Barton Marc Alan
Kingston Hospital NHS Trust, Emergency Medicine, Galsworthy Road, Kingston upon Thames KT2 7QB, UK.
BMJ Case Rep. 2010;2010. doi: 10.1136/bcr.10.2009.2360. Epub 2010 Mar 4.
An 8-year-old girl attended the children's emergency department after having been play-fighting with her younger brother. Her arm had been pushed away by her father during the fight. The girl immediately complained of pain in her arm and refused to move it. Following analgesia and investigation with a plain radiograph of the elbow it was decided to attempt a manipulation procedure with the possibility that this could represent a 'pulled elbow' in an unusual age group. Soon after the manipulation the child was completely pain-free and moving her arm fully at the elbow, suggesting a diagnosis of radial head subluxation. The patient demonstrated hypermobility of several joints and she was able to hyperextend her unaffected elbow by >10°. This case highlights the association between radial head subluxation and joint hypermobility.
一名8岁女孩在与弟弟打闹玩耍后前往儿童急诊科。打斗过程中她的手臂被父亲推开。女孩立即诉说手臂疼痛并拒绝活动。给予镇痛处理并对肘部进行X线平片检查后，决定尝试手法复位，考虑到在这个不常见的年龄组可能是“牵拉肘”。手法复位后不久，患儿疼痛完全消失，肘部能完全活动，提示桡骨头半脱位的诊断。该患者表现出多个关节活动过度，她能够将未受影响的肘部过度伸展超过10°。此病例凸显了桡骨头半脱位与关节活动过度之间的关联。
