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手腕:常见损伤与处理

The wrist: common injuries and management.

作者信息

Parmelee-Peters Katrina, Eathorne Scott W

机构信息

Providence Athletic Medicine, Providence Medical Center-Providence Park, 47601 Grand River Avenue, Suite A101, Novi, MI 48374, USA.

出版信息

Prim Care. 2005 Mar;32(1):35-70. doi: 10.1016/j.pop.2004.11.015.

Abstract

Primary care physicians not only have an important role in the diagnosis and initial treatment of wrist injuries, but also play a key role in the education of families about prevention. Children and adolescents are often competitive in sports throughout the year. Periods of rest can be important in prevention of overuse injuries in the very active, developing athlete. Protective gear such as wrist guards, used during activities such as inline skating and snowboarding, has been shown to prevent acute injuries that often require surgery or lead to prolonged disability [84,85].A primary care physician will often be the first health care provider to assess most wrist complaints. The intent of this article is to familiarize the primary care physician with the most common wrist injuries in active people, and to demonstrate that many injuries can have poor outcomes if unrecognized. It is important to have good clinical knowledge of the functional anatomy of the wrist in order to maximize the information gathered on examination and to narrow one's differential diagnosis. The athlete's sport and desires regarding return to play, and the impact of the timing of injury management on his or her further participation in sport are important to consider. A highly active person may be referred to a musculoskeletal specialist for advanced testing or surgical repair earlier in the evaluation of certain injuries than a less active one. Armed with good clinical knowledge of anatomy and an understanding of common wrist injuries,primary care physicians can successfully manage many wrist complaints.

摘要

初级保健医生不仅在手腕损伤的诊断和初始治疗中发挥着重要作用,而且在向家庭传授预防知识方面也起着关键作用。儿童和青少年全年在运动中往往具有竞争性。对于非常活跃的、正在发育的运动员来说,休息时间对于预防过度使用损伤可能很重要。在轮滑和单板滑雪等活动中使用的护腕等防护装备已被证明可以预防通常需要手术或导致长期残疾的急性损伤[84,85]。初级保健医生通常会是评估大多数手腕问题的首位医疗服务提供者。本文旨在使初级保健医生熟悉活跃人群中最常见的手腕损伤,并表明许多损伤如果未被识别可能会导致不良后果。为了最大限度地利用检查中收集到的信息并缩小鉴别诊断范围,了解手腕的功能解剖学的良好临床知识很重要。运动员的运动项目以及其关于重返比赛的意愿,以及损伤处理时机对其进一步参与运动的影响都是需要考虑的重要因素。在某些损伤的评估中,高度活跃的人可能比不太活跃的人更早被转介给肌肉骨骼专科医生进行进一步检查或手术修复。凭借良好的解剖学临床知识以及对常见手腕损伤的了解,初级保健医生可以成功处理许多手腕问题。

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