd~d~ mo he ]dkde oc mo ce feco{ehagdne( ~onocndeh t a{moceme mo eno{ma e he p{o~oc}endac nhdcdne mo nemependoc}o#

># P[ABO^DACEHO^ E U_DOCO^ RE MD[DGDMAFomdna~ a{}apomd~}e~Fomdna~ moh ~o{rdnda mo {gocnde~

=# PAKHENDAC MDECE D O\NOPNDACO^Pakhendac emh}e uo nac~h}e eh ~o{rdnda mo {gocnde~ moh La~pd}eh ^dfacKahdre{ nac B{en}{e~ mo he he Mdebd~d~ mo he ]dkde#

?# FO]AMAHAGdECa ephdne#

2# EN]DRDMEMO^ 0 P[ANOMDFDOC]AÔ]DAHAGdEHe ne~e fe~ b{onoc}o o~ }{efe}dne pa{ enndmoc}o e}apomo~}{o 0 }{efemd{on}a m{ec}o p{en}dne mopa{}dre ( oc ha~ cdca~ oh }{efe ~o e~andegoco{ehfoc}o e nedme~ mo eh}{e 0enndmoc}o~ ne~o{a~#NHE^DBDNENDACô he~ nhe~dbdne mo~mo > pc}a~ mo rd~}e95# ôuc ~ daneyenhac9

moh }o{nda ~po{da{# moh }o{nda fomda# moh }o{nda dcbo{da{#

Pegdce ; mo 52


3/16

Ro{~d2c9 5

FECOIA MO B[EN]_[E^ MO N2mdga9 L^P&G_&540N&MDEBD D^ MO ]DKDE 0;2

Eh#NEHMbEFERA[s&&&&&&&&&&&&&&&&&&&&&*&&&&&&&&&&&&&&&= QsEs}*::Pdkd(d+:ds5j#ds#a~pd}ehdf2c Kahdre{ LA^PD]EHDYEND2CA[]APOMDE

;# ôuc ~ fonecd~fa9 pa{ gahpo md{on}a# pa{ fonecd~fo dcmd{on}a# pa{ }a{~d2c# pa{ ndyehhefdoc}a# pa{ bho|d2c# pa{ nafp{o~d2c#

># ôuc he ece}a{che moh {e~ga9 ]{ec~ro{~eho~ & {e~ga cdna Akhbne~ & {e~ga makho O~pd{abmoe~ & nacfdc}e Nacfdc}e~ & nac o~}ehhdma

=# ôuc letec ~dmo p{araneme~ pa{ c }{efe}d~fa mo9 Keie oco{gbe# Eh}e oco{gbe#He dcba{fend2c meme ~ouc o~}e~ nhe~dbdnendaco~( cdme~ e me}a~ nhbcdna~ nafaomem( meca feta{ 0 foca{ mo he~ pe{}o~ khecme~( fonecd~fo mo he b{en}{e(fegcd}m mo he oco{gbe moh }{efe}d~fa( pa~dkho o|pa~dnd2c moh bana mob{en}{e( mo~rdendaco~ mo ha~ b{egfoc}a~( o}n#( po{fd}d{ec nacbdg{e{ c nem{anhhcdna ft o|en}a moh ne~a oc }{e}efdoc}a( t uo pomo famdbdne{~~}ecndehfoc}o oh p{ac2~}dna t he }o{epo}dne e ~ogd{#

^DC]AFE^Nac b{onocnde ~o ocnoc}{ec p{o~oc}o~ }ama~ ha~ ~hc}a{ce~ t ~dgca~ p{apda~mo he~ b{en}{e~( pa{ 5 0 neh( oc he feta{be mo ha~ ne~a~( oh mdegc2~}dna bhtomo~mo he ~dfpho dc~ponnd2c9

Maha{ dc}oc~a# Dfpa}ocnde bcndaceh( ecuo oh po{aco o~}o dcmofco# Omofe# Oubfa~d~# N{opd}a 2~oa nac ha~ dc}oc}a~ mo fardhdye{ he pdo{ce#

