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中医药研究论丛
 222.11 中西医合治成人锁骨骨折病例报告
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TJ TCM.22(2) : 107-114, 2019
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中西医合治成人锁骨骨折病例报告
Integrative Chinese and Western Medicine in Treating Clavicle Fractures: A Case Report
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谢嘉娟1,2 陈旺全3,4*
1 国防医学院医学系，台北，台湾
2 三军总医院家庭暨社区医学部，台北，台湾
3 义守大学学士後中医学系，高雄，台湾
4 义大医院中医部，高雄，台湾
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【摘要】
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ㄧ壮年男性於2018 年01 月05 日因交通意外，身体左倾着地，致左肩疼痛、肢体数处表浅性损伤，起初自行使用成药，2018 年01 月15 日因局部逐渐肿胀、疼痛加剧无法入睡至急诊，经X 光诊断为左侧锁骨中段骨折，会诊骨科医师诊视，锁骨闭锁性骨折并部分位移采取非手术治疗为原则，以八字肩带与三角巾悬臂吊带回复生理结构与功能，并控制疼痛与均衡营养。2018 年01 月27 日因腋下红疹、左手酸麻肿胀等症状回诊，门诊X 光复查无明显进展，医师建议继续以八字肩带固定、加强营养补充及戒除咖啡，表示西药功效有限，可考虑寻求第二意见；病人与亲友讨论後，决定接受中西医整合非手术治疗。2018 年01 月30 日中医舌诊舌质隐青有瘀斑，脉沉弦，由於骨断筋伤、瘀血停滞、经络不通、局部肿胀疼痛，治宜活血化瘀为主，选用活血疏肝汤治之。2018 年02 月26 日回诊追踪，骨折处无压痛，X 光复查骨痂形成良好，迳移除八字肩带，回复日常活动（碰撞性运动除外），并开始积极锻炼肌力。2018 年04 月28 日追踪，病人自述患处无疼痛、活动功能正常，搬运重物轻松自如。2018 年12 月22 日健检X 光显示左侧锁骨中段骨折愈合良好。中西医相辅相成，本案例中西医合治成人锁骨骨折的经验，可作为中西医整合医学应用的叁考。
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【关键词】成人锁骨骨折、中西医合治、非手术治疗
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Chia-Chuan Hsieh1,2 Wang-Chuan Chen3,4*
1School of Medicine, National Defense Medical Center, Taipei, Taiwan
2Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan
3School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan
4Department of Chinese Medicine, E-Da Hospital, Kaohsiung, Taiwan
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【Summary】
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The middle-aged man fell down on the road in a traffic accident, which caused left shoulder pain and several superficial injuries over the limbs. Despite self medication with over-the-counter drugs for days, painful disability of left shoulder was gradually exacerbated, which bothered his sleep. He visited our emergency room, where the X-ray disclosed fracture of the left clavicle, middlethird. The orthopedist was then consulted, that non-operative management is the first choice of closed midshaft clavicle fractures. The goals of treatment are to restore normal anatomy, limit pain and promote a quick return to activity. A figureof-eight dressing and a triangular bandage were used for immobilization. However, some skin rashes over the axilla were noted days later. He visited our clinic, where the X-ray revealed no obvious interval change. Continuation of figure-ofeight dressing, more nutritional supplement and cessation of coffee consumption were recommended. Seeking a second opinion may be considered. Adoption of integrative Chinese and Western medicine in treating a clavicle fracture is an option. Six weeks after diagnosis, there was no tenderness at the injury site. The follow-up X-ray showed callus formation at fracture site. The figure-of-eight dressing was then removed; return to noncontact sports and full daily activities were suggested. Fourteen weeks after diagnosis, he returned to contact activities without discomfort, which solid bony union was presumed. Integrative Chinese and Western medicine is the trend of the future. The experience of treating a clavicle fracture with comprehensive non-operative management in an adult is an example of applying integrative Chinese and Western medicine.
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【Keywords】Clavicle fracture, integrative Chinese and Western medicine, nonoperative
management
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