Re: [討論] 跟腱斷裂較嚴重還是ACL斷裂??已回收
某權威臨床辭海告訴你,絕對是Tendo Calcaneus斷裂嚴重
跟腱為腓腸肌、比目魚肌在跟骨端的共同肌腱,屬於小腿後Deep Transverse Fascia、
Posterior Fascia Septum外側的淺層肌肉,中間包裹一小小條的蹠肌,腓腸肌、比目魚
肌、蹠肌三條肌肉,主要負責以跟骨末端形成分節式槓桿,提供往前推進的主要肌力,和
腓腸肌、比目魚肌相比之下蹠肌是最無力的肌肉
斷裂常見於中年、男性、網球選手,而且根據該權威臨床辭海,跟腱斷裂是會伴隨劇烈疼
痛,因此診視S大提供的敘述,除了疼痛其他都符合跟腱斷裂的症狀(原本肌腱位置空洞化
、完全失去行動力),S大可能是肌腱整個從跟骨附著處完整的拉扯脫離,而不是從中斷裂
(須以鋼線縫合回跟骨末端)
脫離或完全斷裂,等於完全奪走水平移動能力,只剩貧弱的蹠肌,還有分節槓桿上另兩條
、位於足底四層肌肉中第二層的屈拇/趾長肌
只能使用「抬」起來、往前「甩」、再「放」下去和腳趾「爬」行這些方式移動
一般手術使用Bunnell Suture、Fascia/Sheath Repair等技巧修補,因為肌腱與肌肉有血
液供應,初期可能要視手術方式與狀況做引流,以免和附近組織發生粘連
Anterior Cruciate Ligament(前十字韌帶)
為關節囊內兩端在股骨外踝內後、脛骨前,與後十字韌帶呈現矢狀交叉的韌帶,作用是穩
定膝關節,膝蓋伸直時拉緊、彎曲時放鬆,防止股骨(大腿骨)向後、脛骨(小腿骨)向前滑
動,膝關節主要強度,首要來自股四頭肌:股直肌、外側廣肌、內側廣肌、中間廣肌,和
關節囊內外四條韌帶:前後十字韌帶、內外側副韌帶
很有意思的是,根據該權威臨床辭海提到,就算膝關節四條韌帶全部斷裂,股四頭肌依然
能提供膝關節最佳的支持,維持膝關節穩定能力,當然該權威書也提到,如果關節囊與側
副韌帶受損,還是必須盡早動手術
僅僅前十字韌帶斷裂,日常生活(除了劇烈運動外)並不受影響
依此看來,只是比較兩者斷裂影響的嚴重程度(不考慮癒後),絕對是跟腱無誤
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打到一半斷線 有意見嗎?
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不好意思 裡面全都是我求學生涯學到的常識
100%原創文章
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知道錯就好 下次別再搶1F亂放話
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你以為這些知識這麼容易學?
拼死考進全國前幾百名 花了N年背一堆跟辭海一樣的原文書
還要被無知酸酸影射抄襲? 沒罵髒話算很好了
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正常壓力釋放
※ 編輯: Air24 來自: 1.161.1.16 (04/16 00:31)
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