Pegdce > mo 52


4/16

Ro{~d2c9 5


Eh#NE_$,E FETA[s&&&&&&&&&&&&&&&&&&&&&*&&&&&&&&&&&&&&s ssEs####################r#s #Fa~#5dkD dfAc90 | =0 nf$ uo po{fd}e oh o|efocmo }ame he }dkde( dcnhtocma pa{ 5 0 foca~ cee{}dnhend2c ,{amdhhe 0 }akdhha$ o dmoehfoc}o he~ ma~#

P{atonnd2c ec}o{a&pa~}o{da{ t he}o{eh# Na{{on}e }oncdne {emdau{ebdne(

He ~ofdahagde {emdau{ebdne po{fd}o dcro~}dge{9 O~}ema kdah2gdna moh o~uoho}a# Cdroh mo he b{en}{e# Ece}afde moh {e~ga9 cdna( fh}dpho( nacfdcnd2c(md{onnd2c( ba{fe( o}n# Nafp{afd~a moh po{aco( Mo~rdend2c mo ha~ b{egfoc}a~#

Ha~ me}a~ {obo{dma~ ~ac o~ocndeho~ pe{e nacbdg{e{ oh p{ac2~}dna toh phec }o{epo}dna# Mo o~}o fama }ocofa~ nac b{onocnde9

Pegdce = mo 52


5/16


La~pd}ehdf2c Kahdre{ LA^PD]EHDYENDAC

A[]APOMDE

EHNF#DI,E# FETA[s&&&&&&&&&&&&&&&&&&&&&*&&&&&&&&&&&&&&s QsEs# ( ( st##X'1( #spk9D4f,Ibh5j#=}rf

Ro{~d2c9 5

[e~ga }{ec~ro{~eh 0 hdgo{efoc}o akhbna9 p{apda mob{en}{e pa{ gahpo md{on}a( o~}ekho t mo bendh}{e}efdoc}a a{}apomdna# [e~ga o~pd{abmoa9 p{amndma pa{ c fardfdoc}a mo}a{~d2c 0 {a}end2c mo he pdo{ce nac pdo bdia ,0rdnoro{~e$( kdneme~ goco{ehfoc}o oc he cd2c moh

5 !> fomda nac oh md~}eh: mo ft mdbbndh {omnnd2c(dco~}ekho~: ha~ o|}{ofa~ 2~oa~ ~ohoc ocnac}{e{~omo~pheyema~ t efoceyec po{ba{e{ he pdoh# [e~ga fh}dpho9 goco{ecma ce b{en}{e nacfdc}e:~o p{amno lekd}ehfoc}o pa{ c }{efe}d~famd{on}a( ft rdahoc}a: pa{ ohha nac fnle b{onocndere ena{cpeceme mo g{ero nac}~d2c mo pe{}o~khecme~( o|}oc~a~ lofe}afe~( o{a~daco~ mo he pdoha o|pa~dnd2c mo ha~ b{egfoc}a~# [e~ga oc ehe mo fe{dpa~e( uo nacbdg{e c }o{no{ b{egfoc}a,Bdg{e >0$#

Pegdce ? mo 52


6/16

La~pd}ehdf2c Kahdre{


LA^PD]EHDYENDACA[]APOMDE Ro{~d2c9 5

B{eo}{e ~ogfoc}e{de9 makho baoa mo b{eo}{e( p{a|dfeh t md~}eh#Oc o~}a~ oe~a~ o~ o~po{ekho uo ca mo ha~ baoa~( fe~b{oooc}ofoc}o oh md~}eh( lege c {o}e{ma mo oac~ahdmeod2c,Bdg{e >5$#

Pegdce 2 mo 52


7/16

Ro{~d2c9 5


EHNEI##M,E FETA[b&&&&&&&&&&&&&&*&&&&&&&&&&&i %$b:sssFe~Ihkh ^f2c -:##5sLa~pd}ehdfac Kahdre{ LA^PD]EHDYENDAC

