骨科英文书籍精读（128）｜腕关节损伤（3）

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Arthroscopy

Wrist arthroscopy is the best way of demonstrating TFCC or interosseous ligament tears.

Principles of management

‘Wrist sprain’ should not be diagnosed unless a more serious injury has been excluded with certainty. Even with apparently trivial injuries, ligaments are sometimes torn and the patient may later develop carpal instability.

If the x-rays are normal but the clinical signs strongly suggest a carpal injury, a splint or plaster should be applied for 2 weeks, after which time the xrays are repeated. A fracture or dislocation may become more obvious after a few weeks, but a second negative x-ray still does not exclude a serious injury. A bone scan or MRI at this stage will confirm the diagnosis and avoid an unnecessary period of immobilization and time from work. If these tests are not readily available, then the patient should be re-examined repeatedly until the symptoms settle or a firm diagnosis is made.

---from 《Apley’s System of Orthopaedics and Fractures》

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重点词汇整理：

trivial /ˈtrɪviəl/adj. 不重要的，琐碎的；琐细的

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百度翻译：

关节镜检查

腕关节镜检查是显示TFCC或骨间韧带撕裂的最好方法。

管理学原理

“手腕扭伤”不应被诊断，除非更严重的损伤已经被排除在外。即使有明显的轻微损伤，韧带也会撕裂几次，患者以后可能会出现腕关节不稳。

如果x光片正常，但临床症状强烈提示腕关节受伤，应使用夹板或石膏敷2周，之后再重复x光检查。骨折或脱位可能在几周后变得更明显，但第二次x射线阴性仍不能排除严重损伤。这一阶段的骨扫描或核磁共振将确认诊断，并避免不必要的固定时间和工作时间。如果这些检查不易获得，则应反复检查病人，直到症状缓解或作出明确诊断。

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