Dislocation肘关节脱位课件.ppt

WARRAICH ROLL#17-C Elbow Dislocation Basics History of trauma. Posterior dislocation is most common. Age group : 20 years of age. Rarely, elbow dislocation can occur in elderly patients after a fall. Common site : ulnohumeral joint. Classification (stimson) Proximal radioulnar joint intact: Posterior (90%): Posterolateral Posteromedial Anterior Medial lateral Proximal radioulnar joint disrupted : Anteroposterior Radius is anterior Ulna is posterior Medial lateral: Radius is lateral ulna is medial Treeible traid of the elbow : Posterior dislocation of elbow Radial head fracture Fracture of coronoid process of ulna Pathophysiology The collateral ligaments usually are ruptured, with injury to the brachialis muscle and coronoid. Associated Conditions Fracture of the radius Fracture of the ulna Fracture of the humerus Ulnar and median nerve injury Brachial artery injury Cont.. fig : complex dislocation of the elbow . In addition to dislocation , there are multiple fracture of the elbow. Cont… Nerve injury Cont.. Artery injuries : Diagnosis Signs and Symptoms The patient presents with : pain, swelling, elbow deformity, and inability to move the elbow. Physical Exam Assess the patients neurovascular status. Examine the functions of the radial, median, and ulnar nerves before reduction. The median nerve can be injured at the time of reduction by becoming entrapped in the joint. check nerve function before and after reduction. Evaluate the patient for brachial artery injury before reduction. The brachial artery may be trapped in the joint along with the median nerve. Vascular injury is an indication for immediate surgery. Cont.. Fig : Cont.. Artery injuries : Exam.. The upper extremity should be inspected for other injuries, such as Monteggia fracture-dislocation[fracture of the ulna with radial head dislocation]. Palpate the forearm for increased swelling or signs of compartment syndrome Tests Imaging Radiography: AP : greater superimp