A[]APOMDE

Bdg{e >5

Adye~ ~oec pane~ he~ b{en}{e~ uo lec fa}drema feta{o~ nac}{aro{~de~{o~pon}a eh }{e}efdoc}a mobdcd}dro#He hd~}e mo pa~dkho~ nafphdnendaco~( {do~ga~ p{amndma~ m{ec}o oh mo~e{{ahhamoh }{e}efdoc}a( 0 mdbdnh}emo~ oc oh fecoia mo he b{en}{e fd~fe( o~dcudo}ec}o9 Ohoreme dcndmocnde mo o|pa~dndac moh bana mo b{en}{e# B{onoc}o nafp{afd~a mo he~ pe{}o~ khecme~ uo nk{oc he mdebh~d~}dkdeh( eg{erema pa{ oh }{efe}d~fa ud{{udna mo he }oncdne apo{e}a{de( nac oh{do~ga dcfdcoc}o mo he dc}onnhac nac~on}dre# G{ec }ocmocnde e he dco~}ekdhdmem mo ha~ b{egfoc}a~( ~ak{o }ama oceuohhe~ b{en}{e~ mo {e~ga~ akhdna~ 0 lohdnadmeho~# Mdbdnh}em e rono~ dcrocndkho pe{e hag{e{ he {omnnhac na{{on}e# Akhduendac mo nac~ogd{ {omnndaco~ po{bon}e~( ~ak{o }ama oc oh phecahe}o{eh zre{a t rehga moh b{egfoc}a md~}ehv#

Pegdce 7 mo 52


8/16

Ro{~d2c9 5


ED##NE_hbE FETU[s&& &* s ssEcn####################t##s #

s#s^f2c}a9E#QLa~pd}ehdf2c Kahdre{ LA^PD]EHDYENDAC

A[]APOMDE

Nacandme hoc}d}m mo ha~ p{ano~a~ mo a~}oagoco~d~ {ope{ema{e# B{onoc}o p{amnndac mo ~onohe~ pa~}&to~a9 omofe~ {o~dmeho~ ne~ddcrocndkho~( {dgdmoy mo {amdhhe t }akdhha( e}{abde~ f~nhe{o~( o~pondehfoc}o mohnem{dnop~( o}n#O~}e hd~}e mo {do~ga~ t mdbdnh}emo~ nac uo ~o ocb{oc}e oh fomdna oc o~}eb{en}{e( o|phdne uo ~o ~dgec }amerde phec}oecma mdro{~a~ {co}ama~ mo}{e}efdoc}a#Pa{ c hema( let udoco~ p{onacdyec( t nac ft koce~ {eyaco~( heo|nohocnde moh {co}ama ud{{udna ,a~}oa~dc}o~d~$ nafa }{e}efdoc}a dmoeh: leta}{a~( }e{ckdoc nac o|nohoc}o~ {eyaco~( uo p{onacdyec nafa dmoeh oh}{e}efdoc}a a{}apomdna#He {o~po~}e na{{on}e eh p{akhofe mo neme ocbo{fa( o~}e oc {ona{me{ uo hemond~dac }o{epo}dne o~}e mo}o{fdceme pa{ he nac~dmo{endac mo cfo{a~e~nd{nc~}ecnde~( uo ~ohoc ~o{ mdbo{oc}o~ oc neme ne~a oc pe{}dnhe{( t ~aha oho~}mda t orehendac dc}ohdgoc}o t n{d}o{da~e mo neme ne~a( po{fd}d{e heohonnhac moh {co}ama }o{epo}dna dmoeh9 ]dpa mo b{en}{e# Ece}afde mo ha~ {e~ga~# Dco~}ekdhdmem mo ha~ b{egfoc}a~# O~}ema mo he pdoh mo he pdo{ce# Omem moh ocbo{fa# O|po{docnde moh oudpa mo fomdna~ }{e}ec}o~# Cdroh mo emonendac mo dcb{eo~}{n}{e la~pd}ehe{de ,pekohhac e~op}dna(epata {emdau{ebdna( o|nohocnde mo dc~}{foc}eh( o}n#$#^aha mo~po~ mo leko{ o~}mdema p{abcme t {obho|drefoc}o neme ne~a( ohfomdna moko{e }afe{ ce mond~dac mobdcd}dre t rehomo{e pe{e o~o ocbo{fa ocba{fe pe{}dnhe{#Oc he en}ehdmem let c nacrocndfdoc}a ne~d cdro{~eh oc oh ~oc}dma mo uo oh}{e}efdoc}a a{}apomdna( ca ud{{udna( ~o{de( oc he feta{de mo ha~ ne~a~( ohfe~ obdney t oh uo foca~ {do~ga~ p{o~oc}e eh ocbo{fa# Fo}ama~ caeg{o~dra~( ~ema~ oc ba{fe ~dfpho 0 nafphofoc}ema~ nac }oncdne~ mo}{enndac( ofphoecma oh to~a nafa ohofoc}a mo nac}oc~dac o dcfardhdyendac(nac ce }oncdne na{{on}e( hag{ec nac~ogd{( oc he dcfoc~e feta{de mo ha~ne~a~( nac~ahdmendaco~ po{bon}e~ oc pheya~ re{dekho~ oc}{o > e ? fo~o~#

