b****n
发帖数: 90 | 1 5月26日,小孩（女孩，5岁,30斤,104厘米高）左手手臂摔伤，去ER急诊，一个老医生看
了X光说,只是尺骨骨折,打石膏就行了.打了石膏后,两天后受伤的左手的手掌肿大,无名
指和掌心发青,这里医生说正常,小孩过去几天都说不痛.我们担心手掌是否骨折，今天
又照了x光,手掌没有骨折.
今天送小孩去另一个医生那里换石膏,这位年轻医生说以前那个医生没有看正确,除了尺
骨骨折,桡骨还脱臼,必须手术打钉子固定骨头,把桡骨归位.给我们安排了明天凌晨作手
术.
现在我们也不知道究竟该相信哪个医生,因为时间紧迫,也来不及再找别的医生看，我们
只好四处打听，请懂的人帮我们看看x光片，我们想知道除了尺骨骨折，桡骨是否脱臼?
现在是否必须手术?
假使桡骨真的象年轻医生说的是脱臼,5天前看急诊时如果诊断正确,是否可以避免手术? | b****n
发帖数: 90 | | p**a
发帖数: 28 | 3 This is a proximal ulna fracture with radial head anterior dislocation, also
called Monteggia fracture type 1. The
young surgeon is correct, do not believe a doctor just because he is old.
However for treatment, try closed reduction with cast fixation first. In
your case, since it is 5 days out, it could
be difficult for closed reduction, but worth a try. If it cannot be reduced
by manuver, then surgical open
reduction and internal fixation is indicated.
【在 b****n 的大作中提到】
: 另一张x光片
| b****n
发帖数: 90 | 4 Thanks a lot. You are so helpful. We are trying to avoid the surgery if
possible because the surgery and the tense follow-up will bring us a lot of
mess.
My daughter did not feel any pain from her arm in the temporary cast in the
past 5 days, does that suggest anything? Thanks again.
also
reduced
【在 p**a 的大作中提到】
: This is a proximal ulna fracture with radial head anterior dislocation, also
: called Monteggia fracture type 1. The
: young surgeon is correct, do not believe a doctor just because he is old.
: However for treatment, try closed reduction with cast fixation first. In
: your case, since it is 5 days out, it could
: be difficult for closed reduction, but worth a try. If it cannot be reduced
: by manuver, then surgical open
: reduction and internal fixation is indicated.
| p**a
发帖数: 28 | 5 It does not mean anything having no pain in the cast. The radial head MUST
be reduced, either closedly or
surgically. To maintain the reduction, the ulna fracture MUST be reduced and
stabilized, either with cast or
internal fixation. Probably the surgeon feels that it would be very
difficult for close reduction and cast fixation.
In this case, surgery is in your best interest.
No matter what you choose, close reducton or surgery, the earlier the better
. Do not wait too long with wishful
thinking, or looking for another "old" doctor.
of
the
【在 b****n 的大作中提到】
: Thanks a lot. You are so helpful. We are trying to avoid the surgery if
: possible because the surgery and the tense follow-up will bring us a lot of
: mess.
: My daughter did not feel any pain from her arm in the temporary cast in the
: past 5 days, does that suggest anything? Thanks again.
:
: also
: reduced
| b****n
发帖数: 90 | 6 很感谢你的专业答复!
and
better
【在 p**a 的大作中提到】
: It does not mean anything having no pain in the cast. The radial head MUST
: be reduced, either closedly or
: surgically. To maintain the reduction, the ulna fracture MUST be reduced and
: stabilized, either with cast or
: internal fixation. Probably the surgeon feels that it would be very
: difficult for close reduction and cast fixation.
: In this case, surgery is in your best interest.
: No matter what you choose, close reducton or surgery, the earlier the better
: . Do not wait too long with wishful
: thinking, or looking for another "old" doctor.
| s********o
发帖数: 3319 | 7 赞功力深厚心地善良！你以前积水潭的？
and
better
【在 p**a 的大作中提到】
: It does not mean anything having no pain in the cast. The radial head MUST
: be reduced, either closedly or
: surgically. To maintain the reduction, the ulna fracture MUST be reduced and
: stabilized, either with cast or
: internal fixation. Probably the surgeon feels that it would be very
: difficult for close reduction and cast fixation.
: In this case, surgery is in your best interest.
: No matter what you choose, close reducton or surgery, the earlier the better
: . Do not wait too long with wishful
: thinking, or looking for another "old" doctor.
|
|
