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Avulsão: Definição, Contexto Médico e Exemplos de Uso

Definição

Avulse (verb) / Avulsion (noun): To forcibly tear away or detach a structure from its normal attachment, typically by violent mechanical force.

Medical Contexts

StructureMechanismExamples
Tendon/LigamentSudden eccentric loadBiceps tendon avulsion (distal), ACL avulsion (tibial spine), Achilles avulsion (calcaneus)
Bone FragmentLigament/tendon pulls off cortical boneAnkle avulsion fracture (lateral malleolus), pelvic avulsion (ASIS/AIIS/ischial tuberosity in adolescents)
NailCrush/strip injurySubungual hematoma → nail plate avulsion
ToothTraumaComplete displacement from socket (avulsed tooth = dental emergency)
Skin/Soft TissueShear force (degloving)Morbidly obese: pannus avulsion; ring avulsion (finger); scalp avulsion
NerveTraction injuryBrachial plexus avulsion (motorcycle accident); rootlets torn from cord

Clinical Features

  • Acute, severe pain.
  • Deformity, loss of function (active motion lost if tendon avulsed).
  • Ecchymosis, swelling, palpable defect.
  • Radiographic: Bone fragment at attachment site; MRI/US for soft tissue.

Management Principles

  • Acute Surgical Repair: Most tendon/ligament/bone avulsions → anatomic reduction + fixation (suture anchors, screws) within 2–3 weeks for best outcome.
  • Avulsed Tooth: Reimplant within 30 min (Hank's balanced salt solution/milk/saliva); splint 2 weeks.
  • Degloving/Skin Avulsion: Debridement, skin graft/flap; may require amputation if vascularized.
  • Conservative: Minimally displaced bony avulsions (e.g., ischial tuberosity) → protected weight-bearing, PT.

General Usage

Beyond medicine: "The flood avulsed the bridge from its foundations." "The scandal avulsed his reputation." Always implies violent, sudden separation.

Mordidas de Formiga

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