Pegdce < mo 52


9/16

Ro{~d2c9 5


ED# #NED # #MbE FETA[{&&&&&&&&&&&&&&&&&&&&&&*&&&&&&&&&&&&&&s MOssEss:}s4::2:9#.mds'+a~pd}ehdf2c Kahdre{ LA^PD]EHDYENDACA[]APOMDE

]{e}efdoc}a a{}apomhna]ec p{ac}a nafa ~oe pa~dkho( oc goco{eh e he~ pane~ la{e~ moh enndmoc}o( ~omoko {omnd{ e dcfardhdye{ he b{en}{e# Oc o~}o fafoc}e ha~ b{egfoc}a~pomoc ~o{ fecdphema~ nac bendhdmem( ca let nac}{en}{e f~nhe{( ec ohomofe ca ~o le p{amndma: pa{ 5 0 }ec}a( he~ nacmdndaco~ pe{e hag{e{ ce{omnndac o dc{cardhdyendac ~ac dmoeho~#Oc goco{eh( ~d ~o en}e nac ~erdmem( dc~pd{ecma t gececma~o he nacbdecyemoh pendoc}o( cd ~dudo{e o~ cono~e{de he eco~}o~de ,baneh 0opdm{eh$#5# Ocbo{fa ~oc}ema nac efke~ pdo{ce~ nahgecma oc oh ka{mo mo henefdhhe# ODpo~a fd~fa mo he pdo{ce en}e ehdcoecma t {omndocma he b{en}{e#;# Fomdna ~oc}ema b{oc}o eh ocbo{fa oc c cdroh fe~ keia uo he nefdhhe#># Nahanendac mo fehhe }khe{ t p{a}onndac mo he~ p{afdcocnde~ a~oe~(=# Nac}{ah rd~eh mo he na{{on}e ehdcoendac mo ha~ oio~ mo he pdo{ce9 oiohe}o{eh( ec}o{a pa~}o{da{ t {a}endac#?# Nahanendac mo he~ rocme~ octo~eme~ le~}e pa{ ocndfe moh }akdhha,p{dfo{ }dofpa$#^o nac}{ahe t na{{dgo ha~ ecuha~ moh pdo( ord}ecma he pa~dndac oc oudco( ocre{a 0 rehga: ~o nac}{ahe t na{{dgo ha~ oio~ mo he pdo{ce9 {a}endac( re{a&rehga tec}o 0 {on{re}f#2# B{egema oh to~a uo dcfardhdye oh pdo( ~o p{ahacge le~}e c pheca pa{mokeia mo he {amdhhe ,~ogcma }dofpa$#7# Nac}{ah {emdau{ebhna mo he pa~dndac mo ha~ b{egfoc}a~#


10/16



A[]APOMDE Ro{~d2c9 5

ô lete nafp{akema uo ca let omofe#OD nac}{ah {emdau{ebdna mofo~}{e ce na{{on}e t o~}ekho {omnnd2c#Ca lete faho~}de~ mo{dreme~ moh to~a#

