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中醫藥研究論叢
 222.11 中西醫合治成人鎖骨骨折病例報告
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TJ TCM.22(2) : 107-114, 2019
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中西醫合治成人鎖骨骨折病例報告
Integrative Chinese and Western Medicine in Treating Clavicle Fractures: A Case Report
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謝嘉娟1,2 陳旺全3,4*
1 國防醫學院醫學系，台北，台灣
2 三軍總醫院家庭暨社區醫學部，台北，台灣
3 義守大學學士後中醫學系，高雄，台灣
4 義大醫院中醫部，高雄，台灣
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【摘要】
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ㄧ壯年男性於2018 年01 月05 日因交通意外，身體左傾著地，致左肩疼痛、肢體數處表淺性損傷，起初自行使用成藥，2018 年01 月15 日因局部逐漸腫脹、疼痛加劇無法入睡至急診，經X 光診斷為左側鎖骨中段骨折，會診骨科醫師診視，鎖骨閉鎖性骨折併部分位移採取非手術治療為原則，以八字肩帶與三角巾懸臂吊帶回復生理結構與功能，並控制疼痛與均衡營養。2018 年01 月27 日因腋下紅疹、左手痠麻腫脹等症狀回診，門診X 光複查無明顯進展，醫師建議繼續以八字肩帶固定、加強營養補充及戒除咖啡，表示西藥功效有限，可考慮尋求第二意見；病人與親友討論後，決定接受中西醫整合非手術治療。2018 年01 月30 日中醫舌診舌質隱青有瘀斑，脈沉弦，由於骨斷筋傷、瘀血停滯、經絡不通、局部腫脹疼痛，治宜活血化瘀為主，選用活血疏肝湯治之。2018 年02 月26 日回診追蹤，骨折處無壓痛，X 光複查骨痂形成良好，逕移除八字肩帶，回復日常活動（碰撞性運動除外），並開始積極鍛鍊肌力。2018 年04 月28 日追蹤，病人自述患處無疼痛、活動功能正常，搬運重物輕鬆自如。2018 年12 月22 日健檢X 光顯示左側鎖骨中段骨折癒合良好。中西醫相輔相成，本案例中西醫合治成人鎖骨骨折的經驗，可作為中西醫整合醫學應用的參考。
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【關鍵詞】成人鎖骨骨折、中西醫合治、非手術治療
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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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