Habermeyer P
Chirurgische Klinik Innenstadt, Ludwig-Maximilians-Universität München.
Orthopade. 1988 Jun;17(3):313-9.
Ligamentous injuries following dislocations of the elbow joint are a primary indication for nonsurgical treatment. The principles of closed reduction are longitudinal traction of the forearm, followed by flexion. The period of immobilization in a plaster cast should be decided on an individual basis. For elbows that show no tendency to redislocate, immobilization for no more than 1 week should suffice. For elbows with a tendency to redislocate 2-3 weeks' immobilization is recommended. Radiological follow-up shows a high percentage of degenerative changes, i.e. subchondral sclerosis, osteophytosis, periarticular calcification, irregularities in the epicondyles. In addition to slight degenerative changes, there are few subjective complaints and functional impairments. Now evidence has been found to recommend primary surgical treatment of ligamentous injuries associated with dislocation of the elbow.
肘关节脱位后的韧带损伤是非手术治疗的主要指征。闭合复位的原则是前臂纵向牵引,然后屈曲。石膏固定的时间应根据个体情况决定。对于没有再脱位倾向的肘关节,固定不超过1周就足够了。对于有再脱位倾向的肘关节,建议固定2 - 3周。影像学随访显示,退行性改变的比例很高,即软骨下硬化、骨赘形成、关节周围钙化、髁上不规则。除了轻微的退行性改变外,很少有主观症状和功能障碍。现在已有证据推荐对与肘关节脱位相关的韧带损伤进行一期手术治疗。