Ndmema~ pa~}o{da{o~P{dfo{e be~o5# OD ocbo{fa pomo ofpoye{ e nefdce{ nac epata oc ; ke~}aco~ ,~dcepata moh to~a$ mo~mo oh mhe ~dgdoc}o mo he {omnnd2c#;# ^d ca nefdce( moko po{fecono{ oc nefe( nac he pdo{ce ohoreme#># E ha~ 7 e 50 mhe~( oh {do~ga moh omofe p{en}dne{coc}o le mo~epe{ondmat te ca o~ cono~e{da fec}oco{ he pdo{ce ohoreme#=# Nac}{ahe{ he p{en}dne mo ha~ oio{ndnda~ mo nem{dnop~( nemo{e tfardfdoc}a mo ha~ moma~ moh pdo#?# OD o~}ema moh pendoc}o t oh o~}ema moh to~a( mokoc ~o{ nac}{ahema neme7 e 50 mhe~#2# E~d ~o fec}doco pa{ > e ? ~ofece~# ]{ec~n{{dma o~}o hep~a ~o menafdocya e ce ~ogcme be~o oc oh }{e}efdoc}a#7# Cora nac}{ah {emdau{ebdna#

ôgcme be~o]{ec~n{{dme~ = e ?~ofece~95# ô ~ene oh to~a# E~oa mo he pdo{ce: o|efoc moh o~}ema mo he pdoh#;# Nac}{ah nhhcdna mo he o~}ekdhdmem moh bana mo b{en}{e# Ca moko ahrdme{~ouo o~ oh o|efoc nhhchna t ca oh e~pon}a {emdau{ebdna moh bana mo b{en}{e( ohuo me ce fe~ bdoh dcba{fend2c {o~pon}a eh p{ag{o~a mo he nac~ahdmend2c#># [emdag{ebde9 mo nac}{ah ~dc to~a#=# Nahanend2c mo cora to~a( ~dofp{o oc }{o~ }dofpa~( nafa bonahanema he p{dfo{e roy#

]ena mo fe{nle#?# Core {emdag{ebde mo nac}{ah( ce roy b{egema oh to~a#2# Na{{onnd2c mo mo~rdendaco~ mo oio ~d he~ lkdo{e#7# ^d oh g{ema mo o~}ekdhdmem nhhcdna moh bana mo b{en}{e nacbdo{onacbdecye oc nec}a e ~ ~ahdmoy( pomo e}a{dye{~o he fe{nle nac epata mo

Pegdce 50 mo 52


11/16

Ro{~d2c9 5



A[]APOMDE

ke~}aco~# ^d e~h ca an{{do{e( ca ~o e}a{dye he fe{nle le~}e oh p{a|dfanac}{ah#Oc o~}e~ nacmdndaco~( nefdcecma nac epata moh to~a( nac etme moke~}aco~( ~o fec}doco le~}e nfphd{ > fo~o~ mo }{e}efdoc}a#

]o{no{e be~oNfphdme~ he~ 5; ~ofece~95# ô {o}d{e oh to~a#;# E~oa t o|efoc moh o~}ema }{abdna mo he pdoh#># Nac}{ah nhdcdna moh g{ema mo ~ahdmoy t o~}ekdhdmem moh bana mo b{en}{e#=# [emdag{ebde mo nac}{ah#ôuc ~oe mo nacbdekho nhdcdnefoc}o oh nehha a~oa( nafphofoc}ema pa{ hedcba{fendac {emdau{ebhne( ~o p{anomo95# [o}d{a mobdcd}dra moh to~a#;# Moe{ckhendac nac}{aheme nac epata mo ke~}aco~#># Rocme ohe~}dne#=# [olekdhd}endac nac}{aheme mo fardfdoc}a~ mo {amdhhe( }akdhha( pdo ta{}oia~#?# [olekdhd}endac nac}{aheme mo nem{dnop~(2# Nac}{ah nhdcdna neme 50( 5?( ;0 T >0 mhe~( le~}e ~ {onpo{endacnafpho}e#7# Nac}{ah {emdau{e}dna e ha~ >0 t 20 mhe~ mo ~enema oh to~a#

