最近审阅: 27 十月 2020
最近更新: 10 三月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 疼痛
  • 软组织肿胀
  • 瘀斑
  • 血肿扩大
  • 肢体功能受损
  • 无法负重
  • 压痛点
  • 畸形
  • 拒绝
  • 损伤位置存在伤口
  • 缺血性肢体症状
  • 低血压/低血容量休克

其他诊断因素

  • 神经感觉改变
  • 运动功能受损
  • 骨擦音
  • 骨痂
  • 股骨颈或股骨干应力性骨折症状再现

危险因素

  • 直接外伤
  • 间接外伤
  • 骨质疏松症(不全骨折)
  • 慢性肾功能衰竭
  • 糖尿病
  • 骨肿瘤(病理性骨折)
  • 年龄>70 岁
  • 年龄<30 岁
  • 男性(急性骨折)
  • 女性(应力性和不全骨折)
  • 长期使用皮质类固醇(不全骨折)
  • 低 BMI(不全骨折)
  • 近期跌倒史(不全性骨折)
  • 既往骨折(不全骨折)
  • 癫痫发作(肱骨近端骨折)
  • 长期使用双磷酸盐

诊断性检查

首要检查

  • 四肢 X 光检查
  • FBC、血型检查和交叉配血(严重外伤)
更多 首要检查

需考虑的检查

  • 骨折的非增强 CT
  • 三相骨扫描
  • 肢体 MRI
  • 筋膜室压力测试
  • 多普勒血压检测(踝/臂收缩压指数)
  • 超声双功扫描
  • 血管造影术
  • 双能 X 线吸收测定法骨密度扫描
更多 需考虑的检查

治疗流程

撰稿人

Attending Physician

Rutgers University Health Services

Clinical Assistant Professor of Internal Medicine and Family Medicine

Rutgers Robert Wood Johnson Medical School

Piscataway

NJ

利益声明

PHC has given lectures for MCE Conferences, a medical education company, and received a stipend/free hotel room during the conference. MCE Conferences accepts no funding from pharmaceutical companies or other outside agencies, and PHC declares that the lectures have no impact on the topic.

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Professor

Trauma and Orthopaedic Surgery

University of Leeds

Leeds

UK

利益声明

PG is an editor for Chief Injury. He has received research grant support from Depuy-Synthes, Biomet, and Pfizer, and has received honoraria from Olympus Biotech, Medtronic, Pfizer, Biomet, and AO Foundation.

Orthopaedic Trauma Surgeon

Assistant Professor

Department of Surgery

McMaster University

Hamilton

ON

利益声明

BP has received speaking fees from AO North America, OTC, Stryker, and Smith & Nephew. BP has received consult fees from Stryker Canada.

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