Re: [情報] 勇士更衣室細節:多名球員不滿KD傷病不透明
先說我勇黑辣, 看上一篇我的文章就知道了
--
其實根據這篇報導
https://www.washingtonpost.com/sports/2019/06/14/steve-kerr-kevin-durant-is-going-miss-next-season/?utm_term=.cc5eacdbaafa
縮網址: https://tinyurl.com/yxvbkwpz
Kerr said Wednesday that the decision to finally greenlight the Game 5 return
was a “collaborative” one that included Durant; his agent, Rich Kleiman;
the team’s medical staff; and an outside medical expert who provided a
second opinion.
勇士總教練週三賽後回答記者:
讓KD上場的這個決定是大家都同意的決策
包含了KD本人/他的經理人/球團的醫療團隊/提供第二意見的醫療專家
“Would we go back and do it over again? Damn right,” Kerr said. “That’s
easy to say after the results. Our feeling was the worst thing that could
happen would be a reinjure of the calf. That was the advice and the
information that we had. At that point, once Kevin was cleared to play, he
was comfortable with that. We were comfortable with that. So the Achilles’
came as a complete shock. Had we known that this was a possibility, that
this was even in the realm of possibility, there’s no way we ever would have
allowed Kevin to come back.”
(下面這段就是被板友們嘴爆的那一段)
如果回到G5賽前, (根據賽前的檢驗結果)我絕對同樣讓KD上場
因為KD跟腱斷裂才事後諸葛說他不該上場很簡單啦
就賽前醫生的判斷, KD頂多就小腿再一次拉傷
所以我們(球團)跟KD都覺得那就上場拚一波吧
也因為如此(沒有心理準備), 所以當KD阿基里斯腱斷裂的時候大家都嚇到了
如果我們在賽前就知道阿基里斯腱有可能斷裂, 我們是不可能放KD上場打球的
--
再來看看醫生有沒有可能誤診 aka 第一次受傷就是阿基里斯腱撕裂/斷裂
卻單純診斷是小腿拉傷
首先是這一篇
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655731/
HISTORY
A sudden pain in the back of the leg, with an audible snap, is the classic
story in Achilles tendon rupture. Patients will often think that they have
been hit directly in the calf; it is very rare for there to be prior symptoms
from the tendon.
通常病患會聽到啵一聲, 伴隨小腿背側突然的疼痛
病患會以為自己小腿被撞到, 事前很少會有其他症狀
Points to remember
Patients who think they sprained their ankle or calf may have ruptured their
Achilles tendon.
Patients who rupture their Achilles tendon have usually not had any previous
Achilles symptoms.
以為自己是腳踝扭傷或是小腿拉傷的病患的確有可能是阿基里斯腱斷裂
阿基里斯腱斷裂的病患, 可能從未出現相關病史
Points to remember
Patients with rupture of the Achilles tendon can still walk.
Patients with rupture of the Achilles tendon can still actively move the
ankle up and down.
Patients with an Achilles tendon rupture may even manage to stand on tiptoes
(on both feet together — though not on the injured limb alone).
Patients with an Achilles tendon rupture will not always have a palpable gap
in the tendon.
阿基里斯腱斷裂的病患還是可以走路
阿基里斯腱斷裂的病患還是可以自主移動小腿(因為還有其他肌肉可以輔助移動腳踝)
阿基里斯腱斷裂的病患可以搭配另一隻腳用腳尖站立, 單獨受傷的腳就無法了
阿基里斯腱斷裂的病患不一定都可以觸診到斷裂的間隙
The calf squeeze (Simmonds’ test) should be performed, and the findings
clearly documented, in all ankle injuries and ‘calf sprains’.
在所有腳踝扭傷或是小腿拉傷的病患都必須進行Simmonds' test以診斷阿基里斯腱斷裂
Imaging studies are not required to make the diagnosis in the acute
situation, and frequently offer false reassurance.
緊急的病患不需要影像學才下診斷,
甚至影像學(包含超音波/MR)可能出現偽陰性(有斷但看不出來)
另一篇
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436906/
RADIOLOGY
In patients with equivocal clinical signs diagnostic imaging is required.
如果病患的症狀不是這麼典型, 那最好還是進行影像檢查
Ultrasound is readily available, cheap, non-invasive but user dependant.
Ultrasound has a diagnostic reported sensitivity, specificity and accuracy of
100%, 89.9% and 94.4% respectively[19].