Dcfardhdyend2c bcndacehNfphdme he p{dfo{e be~o ,> e ? ~ofece~$ t ~ouc ~oe mo nacbdekhonhdcdnefoc}o oh nehha mo b{en}{e( t mopocmdocma mo he o|po{docnde }oncdne mohfomdna }{e}ec}o( pam{de dcdnde{~o he ~ogcme be~o moh }{e}efdoc}a nac ceka}e mo to~a ,ka}e mo ê{fdoc}a$( nac epata oc }ko{a~dmem ec}o{da{ mo he}dkde( ft kdoc famoheme oc }afo e he ke~o mo ha~ phe}dhha~ }dkdeho~( nacepata oc oh nac}a{ca {a}hdeca( moiecma hdk{o oh lona paphd}oa( 5 0 uo Dopo{fd}o he hdk{o bho|dac mo he e{}dnhendac mo he {amdhhe#Oc he fomdme uo lete mme~ nhdcdne~ mo ce nac~ahdmendac {o}{e~eme 0 beh}emo }oncdnd~fa oc oh fecoia mo o~}o }dpa mo to~a( o~ enac~oiekho mondmd{~o

Pegdce 55 mo 52


12/16

Ro{~d2c9 5


EHNEHD$,E FETA[s&&&&&&&&&&&&&&&&&&&&&*&&&&&&&&&&&&&&s ssEs###################{9ssIH #}8Dah %d :}k4fw -:# #55QLa~pd}ehdfac Kahdre{ LA^PD]EHDYENDACA[]APOMDE

pa{ nac}dce{ he ~ogcme t }o{no{e be~o nac ka}e he{ge( kdoc famoheme tefkhe}a{de#He }oncdne moh to~a nac +dcfardhdyend2c bcndaceh+( {oen}ehdyeme pa{^e{fdoc}a( na{{o~pacmo e ce famehdmem mo }{e}efdoc}a uo o~ p{dre}dre moho~pondehd~}e te eroyema oc oh fecoia mo o~}e famehdmem }o{epo}dne#

Nd{nc~}ecnde~ o~pondeho~ uo nafphdnec he~ b{en}{e~ mo he }dkdeOc he dcfoc~e feta {de mo ha~ ne~a~( he b{en}{e mo }dkde ca p{o~oc}e lonla~nhdcdna~ uo nafphduoc he orahnd2c t oh }{e}efdoc}a uo lofa~ mo~n{d}a# ^dcofke{ga( nac ndo{}e b{onocnde( he b{en}{e ~o {amoe mo nd{nc~}ecnde~emro{~e~ uo akhdgec e famdbdne{ oh phec }o{epo}dna uo lofa~ ~ocehema9 B{en}{e~ o|po~}e~ {ondoc}o~ 0 ec}dge~ te dcbon}eme~# B{en}{e~ nac g{ec omofe mo he pdo{ce( khe~( o~na{dendaco~(uofem{e~( o}n# B{en}{e~ dco~}ekho~#Neme ce mo o~}e~ nd{nc~}ecnde~ akhdgec e }afe{ mond~daco~ }o{epo}dne~re{deme~ t uo ~ac pe{}dnhe{o~ pe{e neme ne~a oc o~}mda# ^ }{e}efdoc}a o~p{apda moh o~pondehd~}e( oc c efkdoc}o fomdna&ud{{udna eh}efoc}oo~pondehdyema# Me{ofa~ ~ahefoc}o ehgce~ pe}e~ ke~dne~ mop{anomdfdoc}a#5# B{en}{e~ o|po~}e~9 moko gde{ ~ p{anomdfdoc}a ~ouc ndo{}a~p{dcndpda~ ke~dna~9

e# Ord}e{ p{anomdfdoc}a~ uo legec o|po~}e ce b{en}{e no{{eme,}{e}efdoc}a dcn{oc}a$#k# Ek{d{ t o|paco{ efphdefoc}o oh bana o|po~}a#n# E~oa bd~dna t ud{{udna moh bana#m# [omnd{ ha~ o|}{ofa~ 2~oa~: ca ahrdmofa~ uo ca o~ o~op{ond~efoc}o oh akio}dra mo he dc}o{rocnd2c#o# Ndo{{o pa{ pdeca~ ,o|nop}a epaco{a~d~$# F~nha~ eb{ac}ema~(nohhe{ t pdoh# O~ ce nacmdnd2c dcmd~n}dkho( uo cdcgce ~}{emoko uome{ e }oc~d2c#

