AthleticTherapyStFX运动疗法.ppt

The Face Lecture 19 Facial Injuries nInjuries to the cheek, nose, lips and jaw are very common in sports - especially those with moving objects, and or contact sports. nWearing proper protective equipment can prevent many injuries. nBecause the face has a vast arterial system , lacerations bleed freely and rapid swelling often occurs. Soft Tissue Injuries ncontusions , abrasions , lacerations are all managed the same on the face as in the rest of the body. nMinor lacerations ( less than 1 inch long and 1/8th inch deep) can be closed with a steristrip other wise sutures should be done. Facial Fractures n Direct impact can fracture facial bones including the mandible (the jaw), maxilla (upper jaw) zygomatic (cheek) or the nasal bones Nasal Fractures- nmost common facial fracture in sport , it is particularly susceptible to lateral displacement. nNose may appear flattened and lose its symmetry. nDeformity is usually present- especially with a lateral blow nNosebleeds are almost always seen. nThere may be crepitus over the nasal bridge and ecchymosis under the eyes nRx- Control the bleeding , apply ie. to limit swelling and refer to Physician nZygomatic Fractures nWith direct impact to the zygomatic bone the cheek will appear flat or depressed nSwelling and ecchymosis about the eye may interfere with vision nRx- Refer to doctor ASAP nMandibular fractures are the third most common fracture associated with sports participation behind the nasal and zygotic fractures. nSeldom occur as isolated fractures - but usually as double fractures or fracture - dislocation. nIn all fractures it is important to maintain an open airway, dress wounds , immobilize as best as possible and refer to physician. 27-9 Nasal Injuries nEpistaxis - nose bleed - in most cases bleeding will stop spontaneously by applying mild pressure at the nasal bone, ice may be used to stop persistent bleeding , Nasal plugs may be used - if bleeding continues for more than five minutes refer to physician. Oral and Dental Injuries nTo prevent dental injuries - mouthgaurds should be used at all times nLacerations of the mouth - nRX- Apply direct pressure - cleanse the area with a saline solution nLacerations that extend completely through the lip or large tongue lacerations - require special suturing nDental Injuries - when the tooth is displaced outwardly or laterally - try to place tooth back into its normal position nwhen a tooth is displaced inwardly - it should be left alone nall dental injuries should be seen by a dentist ASAP nTeeth that have been totally avulsed from their socket can often be located nThese teeth can be saved but time is of the essence nDo not touch the root or brush the tooth off nIf the tooth is rinsed in milk or saline and replace intraorally with 30 minutes the prognosis for successful replanting is 90% nReplanting that occurs after 2 hours results in a 95% failure rate nThe tooth can be replace or place under the tongue for transport to the dentist nTap water or drinking water will damage the root and compromise replanting , hense should not be used nFractures - should be referred to dentist ASAP Ear Injuries nCauliflower ear- a relatively minor injury caused by repeated trauma - a hematoma forms between the perichondrium and the cartilage of the outer ear nThe hematoma should be aspirated by a physician to avoid permanent cartilage damage nIf left untreated the hematoma forms a fibrosis in the overlying skin , leading to necrosis of the auricular cartilage , resulting in the cauliflower ear appearance nProtective headgear in sports such as boxing, wrestling, water polo and rugby is designed to prevent trauma to the ear but must be worn regularly to be effective nRx - PIER Eye Injuries nMany eye injuries can be prevented with proper protective wear nEspecially true in racquet sports (squash, racquetball) nPeriorbitaal Ecchymosis ( Black Eye) - swelling and hemorrhage into the surrounding eyelids and area nInspect eye for obvious abnormalities and palpate for possible orbital fractures nInspect the anterior chamber of the eye for bleeding nCheck the ability of individual to focus nIce the eye by using crushed ice or ice water in a latex surgical glove , do not use chemical bags nRx- Refer to ophthalmologist for further examination nForeign bodies- dust or dirt can lead to intense pain and tearing nThe foreign body if not imbedded should be removed nThe eye should be inspected for any scratches , abrasions or lacerations nIf unable to remove -patch both eyes with a sterile gauze pad and refer to physician nConjunctivitis ( Pinkeye) nA bacterial infection of the conductive (the membrane between the inner lining of the eye lid and the anterior eyeball) nThe infection leads to itching , burning and watering of the eye, causing the conjunctiva to become inflamed and red - giving it a pinky appearance nRx- This condition is highly infectious - refer to physician nCorneal Abrasion - a foreign body may scratch the cornea - resulting in pain and tearing nBlinking and movement aggravates this condition nA corneal abrasion is best seen by using a fluorescein dye strip - the dye alluminates the abrasion nRx- involves an topical ointment and an eye patch nDetached Retina - damage to the posterior segment of the eye can occur with or without trauma to the anterior segment nA detached retina occurs when fluid seeps into the retina