超音波是相對容易取得/便宜/非侵入性的檢查工具
但是判讀需要有經驗的醫師
敏感度100%/特異性89.9%/準確度94.4%
It can discriminate between partial and complete tears except those located
at the proximal pole or musculotendinous junction of the tendon where
sensitivity and specificity drop to 0.5 and 0.81 respectively[20]. An
additional advantage in ultrasound in the dynamic observation of tendon gaps
which have been shown to correlate strongly with those observed during
operative repair[21]. Some authors argue that if the gap between the tendon
ends is greater than 5 mm as assessed by ultrasound in full equinus than
surgical intervention is indicated[22].
根據肌腱受傷的部位, 用超音波檢查的敏感度跟特異性會有很大的差異
而超音波檢查還有一個優點就是其動態性, 跟手術時直接觀察術區的差別相距不遠
(簡單來說X光/MR都像是拍照, 記錄當下的狀態, 而超音波探頭可以各種角度移動)
下面一句則是在討論檢驗結果與治療方式的選擇, 先不翻
Magnetic resonance imaging remains the gold standard for the diagnosis of the
Achilles tendon rupture with a sensitivity of 100% and a specificity of
0.03[23].
MRI則是診斷的黃金準則
其敏感度達到100%, 特異性 0.03
(敏感度就是真陽性, 真正生病的病例被檢查出來的比例, 偽陰性為0)
(但特異性這麼低其實代表偽陽性的機率很高)
(引用的那篇論文點進去, 標題還寫著"診斷不需要MRI, 甚麼鳥蛋)
----
根據兩篇文章, 一篇認為只要做理學檢查(Simmonds' test)就足以診斷
一篇推崇MRI檢查
當然只要是人哪有不出錯的, 像是文中提到的超音波檢查就非常依賴使用者
可是兩個醫療團隊如果都放行的話,
醫生誤診或是球團說謊的機率應該非常非常的低
當然就我的意見是認為這件事真的就是KD運氣很差
第一節根本就死神降臨
大概也是這樣Kerr才會擺在場上這麼久
後來發生甚麼事大家也都知道了
Kerr 跟 Myers 被罵也是活該
--
※ 發信站: 批踢踢實業坊(ptt.cc), 來自: 111.241.160.122 (臺灣)
※ 文章網址: https://www.ptt.cc/bbs/NBA/M.1560607786.A.3D8.html
→
06/15 22:11,
7年前
, 1F
06/15 22:11, 1F
推
06/15 22:13,
7年前
, 2F
06/15 22:13, 2F
我不是醫生哦, 只是有一些醫療背景
不過一般來說軟組織的受傷, 影像學"應該"是看得出來的
但是同樣像文中提到所提, 影像的診斷非常依賴醫師的判讀技術
我們都沒看到這些影像資料, 也只能僅止於猜測了
推
06/15 22:14,
7年前
, 3F
06/15 22:14, 3F
→
06/15 22:14,
7年前
, 4F
06/15 22:14, 4F
推
06/15 22:15,
7年前
, 5F
06/15 22:15, 5F
→
06/15 22:16,
7年前
, 6F
06/15 22:16, 6F
→
06/15 22:17,
7年前
, 7F
06/15 22:17, 7F
※ 編輯: incKevin (111.241.160.122 臺灣), 06/15/2019 22:22:28
推
06/15 22:17,
7年前
, 8F
06/15 22:17, 8F
推
06/15 22:17,
7年前
, 9F
06/15 22:17, 9F
→
06/15 22:17,
7年前
, 10F
06/15 22:17, 10F
→
06/15 22:17,
7年前
, 11F
06/15 22:17, 11F
→
06/15 22:17,
7年前
, 12F
06/15 22:17, 12F
→
06/15 22:17,
7年前
, 13F
06/15 22:17, 13F
→
06/15 22:17,
7年前
, 14F
06/15 22:17, 14F
→
06/15 22:17,
7年前
, 15F
06/15 22:17, 15F
→
06/15 22:18,
7年前
, 16F
06/15 22:18, 16F
→
06/15 22:18,
7年前
, 17F
06/15 22:18, 17F
→
06/15 22:18,
7年前
, 18F
06/15 22:18, 18F
→
06/15 22:19,
7年前
, 19F
06/15 22:19, 19F
推
06/15 22:21,
7年前
, 20F
06/15 22:21, 20F
