Barnaby W
Department of Emergency Medicine, Kaiser-Permanente Medical Center, Oakland, California.
Emerg Med Clin North Am. 1992 Feb;10(1):133-49.
Wrist injuries are and will continue to be one of the most difficult and interesting orthopedic problems encountered by emergency physicians. With a knowledge of basic wrist anatomy, the gathering of a detailed history of the mechanism of injury, thorough physical examination, and appropriate radiography, the physician will be able to make an accurate early diagnosis. This will prevent the development of serious functional problems such as osteonecrosis or malunion with all their attendant pain and disability, which is especially serious for the young active worker or athlete. A thorough radiographic examination should be done, the six-view series being the most revealing initial study, particularly for possible scaphoid fractures. All injured wrists should be properly immobilized and re-evaluated if a fracture or serious ligamentous injury is at all suspected. An appreciation of the simplicity of design and remarkable functional complexity of the wrist together with a respect for the subtlety of presentation of injury will help the emergency physician to ensure that patients have highest standard of care and an excellent outcome.
腕部损伤一直是急诊医生所面临的最棘手且最具挑战性的骨科问题之一，并且在未来仍将如此。凭借对腕部基本解剖结构的了解、详细收集损伤机制的病史、全面的体格检查以及适当的影像学检查，医生将能够做出准确的早期诊断。这将预防诸如骨坏死或畸形愈合等严重功能问题的发生，以及随之而来的所有疼痛和残疾，这对于年轻的体力劳动者或运动员来说尤为严重。应进行全面的影像学检查，六视图系列是最具诊断价值的初始检查，特别是对于可能的舟骨骨折。如果怀疑有骨折或严重的韧带损伤，所有受伤的手腕都应妥善固定并重新评估。认识到腕部设计的简单性和显著的功能复杂性，以及尊重损伤表现的细微之处，将有助于急诊医生确保患者得到最高标准的治疗并获得良好的治疗效果。
