Name: 急診醫生回答「創傷問題」：有些傷口縫線是動物腸子做的！急診醫生回答創傷問題｜名人專業問答｜GQ Taiwan (肋骨骨折會自己好嗎？急診醫生回答「創傷問題」：有些傷口縫線是動物腸子做的！ ER Doctor Answers Injury Questions｜名人專業問答｜GQ Taiwan)
Uploaded: 2025-07-02T19:34:42.000Z
Duration: 16 min 54 s

In the emergency department all the time, I'm like, I'm sorry, your bone is fractured.

在急診科，我總是說，對不起，你的骨頭骨折了。

And they're like, whew, I'm just glad it's not broken.

And I'm like, no, that's actually the exact same thing.

Max Slaughter, and I'll be answering your questions from Twitter today.

馬克斯-斯洛特（Max Slaughter），今天我將在推特上回答你們的問題。

This is Injury Support. ["Injury Support"] This is from Sid1998.

這是 "傷害支持"。[這是來自 Sid1998 的消息。

How many concussions is too many concussions?

I'm thinking, by the way that you delivered that, that you're actually asking for yourself.

我想，從你的表達方式來看，你其實是在要求自己。

A concussion is the state that you are in mentally.

Temporarily, after a mild traumatic brain injury, the symptoms range from decreased attention span, lethargy, or feeling really tired, feeling a little confused, severe headaches, light sensitivity, and nausea, the feeling that you're gonna throw up.

輕微腦外傷後的暫時症狀包括注意力下降、嗜睡或感覺非常疲倦、有點糊塗、嚴重頭痛、對光敏感和噁心，即感覺要嘔吐。

So there's a very wide range of symptoms that you can have with this condition.

是以，這種疾病的症狀範圍非常廣泛。

It depends on the type of concussion, how big was the concussion, and also how severe were your symptoms afterwards.

這取決於腦震盪的類型、腦震盪的程度以及腦震盪後症狀的嚴重程度。

I'd say the most feared outcome of multiple concussions is something called CTE, or chronic traumatic encephalopathy.

我想說的是，多次腦震盪最令人擔憂的結果是一種叫做 CTE 的東西，即慢性創傷性腦病。

People with chronic traumatic encephalopathy, a lot of them are boxers or football players who get repetitive head traumas, end up with very severe issues long-term, like dementia, really bad headaches, behavioral changes, aggressiveness, and suicidality.

慢性外傷性腦病患者，其中很多是拳擊手或足球運動員，他們的頭部會受到反覆創傷，最終會出現非常嚴重的長期問題，如痴呆、非常嚴重的頭痛、行為改變、攻擊性和自殺傾向。

There was one study that showed that about 17 concussions was the average of a lot of people who had chronic traumatic encephalopathy, but the answer is avoid concussions at all costs.

有一項研究表明，許多患有慢性創傷性腦病的人平均腦震盪次數為 17 次，但答案是不惜一切代價避免腦震盪。

From HoloHona, what happens when you break a bone and don't set it back correctly?

來自 HoloHona 的消息：如果你骨折了，但沒有正確地把它放回去，會發生什麼？

It depends on where the fracture is, how severe the fracture is, and how well-aligned the bones are.

這取決於骨折的部位、骨折的嚴重程度以及骨骼的對齊程度。

I hear about people really hurting themselves, a bone is facing in the wrong direction, they're like, I'm gonna be a man and just fix it on the spot.

我聽說有人真的傷到了自己，骨頭朝錯了方向，他們就想，我要像個男人一樣，當場把它修好。

Don't do that, you have no idea what injury that looks like under the surface of your skin, it may not need any realignment at all, so do not try to set your bones back, do not try to put your dislocations back in place, please don't do this at home.