→
06/15 22:22,
7年前
, 21F
06/15 22:22, 21F
→
06/15 22:23,
7年前
, 22F
06/15 22:23, 22F
推
06/15 22:24,
7年前
, 23F
06/15 22:24, 23F
→
06/15 22:24,
7年前
, 24F
06/15 22:24, 24F
推
06/15 22:26,
7年前
, 25F
06/15 22:26, 25F
→
06/15 22:27,
7年前
, 26F
06/15 22:27, 26F
推
06/15 22:27,
7年前
, 27F
06/15 22:27, 27F
→
06/15 22:27,
7年前
, 28F
06/15 22:27, 28F
推
06/15 22:36,
7年前
, 29F
06/15 22:36, 29F
→
06/15 22:36,
7年前
, 30F
06/15 22:36, 30F
→
06/15 22:37,
7年前
, 31F
06/15 22:37, 31F
→
06/15 22:38,
7年前
, 32F
06/15 22:38, 32F
→
06/15 22:38,
7年前
, 33F
06/15 22:38, 33F
推
06/15 22:40,
7年前
, 34F
06/15 22:40, 34F
推
06/15 22:41,
7年前
, 35F
06/15 22:41, 35F
推
06/15 23:29,
7年前
, 36F
06/15 23:29, 36F
→
06/15 23:29,
7年前
, 37F
06/15 23:29, 37F
推
06/15 23:33,
7年前
, 38F
06/15 23:33, 38F
推
06/16 00:00,
7年前
, 39F
06/16 00:00, 39F
推
06/16 00:07,
7年前
, 40F
06/16 00:07, 40F
→
06/16 00:07,
7年前
, 41F
06/16 00:07, 41F
推
06/16 00:08,
7年前
, 42F
06/16 00:08, 42F
推
06/16 00:10,
7年前
, 43F
06/16 00:10, 43F
推
06/16 00:15,
7年前
, 44F
06/16 00:15, 44F
→
06/16 00:15,
7年前
, 45F
06/16 00:15, 45F
推
06/16 00:15,
7年前
, 46F
06/16 00:15, 46F
→
06/16 00:16,
7年前
, 47F
06/16 00:16, 47F
推
06/16 00:18,
7年前
, 48F
06/16 00:18, 48F
→
06/16 00:19,
7年前
, 49F
06/16 00:19, 49F
推
06/16 00:20,
7年前
, 50F
06/16 00:20, 50F
→
06/16 00:20,
7年前
, 51F
06/16 00:20, 51F
→
06/16 00:21,
7年前
, 52F
06/16 00:21, 52F
推
06/16 00:22,
7年前
, 53F
06/16 00:22, 53F
→
06/16 00:23,
7年前
, 54F
06/16 00:23, 54F
→
06/16 00:25,
7年前
, 55F
06/16 00:25, 55F
推
06/16 00:37,
7年前
, 56F
06/16 00:37, 56F
→
06/16 00:37,
7年前
, 57F
06/16 00:37, 57F
推
06/16 00:46,
7年前
, 58F
06/16 00:46, 58F
推
06/16 01:22,
7年前
, 59F
06/16 01:22, 59F
→
06/16 01:22,
7年前
, 60F
06/16 01:22, 60F
→
06/16 01:23,
7年前
, 61F
06/16 01:23, 61F
→
06/16 01:36,
7年前
, 62F
06/16 01:36, 62F
→
06/16 01:39,
7年前
, 63F
06/16 01:39, 63F
→
06/16 02:03,
7年前
, 64F
06/16 02:03, 64F
→
06/16 02:05,
7年前
, 65F
06/16 02:05, 65F
推
06/16 02:47,
7年前
, 66F
06/16 02:47, 66F
→
06/16 02:48,
7年前
, 67F
06/16 02:48, 67F
推
06/16 03:53,
7年前
, 68F
06/16 03:53, 68F
推
06/16 03:53,
7年前
, 69F
06/16 03:53, 69F
→
06/16 03:53,
7年前
, 70F
06/16 03:53, 70F
推
06/16 04:59,
7年前
, 71F
06/16 04:59, 71F
→
06/16 04:59,
7年前
, 72F
06/16 04:59, 72F
推
06/16 07:43,
7年前
, 73F
06/16 07:43, 73F
推
06/16 14:01,
7年前
, 74F
06/16 14:01, 74F
討論串 (同標題文章)
NBA 近期熱門文章
4
12
92
135
110
343
138
305
131
252
PTT體育區 即時熱門文章