外伤性肘关节脱位

M. Amarasooriya
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引用次数: 0

摘要

肘关节脱位主要发生在青壮年群体中,近50%发生在体育活动中。诊断和评估手法复位后的同心复位是通过X光平片和透视进行的。计算机断层扫描(CT)可识别可能导致慢性不稳定的细微骨折。根据定义,简单脱位不会伴有骨折,而复杂脱位则会伴有各种骨折,其中可怕的三联症损伤和跨肱骨脱位会给手术带来挑战。通过评估肘关节脱位的方向和力学原理,可以确定受伤的结构。后脱位和后外侧脱位是最常见的脱位模式,外侧韧带复合体通常会受到损伤。大多数简单的脱位都可以通过复位、固定和逐步康复达到良好的功能效果。10%的患者会出现持续性不稳定。复杂脱位给手术带来了挑战,如果处理不当,会导致关节僵硬、疼痛和持续不稳。确定复杂脱位的各个组成部分,如桡骨头骨折、冠状突骨折、尺骨近端骨折和韧带损伤,对于取得满意的疗效非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traumatic elbow dislocations
Elbow dislocations occur mostly in the young adult population and nearly 50% occur during sporting activities. Diagnosis and assessment of concentric reduction following manipulation are performed using plain radiography and fluoroscopy. Computed Tomography (CT) enable identifying subtle fractures that can otherwise lead to chronic instability. Simple dislocations by definition have no associated fractures and complex dislocations are associated with a variety of fractures, with the terrible triad injury and trans-humeral dislocations leading to surgical challenges. Assessment of the direction and the mechanics of elbow dislocation enable identify the structures that have been injured. Posterior and posterolateral dislocations are the most common patterns, where the lateral ligament complex is often compromised. Most simple dislocations are amenable to reduction, immobilization, and gradual rehabilitation resulting in good functional outcome. Ongoing instability can occur in 10% of the patients. Complex dislocations pose a surgical challenge and lead to joint stiffness, pain and ongoing instability if not managed properly. Identifying the individual component of a complex dislocation such as radial head fractures, coronoid fractures, proximal ulnar fractures, and ligament injures is important for satisfactory outcome.
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