脊髓損傷併發雙踝骨折：病例報告

慢性脊髓損傷患者的骨折發生率高於一般族群。脊髓損傷患者功能不佳容易造成意外跌傷，可能導致肢體骨折。此外，慢性脊髓損傷患者較易發生骨質疏鬆症，尤其是癱瘓的肢體部份，因而增加骨折的發生率。慢性脊髓損傷患者發生骨折的特點為：經常發生於低能量、較小的外傷，較易發生在下肢，較易發生在女性及老年患者。此外，由於患者的感覺機能受損，較不易感覺疼痛，常造成就醫的延誤及診斷的困難。脊髓損傷的骨折處置也與一般骨折不同，此型態的骨折往往不需手術，較常使用輔具固定。本篇病例報告一位慢性脊髓損傷患者因跌倒意外而發生雙踝骨折，延遲至四天就醫，才獲得確定診斷與治療。查考國內外文獻，尚無脊髓損傷病患因輕度外傷造成雙踝骨折的病例報告。本研究探討此類案例適當的預防、診斷與治療方式，以作為臨床參考。

關鍵字

脊髓損傷；雙踝骨折；骨質疏鬆症；截癱

並列摘要

The incidence of fracture is higher in patients with chronic spinal cord injury (SCI), particularly female and elderly patients, than in healthy people. Functional impairment due to SCI may lead to accidental falls and fractures, most of which are due to trivial injury or without known trauma. In addition, the inevitable osteoporosis in the paralyzed limbs of individuals with chronic SCI increases their risk of fracture. The lower limbs are more often involved than the upper limbs. Because of the sensory impairment associated with SCI, fractures may be difficult to diagnose, and treatment may be delayed. The treatment of fractures in patients with chronic SCI usually differs from general principles in that conservative treatment with orthoses is considered first. We report a patient with chronic SCI who had bimalleolar fractures caused by an accidental fall. This patient ignored the fracture and went to hospital 4 days after the injury because of fever and general malaise. To our knowledge, this is the first report of bimalleolar fractures in SCI. The proper prevention, diagnosis, and treatment of this injury were discussed.

並列關鍵字

spinal cord injury ； bimalleolar fracture ； osteoporosis ； paraplegia

國際替代計量

脊髓損傷併發雙踝骨折：病例報告

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