中重度的腕挫傷之診斷與治療

Diagnosed and Treatment of Mid-severe Degrees of Wrist Bruise

盧文端(Wen-Ruey Lu)

《中醫骨傷科醫學雜誌》 5期 (2006/12) Pp. 23-28

https://doi.org/10.30098/JCOT.200612.0007

摘要

臨床上常見到中重度腕部挫傷的患者，因跌倒或因車禍，受到扭、挫、砸、撞、拗折之外力，因受傷時體位不同、支撐姿態也不同，形成腕部不同部位的損傷。
中重度腕部挫傷可區分成傷筋、傷骨。此處損傷最重要的共同點就是腕部擠壓性創挫，若能在受傷初期施以正確合宜的蹻筋矯骨手法，並加以使用固定法，以中度腕部傷筋而言，一般2~3週即可復元；重度腕部傷筋骨約5~7週痊癒，但有時也須考慮到一些影響痊癒的因素例如：年齡、體質、受傷程度、就診遲速……等。
臨床上最遺憾的是常見到不少患者，當時因錯過了黃金期的施治機會，而徒留了日後手腕功能性或外觀變形的後遺症。所以在急性期，即受傷的當日是最好治療的黃金期。因初傷、腕關節尚柔軟、關節間滲出液及血瘀還不多，不會造成施術時的困難。患者疼痛成亦較輕、預後功能恢復也好，故掌握急性期的治療時機是非常量要的。
若在受傷早期（於急性期、亞急性期）能給予正確的診斷、矯正復位手法，並使用穩定性高的固定法包紮，癒後功能之恢復幾乎可達90~95%。

關鍵字

中重度腕挫傷 ； 腕部擠壓性創挫 ； 蹻筋矯骨手法 ； 固定法 ； 筋

並列摘要

In clinical service, there are patients suffering from various degrees of wrist bruise after a tumbling off or a car accident. Depending on the injured part of the body and the specific posture of the patient's while tumbling, the external forces such as twisting, banging, pounding, and crashing while tumbling off are the major causes of these bruises on different parts of wrist.
Mid-severe degrees of wrist bruise consist of two specific types of bruises the tendon wounded, and the bone wounded. The common point of these two types of wounds is that they are caused by the extrusion injury on the part pf wrist. In general, if the proper tendon and bone adjustment method is applied during the early acute time, with the help of fixation method, it takes two to three weeks for mid wounded patients to be recovered, and five to seven weeks for severe wounded patients. That is if proper medical techniques and treatment are implemented onto the wounded tendon or the bone. However, other elements such as patient's age, physical condition, degrees of injuries and the timing of having medical inspection also affect the time needed for recovery. It is common for patients who suffer from wrist functional damage or distortion just because of missing the best opportunity for treatment in time-the golden time treatment-after the accident. Therefore, the acute time, the same day of the accident happened, is the best time for medical treatment. Because the joint of the wrist is still soft and the percolating water and the blood stasis are lesser, the practice of medical treatment is relatively easier and the patient's feeling of pain is milder. As a result, the function of the wrist restore better, In short, the acute time is the key to the opportunity and the effect of the medical treatment.
If the injured wrist is diagnosed and the rectify techniques are applied in the early acute time (per acute time, and sub acute time) with the facilitation of the fixation method's high stability, the restoration rate could reach 90-95%.

並列關鍵字

mid-serious degrees of wrist bruise ； the extrusion injury on the part of wrist ； the proper tendon and bone adjustment method ； fixation method ； tendon