不要這樣做，你根本不知道你皮膚表面下的傷勢是什麼樣的，它可能根本不需要任何調整，所以不要試圖把你的骨頭放回去，不要試圖把你的脫臼放回原位，請不要在家裡這樣做。

A joint is basically where two bones meet, we have joints all over our body, and if a fracture goes into that joint, it's more important for that fracture to heal very, very well and for everything to be aligned, because you can imagine if there are, bone fragments inside the joint, and then you try to move your extremity, and it can be very painful, and it can lead to a significant amount of arthritis long-term, so go see an orthopedic doctor, don't try to fix your own breaks at home, that's my answer.

關節基本上是兩塊骨頭相接的地方，我們全身都有關節，如果骨折進入關節，更重要的是骨折要癒合得非常非常好，而且一切都要對齊，因為你可以想象，如果關節內有骨頭碎片，然後你試圖移動你的四肢，可能會非常疼痛，而且長期會導致大量關節炎，所以去看骨科醫生，不要試圖在家裡自己修復骨折，這就是我的答案。

From thisisntfabia, I think I've dislocated my shoulder, help, how do I know if I've dislocated it?

來自 thisisntfabia，我想我的肩膀脫臼了，幫幫我，我怎麼知道我是否脫臼了？

First of all, you'll know if you have a dislocation or a fracture because it'll be one of the most painful things that you've ever experienced in your life, and these are things that need to be seen by doctors, so don't try to diagnose yourself at home using Dr. Google and try to pop things back in place, but I will say in the emergency department, before I get x-rays, if somebody thinks that there's a shoulder dislocation, I will have them take the arm that's affected and try to touch the other shoulder, so if somebody has a shoulder dislocation, they're not gonna be able to do it, so that's one of the things I do after I pop a shoulder back in place, which is awesomely satisfying I must say, we check to see if it's back in place before x-rays by seeing if that arm goes up to the contralateral shoulder that is the opposite shoulder.

首先，你會知道自己是否脫臼或骨折，因為這將是你一生中經歷過的最痛苦的事情之一，而這些事情都需要由醫生來處理，所以不要試圖在家裡用谷歌醫生來診斷自己，並試圖把東西彈回原位。但我要說的是，在急診科，在拍 X 光片之前，如果有人認為肩膀脫臼了，我會讓他們拿著受影響的手臂，試著觸摸另一個肩膀、如果有人肩關節脫位，他們就做不到這一點，所以這是我將肩關節彈回原位後要做的事情之一，我必須說，這讓人非常滿意，在拍X光片前，我們會檢查肩關節是否彈回原位，看手臂是否伸到對側肩部，也就是對側肩部。

This question is from amseries, how does one know when stitches are needed?

這個問題來自 amseries，如何知道何時需要縫合？

It's a difficult answer, there are certain stitches that we put in place because it's just gonna have a better cosmetic outcome, that is, it's gonna look better long-term, but there are other stitches, real, real deep lacerations that we absolutely need to stitch up, for instance, if it gets deep enough to go to this layer called the fascia, now fascia is like really dense tissue and that kind of holds certain structures in place, think of it as like layering, like layering of a cake or something like that, so that particular layer called the fascial plane that separates those two areas, a lot of times needs to be repaired and so we'll put stitches in there to bring that back together and if you don't, the muscles or structures that are under that fascial plane can kind of herniate through and they'll cause you some issues.

這是個很難回答的問題，有些縫合是為了達到更好的美容效果，也就是說，從長遠來看會更好看，但還有一些縫合，真正的深度撕裂傷，我們絕對需要縫合，例如，如果傷口足夠深，到了筋膜層，筋膜就像非常緻密的組織，可以將某些結構固定在原位、把它想象成分層，就像蛋糕的分層或類似的東西，是以，分隔這兩個區域的那層叫做筋膜面的特殊組織，很多時候都需要修復，所以我們會在那裡縫合，使其重新粘合在一起，如果不這樣做，筋膜面下的肌肉或結構就會疝出，給你帶來一些問題。

Also, I should mention there are absorbable sutures and there are non-absorbable sutures, there are certain stitches that we don't want your body to absorb, for instance, if there's a tendon that's been cut and we're repairing that, a lot of times we're gonna use a non-absorbable suture, we want that stitch to stay in place because it takes a long time for tendons to heal fully, there are other areas of the body or certain situations where we want the stitches to dissolve and those dissolvable stitches or absorbable stitches are made out of either synthetic polymers or they're made out of animal intestines, so come to the emergency department and we might stitch you up with animal intestines.

