常见的职业上肢肌肉骨骼疾病。

IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
American family physician Pub Date : 2025-05-01
Scott Hall, Matthew R Compton
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引用次数: 0

摘要

家庭医生在诊断、管理和治疗由职业暴露(包括过度劳累、重复运动和振动)引起的肌肉骨骼疾病方面发挥着重要作用。腕管综合征是一种常见的外周神经卡压综合征,常见于需要重复性手部运动的工人。腕管综合征的治疗包括夹板、康复训练、口服或注射皮质类固醇;保守治疗失败或症状严重的患者可考虑手术释放。外上髁炎是由过度使用引起的肘关节疾病;临床诊断和治疗采用支具、非甾体抗炎药、皮质类固醇注射和物理治疗。肩袖肌腱病是一种肩袖肌肉组织和肌腱的退行性疾病,常见于重复性头顶工作的人群。肩袖肌腱病变是临床诊断,一般通过非甾体类抗炎药、物理治疗和皮质类固醇注射非手术治疗;在最初的保守治疗后,可以考虑影像学来确认诊断。扳机指是一种手部屈肌腱的狭窄性腱鞘炎,发生在工作需要反复握紧的人群中。皮质类固醇注射是扳机指的一线治疗方法。仔细的病史可以帮助临床医生确定损伤是否与工作有关。为受伤工人提供适当的工作限制,使他们能够安全返回工作岗位,这可能会加快他们的康复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Common Occupational Upper Extremity Musculoskeletal Disorders.

Family physicians play a valuable role in the diagnosis, management, and treatment of musculoskeletal disorders that result from occupational exposures, including overexertion, repetitive motion, and vibration. Carpal tunnel syndrome is a common peripheral nerve entrapment syndrome often identified in workers whose jobs require repetitive hand motion. Treatment of carpal tunnel syndrome includes splinting, rehabilitation exercises, and oral or injected corticosteroids; surgical release is considered in patients for whom conservative treatment has failed or who have severe symptoms. Lateral epicondylitis is an elbow disorder resulting from overuse; it is diagnosed clinically and managed with bracing, nonsteroidal anti-inflammatory drugs, corticosteroid injections, and physical therapy. Rotator cuff tendinopathy is a degenerative disorder of the rotator cuff musculature and tendons and is often identified in people who perform repetitive work overhead. Rotator cuff tendinopathy is diagnosed clinically and generally managed nonoperatively with nonsteroidal anti-inflammatory drugs, physical therapy, and corticosteroid injections; imaging may be considered to confirm the diagnosis after initial conservative treatment. Trigger finger is a stenosing tenosynovitis of the flexor ten-dons of the hand and occurs among people whose jobs require repetitive gripping. Corticosteroid injection is a first-line treatment for trigger finger. A careful history can assist the clinician in determining whether an injury is work related. Providing appropriate work restrictions for injured workers to allow a safe return to work may expedite recovery.

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来源期刊
American family physician
American family physician 医学-医学:内科
CiteScore
2.80
自引率
2.50%
发文量
368
审稿时长
4-8 weeks
期刊介绍: American Family Physician is a semimonthly, editorially independent, peer-reviewed journal of the American Academy of Family Physicians. AFP’s chief objective is to provide high-quality continuing medical education for more than 190,000 family physicians and other primary care clinicians. The editors prefer original articles from experienced clinicians who write succinct, evidence-based, authoritative clinical reviews that will assist family physicians in patient care. AFP considers only manuscripts that are original, have not been published previously, and are not under consideration for publication elsewhere. Articles that demonstrate a family medicine perspective on and approach to a common clinical condition are particularly desirable.
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