陳舊性骨折、合併關節錯位畸型癒合的手法整復病例

Medical Case Studies in Healing Practices of Malunited Bones Caused by Old Fracture and Joint Subluxation

盧文瑞(Wen-Ruey Lu)

《中醫骨傷科醫學雜誌》 7期 (2008/12) Pp. 69-77

https://doi.org/10.30098/JCOT.200812.0010

摘要

意外傷害造成肢體骨折，於第一時間內（整復黃金期）錯過正骨手法復位，而拖延時日超過2~3週以上者，稱之「陳舊性骨折」；骨折斷端有錯位形態（包括成角、重疊、旋轉或合併關節錯位等）而伴有功能障礙者稱「骨折畸形癒合」。
陳舊性骨折經過一段時間後血腫已消、骨痂已漸長成，再加上斷端常在關節部位，易形成日復功能障礙，故若距離發生骨折時間不甚長或許可再做復位手法，儘量令患者患肢恢復外觀及功能性的健全與完整。
以下是兩則正值青春期的少年骨折案例，年輕男孩正值成長期骨鈣豐沛、骨傷部結痂恢復迅速，其中一位失治已過一個多月、另一位也延遲三週（20多天）以上，但由於及時施與正確的手法，一案已痊癒、一案結稿前仍在恢復中，其中一例為上肢、是當下矯正成功；另一例為下肢、則是以漸進式矯正方式為之。
骨傷科的復位法當然首重黃金時期，但中醫往往少有機會接到新鮮骨折案例，反而常會接到後遺症的案例，故拯救陳舊性骨折也是中醫傷科醫師必備的技術。

關鍵字

陳舊性骨折 ； 骨折合併關節錯位畸型癒合 ； 陳舊性骨折手法整復 ； 正骨手法 ； 骨痂

並列摘要

”Old fracture” occurs when a patient's fractures of the body caused by accidental injuries cannot be reset immediately or delay healing of fractures more than two to three weeks. Fracture surfaces presenting dislocation (including lift, overlap, rotation and joint subluxation) associated with malfunction problems define as malunion. Malfunction problems may happen to the patient with old fracture after hematoma disappears and callus bones grow. But if the healing of resetting bones can be conducted again no longer than two month of an injury, mulunion and malfunction may not happen to the patient.
I'll present the two following cases of old fracture in young adults. Young boys are sufficient in calcium and benefit a rapid growth in callus bones. They respectively missed an immediate treatment over one month and three weeks after their injuries happened. However, an adequate and proper treatment respectively enabled them to fully recover and to get improved: I moved his dislocated bones of upper limbs back into their correct positions successfully, and it took several times to move back the other's lower limbs. Orthopedic doctors focus on the immediate chance to reset the broken bones. However, those patients to whom an injury of fractured bones happens barely visit Traditional Chinese Medicine doctors at once. The doctors usually have to deal with the sequela of broken bones. So, Traditional Chinese orthopedic doctors need to know how to heal old fracture.

並列關鍵字

old fracture ； malunited bones caused by old fracture and joint subluxation ； the practices of moving bones back to their correct positions ； callus bones