University of Kentucky, Lexington, KY.
J Athl Train. 2000 Jan;35(1):108-10.
To describe a functional rehabilitation program for a football player with a grade 2 posterolateral elbow dislocation to facilitate early return to competition.
Conservative management of a posterior dislocation of the elbow is common. The elbow is the second most frequently dislocated large joint in adults. Two common mechanisms of dislocation are hyperextension and posterolateral rotation. Prolonged immobilization can be detrimental to regaining full range of motion and function of the elbow, whereas early directed rehabilitation may lead to early return to normal function.
Elbow dislocation with medial collateral ligament rupture, elbow subluxation, elbow dislocation with neurovascular compromise, or supracondylar fracture.
The athlete received immediate care of reduction and immobilization in a 90 degrees posterior splint followed by a radiologic evaluation. Postreduction treatment included a short immobilization period and early initiation of protected active and resistive range-of-motion exercises. The athlete was able to return to full football activities in 3 weeks. He competed for the rest of the season with the elbow braced and taped, with no recurring incidents of instability.
The time to return to full participation was rapid. The medial collateral ligament was intact, as determined by magnetic resonance imaging. The athlete has since been followed for 2 football seasons and has not demonstrated any detrimental effects due to his early return.
Early determination of the status of the medial collateral ligament through physical examination or imaging combined with early directed rehabilitation of a posterolateral elbow instability enabled this athlete to respond well. He regained pain-free full range of motion, strength, and function, allowing full participation in football at the Division I level with no recurring incidence of dislocation.
描述一名足球运动员 2 级肘后外侧脱位的功能康复方案，以促进其尽早重返比赛。
肘部后脱位的保守治疗较为常见。肘部是成人中第二大常见脱位的大关节。两种常见的脱位机制是过伸和后外侧旋转。长时间固定可能不利于恢复肘部的完全活动范围和功能，而早期的定向康复可能导致早期恢复正常功能。
伴有内侧副韧带撕裂的肘脱位、肘半脱位、伴有神经血管损伤的肘脱位或髁上骨折。
运动员立即接受复位和 90 度后夹板固定的治疗，然后进行影像学评估。复位后的治疗包括短期固定和早期开始保护性主动和阻力活动范围运动。运动员在 3 周内恢复了全部足球活动。他在整个赛季都戴着肘部支具和绷带参赛，没有再次出现不稳定的情况。
恢复全部参与的时间很快。磁共振成像显示内侧副韧带完整。此后，该运动员已连续随访了 2 个足球赛季，由于其早期恢复，并未出现任何不利影响。
通过体格检查或影像学早期确定内侧副韧带的状况，并结合后外侧肘不稳定的早期定向康复，使这位运动员反应良好。他恢复了无痛的全活动范围、力量和功能，能够在一级联赛中完全参与足球比赛，且没有再次出现脱位的情况。
