腳踝扭傷(sprains)或肌肉拉傷(strains)時該怎麽辦?

1. 扭傷(sprains)和拉傷(strains)有什麽區別?

中文的扭傷是總指四肢關節或軀體部的軟組織(如肌肉、肌腱、韌帶、血管等)的損傷。把肌肉肌腱的拉傷也包括在扭傷裏。而英文的定義卻有些不同。

扭傷(sprains)：指韌帶(ligament)的拉伸或撕裂。而韌帶是連接骨與骨、可彎曲的白色纖維樣的致密結締組織。韌帶扭傷常發生於腳踝、手關節和膝部。
Sprain：A sprain is a stretching or tearing of ligaments. Ligaments are tough bands of fibrous tissue that connect one bone to another. Common locations for sprains are your ankles and knees.

拉傷(strains)：指肌肉或肌腱的急劇收縮或過度牽拉引起的損傷或撕裂。肌腱是一束連接肌肉和骨骼的纖維。人們常說肌肉被拉傷了。常發生於腿腱和背部肌肉群。
Strain：A strain is a stretching or tearing of muscle or tendon. People commonly call strains "pulled" muscles. Hamstring and back injuries are among the most common strains.

肌肉肌腱與韌帶的區別圖

2. 這兩種損傷按輕重可分為三級：

Grade I(Mild韌帶或肌腱輕微的損傷)：Your ligament or tendon stretches excessively or tears slightly. The area is somewhat painful, especially with movement. It's tender. There's not a lot of swelling. You can put weight on the joint.

Grade II(Moderate韌帶或肌腱部分撕裂)：The fibers in your ligament or tendon tear, but they don't rupture completely. The joint is tender, painful and difficult to move. The area is swollen and may be discolored from bleeding in the area. You may feel unsteady when you try to bear weight on your joint.

Grade III(Severe韌帶或肌腱完全斷裂)：One or more ligaments or tendon tear completely. The area is painful. You can't move your joint normally or put weight on it. If the sprain occurs in the ankle or knee, when you try to walk, your leg feels as if it will give way. The joint becomes very swollen and also can be discolored. In cases of severe sprain or strain, your doctor may immobilize the area with a brace or splint. In some cases, such as in the case of a torn ligament or ruptured muscle, surgery may be considered. 重度扭傷，則應送醫治療。

3.輕、中度的扭傷和拉傷的處理方法：

First aid for mild to moderate sprains and strains includes rest, ice, compression, and elevation (known as RICE).

---Rest the injured part（不要活動傷處）. Pain is the body's signal to not move an injury.

---Ice the injury（48小時內，傷處外敷冰塊）. Apply ice packs or cold compresses for up to 20 minutes at a time every 3-4 hours for the first 2 days（first 48 hours) to limit the swelling and help with the spasm（減輕腫脹和肌肉痙攣）.
 
---Compress the injured area（彈性繃帶固定傷處）. Wearing an elastic compression bandage (such as an ACE bandage) for at least 2 days will reduce swelling.

---Elevate the injured part（抬高患肢）. Keep the injured part elevated above the level of the heart as much as possible to reduce swelling（一般高於心髒，減輕腫脹）.

Do not apply heat in any form for at least 24 hours（至少在前24小時內避免熱敷）. Heat increases swelling and pain（熱敷或揉搓會加劇腫脹和疼痛）.

重度扭傷，則應送醫治療。

4. 非處方的止痛藥:

Over-the-counter pain medication is an option. Acetaminophen對乙酰氨基酚  (Tylenol泰諾) is helpful for pain, but ibuprofen布洛芬 (Motrin, Advil) or naproxen 奈普生 (Aleve) might be better because these medications relieve both pain and inflammation.

5. 附上一張可以打印的圖表（醫院兒科發給患兒父母的）:

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