b# Dcfardhdyend2c pa{ p{anomdfdoc}a~ uo oh fomdna lek{e mo~ohonndace{ ~ouc 50enac~oioc he~ nd{nc~}ecnde~95# ]{ennd2c nac}dce }{ec~o~uoho}hne ,mo~mo oh nehnecoa$#;# Ka}e he{ge mo to~a( nac roc}ece b{oc}o eh bana# ^250 ~o{onafdocme oc b{en}{e~ o|po~}e~ mo g{ema D#

Pegdce 5; mo 52


13/16



Eh#NEh#I$,EFETA[{&&&&&&&&&&&&&&&&&&&&&&*&&&&&&&&&&&&&&s ssEs'####s#-ds#bj#i}:(:: ####LA^PD]EHDYENDACA[]APOMDE Ro{~d2c9 5

># Bo{he mo to~a( ft kdoc ei~}eme( oc b{en}{e~ kdoc{omndme~ t nac~dmo{eme~ o~}ekho~#=# Bdiendac o|}o{ce( {o~o{reme e b{en}{e~ efphdefoc}oo|po~}e~ ,g{ema DD 0 DDD$ nac po{mdme mo ~~}ecnde(dcbon}eme~( o}n#g# Nac}{ah po{fecoc}o mo he orahndac mo he lo{dme t mo he b{en}{e#l# Ec}dkda}o{epde emoneme#d# Necma he~ nd{nc~}ecnde~ p{apde~ mo he o|pa~dndac letecmo~epe{ondma( ~o nac}dce oh }{e}efdoc}a }eh neh ~o leno oc ceb{en}{eno{{eme#

]{e}efdoc}a uh{{uhnaAdye~ ~oe he b{en}{e mo }dkde macmo oh }{e}efdoc}a ud{{udna ,a~}oa~dc}o~d~$ le~dma fe~ md~n}dma#He hd~}e mo nafphdnendaco~ md{on}efoc}o p{amndme~ pa{ he }c}o{rocndac o~ he{ge:~dc mme uo mo }ame~ ohde~( he fe~ }ofdkho pa{ ~~ nac~onocnde~ o~ he dcbonndac#O~ pa{ o~a uo oc ne~d }ama~ ha~ ~o{rdnda~ }{e{ce}ahaudna~ moh fcma( ~op{onacdye nafa {co}ama mo ohonndac oh }{e}efdoc}a a{}apomdna te mo~n{d}a({o~o{recma he }oncdne ud{{udne pe{e ne~a~ ~ohonndacema~ ~ouc dcmdnendaco~ fto~}{dn}e~ t p{ond~e~# ^dc ofke{ga( oh he{ga }dofpa mo dc{cardhdyendac ,fdcdfa >fo~o~$( he e}{abde f~nhe{ t he~ {dgdmono~ e{}dnhe{o~ uo nachhore( lenoc uo ha~ne~a~ mo d{{omn}dkdhdmem mo}o{fdcoc uo he }o{epo}dne ~o a{doc}o eh }{e}efdoc}aud{{udna( po{fd}docma ce {omnndac ece}a{cdne t o~}ekho( ce fardhdyen}ace{}dnhe{ p{onay t ce moe{ckhendac nac mo~ne{ge fe~ ~og{e t p{onay#

Dcmdnendaco~ B{en}{e o|po~}e# B{en}{e d{{omn}dkho# B{en}{e dco~}ekho# B{en}{e nac nafp{afd~a re~nhe{# B{en}{e oc lo~a pe}ahaudna# B{en}{e nacfdc}e#OD nd{ieca pomo ~oc}d{ ce pamo{a~e }oc}endac pa{ {o~ahro{ oh p{akhofe ~ecmaphene~( }a{cdhha~( nhera~ dc}{efomhe{o~( o}n#( ocge{dema pa{ he epe{oc}o bendhdmemuo pe{ondo{e ab{ono{ c lo~a mo }ec bendh enno~a# OD o{{a{ o~ ordmoc}o: he~mdbdnh}emo~ }oncdne~ pe{e {omnd{ t o~}ekdhdye{ ha~ b{egfoc}a~ a~oa~ ~ohoc ~o{dc~po{ekho~( nac~}d}tocma~o e focma oc ce dc}o{rocndac mo g{ec nafphoidmem#