此外，我還得提一下，縫合線有可吸收縫合線和不可吸收縫合線之分，有些縫合線是我們不希望你的身體吸收的，例如，如果肌腱被割斷了，我們要對其進行修復，很多時候我們會使用不可吸收縫合線，我們希望這種縫合線能夠保持在原位，因為肌腱需要很長時間才能完全癒合、在身體的其他部位或某些情況下，我們希望縫線能夠溶解，而這些可溶解縫線或可吸收縫線是由合成聚合物或動物腸道製成的，所以來急診科，我們可能會用動物腸道為你縫合。

All right, this next question is from Justin Wolfson, I broke my femur in a car wreck and I have some cues, by the way, this is a terribly painful experience, so Justin Wolfson, my heart goes out to you, brother, how much force does it take to break a frigging femur?

好了，下一個問題來自賈斯汀-沃爾夫森，我在一次車禍中摔斷了股骨，我有一些線索，順便說一下，這是一次非常痛苦的經歷，所以賈斯汀-沃爾夫森，我很同情你，兄弟，摔斷該死的股骨需要多大的力量？

And how did these heal before this surgery existed?

那麼，在這種手術出現之前，這些傷口是如何癒合的呢？

It's a lot of force, the answer is about 4,000 newtons of force, 4,000 newtons is about equivalent to 900 pounds here on Earth's gravity, so you can think of like a sea lion or a really big moose, that is the amount of force that it takes, you think about surgeries in general is being very like gentle, precise operation, orthopedic surgeries are not gentle, they're putting force in there, they're using muscles because it genuinely requires a significant amount of force to get these surgeries done and to put bones back in place, to get that rod into your femur, they basically have to align it where the cavity is, where your bone marrow is, okay, and it's called an intramedullary rod, they align it and they take a big old hammer and they go, nunk, nunk, nunk, nunk, nunk, until it's all the way in there, so it is violent and it takes a lot of force and it's impressive to see.

這是一個很大的力，答案是大約4000牛頓的力，4000牛頓大約相當於地球引力的900磅，所以你可以想象一隻海獅或者一隻非常大的麋鹿，這就是需要多大的力，你想想一般的手術都是非常溫和、精確的操作，而骨科手術並不溫和，他們在裡面施加了很大的力、他們要使用肌肉 因為要完成這些手術 確實需要很大的力量 要把骨頭放回原位好了，這就是所謂的髓內棒，他們把它對準，然後拿著一個大錘子，"咚、咚、咚、咚、咚、咚 "地敲，直到把它敲進去為止，所以這很暴力，需要很大的力量，讓人印象深刻。

No, you really don't, I mean, you have bone marrow throughout the rest of your bones, you'll be fine.

不，你真的不需要，我是說，你全身的骨頭都有骨髓，你會沒事的。

Last question, how did these heal before the surgery existed?

最後一個問題，手術前這些傷口是如何癒合的？

And the answer is very, very poorly, they probably didn't heal very well at all, that person maybe never walked again, if you were in a car accident in the 1500s.

答案是非常、非常糟糕，他們可能根本沒有很好地癒合，如果你在 1500 年代遭遇車禍，那個人可能再也不能走路了。

All right, the next question is from Kiran Kalon, why are shin splints so painful?

好了，下一個問題來自 Kiran Kalon，為什麼脛骨夾板會如此痛苦？

So shin splints are known as median tibial stress syndrome, and it's basically where there's inflammation of a lot of the structures that are there around your tibia, your tibia is this long bone here in your lower extremity, right next to your fibula, which is the skinnier bone that runs along the side, runners always get these shin splints, a lot of cheerleaders get shin splints and these can be very, very painful.

