soft tissue injury
Introduction
Introduction to soft tissue injury Soft tissue injury refers to the skin, subcutaneous shallow fascia, muscle, tendon, tendon sheath, ligament, joint capsule, synovial sac, intervertebral disc, peripheral nerve vessels and other tissues of the human body caused by various acute trauma or chronic strain and pathology of the disease. The pathological damage is called soft tissue damage. Clinical manifestations are pain, swelling, deformity, and dysfunction. The main classification of soft tissue injury: sprains, contusions, crush injuries. There are acute muscle injuries and chronic muscle injuries. There are open injuries, closed injuries and so on. The size, shape, bleeding, degree of injury and extent of the wound, whether the skin has ecchymoses, blisters, whether the skin temperature changes, the circulation of the finger (toe), the ischemic necrosis of the muscle, whether the injured limb is swollen, the skin Nervous and hard, can move, have feelings of disability. basic knowledge The proportion of sickness: 0.5--0.8% Susceptible people: no special people Mode of infection: non-infectious Complications: muscle atrophy, joint dislocation, osteoporosis
Cause
Causes of soft tissue injury
Drug factor (15%)
Drugs are one of the causes of soft tissue injury. Improper drug injection at acupoints is another important reason. According to our statistics, due to the injection of An Nai Jin and compound quinine, it accounts for more than 90% of the total incidence. Mainly related to these drugs are more irritating or improper dose, but some drugs, only acupuncture points injection 0.1 ~ 0.2ml, soft tissue damage can occur.
Iatrogenic factors (5%)
The causes of soft tissue damage and acupoints are also affected. The reason for the operation is also the cause of soft tissue damage. In the case of acupoint injection or acupuncture, in order to seek a better sense of aspiration, repeatedly inserting up and down or exploring in different directions, the stimulation rate is too fast, and soft tissue damage can also be caused.
Trauma factor (35%)
Soft tissue damage caused by various acute trauma or chronic strain.
Prevention
Soft tissue injury prevention
1, do not smoke, drink, should eat less sweets, oily and spicy food. These will affect the development of the disease.
2, usually must drink plenty of water, often drink some green bean soup, chrysanthemum tea and the like, have the role of heat and detoxification.
3, develop good hygiene habits, must wash hands frequently, take a bath, keep the clothes clean, and maintain a good attitude.
4, keep the skin dry and refreshing, sweat gland is smooth, is an effective measure to prevent the body from purulent infection.
5, try to clean the room, do not have mosquitoes, insects and the like, to avoid glass, nail cuts and stab wounds and water and fire burns, etc., to prevent infection.
6, suffering from pruritic skin disease, must be actively treated, to avoid scratching, can not arbitrarily squeeze the drainage, so as not to spread inflammation.
Complication
Soft tissue injury complications Complications muscle atrophy joint dislocation osteoporosis
(a) muscle atrophy
After the tendon injury, due to qi and blood stasis, pain and dressing fixation, the limb activity is reduced, the muscle contraction ability is weakened, causing blood circulation disorder, and the inactive limb muscle atrophy is caused by the long-term, which is called disuse muscle atrophy. In addition, dystrophic muscle atrophy refers to a muscle degenerative disease of unknown cause, characterized by genetic lesions, which are more limited to a certain degree of atrophy of the limbs, slow recovery, and poor prognosis.
(two) joint rigidity
After the tendon injury, due to the loss of treatment and mistreatment, it often causes the contraction and adhesion of the tendons, which makes the active joints and passive activities of the joints constrained and the joints are strong. Especially the treatment of hand tendons should pay attention to early functional exercise to prevent the joints between the interphalangeal joints. happened.
(three) joint dislocation
The main function of the tendon is the joint joint, the complex shape, and the joint movement of the main division. Due to tendon injury or rupture, or endocrine disorders, inflammation and other factors, the ligament is relaxed, and the joint stability is destroyed under the external force such as the muscle strength of the muscle pulling limb, causing subluxation or total dislocation of the joint. Such as knee joint cruciate ligament injury can be combined with knee dislocation, neck inflammation complicated by subluxation of the axon, pelvic inflammation and ankle joint bone suture.
(4) Osteoporosis
The bones and bones are closely related to the internal organs, especially the liver and kidneys, the movement of the main ribs of the liver, the main blood collection; the main kidney essence, the marrow, the bone, the loss of liver and kidney plus the muscle injury shows that the waist and leg activities are not working. Due to lack of liver blood, the blood does not raise the tendons, and even the hands and feet are restrained, the limbs are numb, and the flexion and extension are unfavorable. The hardness of the bone depends on the support of the kidney essence. When the kidney essence is sufficient, the bone marrow is biochemically active, and the bone is nourished by the bone marrow and is strong and powerful. If the kidney is weak and the kidney essence is insufficient, the bone marrow is emptied, the source is insufficient, or the bone function is reduced and osteoporosis occurs. The bones are fragile, the lower limbs are soft and weak, the back pain is back, and the activity is limited. Clinically, patients with tendon injury can stay in bed for a long time, and after the limbs are fixed or discarded, disuse osteoporosis can also occur.
(5) Organizational adhesion
After the bloody veins in the muscles, the fibrous mechanism is easy to cause the repaired parts to adhere to the surrounding tissues and affect the joint activities. Such as the injury of the collateral ligament of the knee joint, the injury of the tendon of the hand, and the like. Therefore, attention should be paid to early functional activity exercise during treatment to prevent adhesions caused during the repair of tendon injuries.
Symptom
Symptoms of soft tissue injury Common symptoms Persistent pain Soft tissue swelling Limb movement incompatibility Peripheral vascular reduction
Clinical symptoms
1. Pain: related to the nature and extent of violence, the distribution of nerves at the injured site, and the strength of the inflammatory response.
2. Swelling: due to bleeding in the local soft tissue or (and) inflammatory reaction exudation.
3. Dysfunction: A disorder that causes limb function or activity.
4. Wounds or wounds: According to the nature and extent of the violence, there may be wounds or skin abrasions of different depths.
Examine
Soft tissue injury examination
an examination
In addition to the general visible symptoms of the naked eye, severe trauma (including crush injury) or severe systemic symptoms should be checked daily for blood and urine, and urine volume should be recorded. If necessary, blood and urine biochemical tests (including myoglobin) should be performed. Electrocardiogram and renal function. Patients with no traumatic wounds can be given B-ultrasound and X-ray examination.
Diagnosis
Diagnosis of soft tissue injury
diagnosis
1. Inquire about the time, cause and injury of the injury, whether it is a crush injury, whether there is urine closure, oliguria and hematuria after the injury; what kind of treatment has been treated, and how effective it is.
2. Pay attention to the presence or absence of shock or other parts of the body, with or without crush syndrome (acute renal failure characterized by limb or trunk swelling, myoglobinuria and hyperkalemia).
3. Investigate the injured part, pay attention to the size, shape, bleeding, degree of injury and extent of the wound, whether the skin has ecchymoses, blisters, whether the skin temperature changes, the circulation of the finger (toe), and whether the muscle is ischemic. Necrosis, whether the injured limb is swollen, the skin is tight and hard, can be active, and there is no sensory disturbance.
4. Severe trauma (including crush injury) or severe systemic symptoms should be checked daily for blood and urine routine, and urine volume should be recorded. If necessary, blood and urine biochemical tests (including myoglobin), electrocardiogram and renal function should be performed.