Pegdce 5> mo 52


14/16



E HNE HM bE # ## ## TA[s&&&&&&&&&&&&&&&&&&&&&*&&&&&&&&&&&&&&s QsEs}d(d(HrA####ss#9:i#(sss ##o#9:(is#LA^PD]EHDYENDACA[]APOMDE Ro{~d2c9 5

Emo{ce~( oh p{onda uo oh ocbo{fa pomo pege{ pa{ ce {omnnd2c po{bon}e ~oho~o{ ohorema t mo p{atonndaco~ dc~a~ponleme~#He hd~}e mo nafphdnendaco~ uo pomoc p{o~oc}e{~o o~ }ofdkho9

Dcbonnd2c mo he lo{dme# A~}oafdohd}d~ moh bana mo b{en}{e# [o}e{ma mo he nac~ahdmend2c# P~omae{}{a~d~# Mold~nocnde mo he lo{dme#

OD nd{ieca uo eb{ac}e he {o~pac~ekdhdmem mo ce }o{epo}dne ud{{udne oc ceb{en}{e mo }dkde( ca moko dgca{e{ uo te o~ c mo~e~}{o ce p~omae{}{a~d~( po{a ~dhe p~omae{}{a~d~ o~}e dcbon}eme( oh mo~e~}{o pomo }oco{ nac~onocnde~ne}e~}{2bdne~#

Nd{ieca }{efe}25aga eh}efoc}o nafpo}oc}o oc nd{gde 2~oe# ^o{rdnda mo nd{gde }{efe}ah2gdne mo o|nohocnde# Ma}ema mo ce dcb{eo~}{n}{e }oncah2gdne mo ~po{da{ nehdmem# E~op~de ge{ec}dyeme oc }ame~ t neme ce mo he~ be~o~ moh }{e}efdoc}a# Dc~}{foc}eh ud{{udna nafpho}a# Eud ca ~o emfd}oc dfp{ard~endaco~# ^d }ame~ o~}e~ nacmdndaco~ ~ac meme~( ~dofp{o o~ p{moc}o poc~e{ fnle~rono~ ec}o~ mo o|paco{ eh ocbo{fa e c {do~ga mo }ec eh}a cdroh# ^d ~o o~}dfe uo oh }{e}efdoc}a moko ~o{ ud{{udna( ~ }{e~hema e c^o{rdnda mo he o~pondehdmem o~ po{oc}a{da#

^d he dcmdnend2c ud{{udne ,a~}oa~dc}o~d~$ o~ rehdme( moko ~o{ {oehdyeme keia he~~dgdoc}o~ nacmdndaco~9

]oncdne~ mo a~}oa~dc}o~d~ oc he~ b{en}{e~ mo pdo{ceO|p{o~d2c nhe{e mo nec nafphoia pomo hDoge{ e ~o{ oh p{anomdfdoc}a ud{{udna eohogd{ oc he a~}oa~dc}o~d~ mo he b{en}{e( o~ he hd~}e( }amerde dcnafpho}e( mo he~ fe~mdro{~e~ }oncdne~ en}ehfoc}o oc ~a lekd}eh9

Ocnherema ocmafomhe{ Phene mo a~}oa~dc}o~d~# ]a{cdhha~ oc b{en}{e~ akhdne~ 0 o~pd{admoe~# Nhera~ }oc~ oc cdco~

Pegdce 5= mo 52


15/16

FECOIA MO B[EN]_[E^ MO N 2m dg a9 L ^P &G _&5 40 N&MDEBD^D^ MO ]DKDE 0;2

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A[]APOMDE

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16/16


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hsp-gu-190c-026 manejo de fracturas de diafisis de tibia

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