脛骨夾板被稱為脛骨正中應力綜合徵，它基本上是指脛骨周圍的許多結構發生發炎，脛骨是下肢的長骨，緊挨著腓骨，腓骨是沿著側面運行的較細的骨頭，跑步者總是會得這種脛骨夾板，很多啦啦隊長也會得脛骨夾板，這些都會讓人非常非常痛苦。

Now, here's the thing though, that pain should resolve with rest, definitely get seen if that pain doesn't resolve with cessation of that activity.

但問題是，疼痛應該在休息後緩解，如果停止活動後疼痛仍未緩解，一定要去醫院就診。

This is from London Hearts1, what is a defibrillator?

這是來自倫敦心臟1的資訊，什麼是除顫器？

So a defibrillator is basically a device that administers electricity to the heart, the bottom part of your heart are the ventricles, all right?

除顫器基本上是一種向心髒通電的設備，心臟的底部是心室，對嗎？

And when the heart naturally does its thing, the top part squeezes first, the atria squeeze, the bottom part squeezes afterwards, boom, boom, boom, boom, boom.

當心髒自然運作時，上半部分先擠壓，心房擠壓，下半部分隨後擠壓，嘭、嘭、嘭、嘭、嘭、嘭。

So if the bottom part of the heart isn't given a good a hearty squeeze there, see what I did there with hearty, that was a total accident.

所以，如果心臟的下半部分沒有得到很好的擠壓，看看我在 "擠壓 "上做了什麼，那完全是個意外。

You're not going to get blood flow to your brain or to your extremities and you're going to start dying.

你的大腦和四肢將無法獲得血液流動，你將開始死亡。

When you go into these dangerous heart rhythms, you get electricity to the heart as soon as possible.

當出現這些危險的心律時，要儘快給心臟通電。

Ask for an AED or automatic external defibrillator.

要求配備 AED 或自動體外除顫器。

Don't be worried, you can do this, you can save someone's life.

別擔心，你能做到，你能拯救別人的生命。

Call for 911 as well because they're trained, they're gonna know what to do, especially in the field.

也要撥打 911，因為他們受過訓練，知道該怎麼做，尤其是在現場。

But if you can get an AED, it'll tell you to put these pads on the chest and on the back and you're gonna basically sandwich the heart and that's gonna make it to where the electricity runs between the two pads.

但如果你能買到自動體外除顫器 它會告訴你把這些墊子放在胸前和背上 你基本上會把心臟夾在中間

If you don't have access to an AED and or you're a professional, this is what you're gonna need.

如果你沒有自動體外除顫器，或者你是專業人士，這就是你需要的。

So this bad boy is over $50,000 worth of machine.

What we do is we hook this up to somebody's chest.

我們要做的就是把這個連接到某人的胸部。

When it's hooked up, you'll be able to see the rhythm that the heart is in.

連接後，您就能看到心臟的節律。

You'll be able to tell, is that person in ventricular fibrillation or ventricular tachycardia?

您可以判斷出，這個人是心室顫動還是心室性心動過速？

And then we can determine, do they need defibrillation or do they need something called synchronized cardioversion?

然後我們就能確定，他們是需要除顫，還是需要一種叫做同步心臟復甦的方法？

This will basically take someone who is inevitably going to die and bring them back to life very rapidly.

這基本上可以讓一個不可避免會死去的人迅速起死回生。

This is one of the best inventions that modern medicine has, to be honest.

老實說，這是現代醫學最好的發明之一。

And the question is, what is the most serious or painful injury you've ever encountered?

問題是，你遇到過的最嚴重或最痛苦的傷害是什麼？

I mean, the most serious injuries are the ones where the patient comes in dead.

我的意思是，最嚴重的傷害就是病人死了。

You classify traumas based on what hit what.

你是根據什麼擊中了什麼來對創傷進行分類的。

So you'll say motor vehicle versus bicyclist or train versus pedestrian.

