A 60-year-old left-handed woman presented to the emergency department with pain in her left forearm. The arm was swollen and tender, especially with passive pronation and supination. The overlying skin was intact, and the results of neurovascular examination were normal. Radiographs of the left forearm were performed (upper image, anteroposterior view; lower image, lateral view). The findings should raise concern for which contributory factor?
一位60岁的左撇子妇女因左前臂疼痛来到急诊室。手臂肿胀和压痛,尤其是被动旋前和旋后。复盖皮肤完整,神经血管检查结果正常。左前臂x线片(上图,正位片;下图,侧面视图)。这些发现应该引起人们对哪个促成因素的关注?
A. Assault
B. Fall
C. Malignancy
D. Osteoporosis
E. Repetitive strain
答案解析:
正确答案是攻击。x线片证实为孤立性尺干骨折,也称为“夜棒骨折”。这种损伤是由于前臂受到钝器外伤造成的,通常发生在上臂为自卫而抬起时,以防头部或躯干受到攻击。在这个案例中,创伤是由亲密伴侣的暴力造成的。对病人的安全和精神健康进行了全面评估,并提供了社会服务。患者接受了切开复位和骨折内固定,随后进行夹板固定,尽管在某些情况下,这种类型的损伤可以非手术治疗。
正确答案:A
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