是以，你會說機動車與騎自行車者或火車與行人。

You can imagine that train versus pedestrian was the most serious thing that I've seen in the emergency department.

你可以想象，火車撞行人是我在急診科見過的最嚴重的事件。

The guy, not to gross you out, but had a traumatic amputation.

我不想讓你覺得噁心，但這傢伙曾因外傷截肢。

That is, his arm was ripped off from the force and he was already DEAD by the time he came in.

也就是說，他的手臂是被外力扯斷的，他進來的時候已經死了。

And so that is the most serious injury that I've seen.

Some of the most painful injuries that I see actually are ones that cause ischemia.

實際上，我所見過的一些最痛苦的損傷都是導致缺血的損傷。

Now ischemia is lack of blood flow to tissue or lack of oxygen.

So if there is an injury that either like rips the blood vessel apart or causes a certain abnormality that would decrease the blood flow to a certain area, that is exquisitely painful.

是以，如果受傷導致血管撕裂，或者造成某種異常，使流向某個部位的血流量減少，就會產生劇烈疼痛。

Hopefully you never have to experience something like that in your lifetime.

希望你這輩子都不用經歷這樣的事情。

Is an Achilles tendon tear the worst injury an athlete can get?

跟腱撕裂是運動員最嚴重的損傷嗎？

So I should tell you what an Achilles tendon is.

所以，我應該告訴你什麼是跟腱。

Rah, rah, rah, rah, rah, rah, rah, rah, rah.

Your Achilles tendon is this tendon back here that attaches your calf basically to your foot and allows you to flex your foot.

跟腱是連接小腿和腳的肌腱，可以讓你的腳彎曲。

And so when this pops, you can't do this anymore.

所以，當這個彈出時，你就不能再這樣做了。

And that's pretty important for running, walking, jumping, et cetera.

這對跑步、走路、跳躍等都非常重要。

This is a shocking, morbid injury, but I would argue this is not the worst injury that an athlete can sustain because think about a spinal cord injury, man.

這是一種令人震驚的、病態的傷害，但我認為這並不是運動員可能遭受的最嚴重的傷害，因為想想脊髓損傷吧，夥計。

You get a cervical spine injury that is you essentially like fracture the bones here in the neck and it ends up pushing on your spinal cord and you may never be able to walk, use your arms or legs.

如果頸椎受傷，頸部的骨頭就會骨折，最終壓迫脊髓，你可能永遠無法行走、使用手腳。

I think paralysis, that's the worst injury that an athlete can get.

我認為癱瘓是運動員最嚴重的傷病。

All right, this next question is from Lesdue Medlegal.

好的，下一個問題來自 Lesdue Medlegal。

Is it okay to treat my dog bite injury at home?

These are at very, very high risk for infection.

這些人的感染風險非常非常高。

Also, when was the last time you got a tetanus shot?

另外，你上次打破傷風針是什麼時候？

But if you get it, guess how fatal it is, 100%.

但如果你得了這種病，你猜它有多致命，100%。

Now, if they can catch the animal and it's a stray animal, that's different.

現在，如果他們能抓到動物，而且是流浪動物，那就不一樣了。

What they do is they watch the dog for multiple days, make sure they don't exhibit any signs of rabies.

他們要做的就是連續多天觀察狗狗，確保它們沒有任何狂犬病的跡象。

You don't have to get all your rabies shots and stuff like that.

But if it's some rando dog that bit you, ran away and you're never gonna see it again, you need to get your rabies shot.

但如果是某隻流浪狗咬了你，然後跑掉了，你再也見不到它了，你就需要注射狂犬疫苗。

You also wanna get x-rays to make sure there isn't a big old chunk of bone under the surface there because, again, very, very high risk for infection.

你還需要拍 X 光片，確保表面下沒有一大塊骨頭，因為感染的風險非常非常高。

From 41Shiesty, what is Tommy John surgery?

來自 41Shiesty，什麼是湯米-約翰手術？