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肘关节前脱位

Anterior Elbow Dislocation

作者信息

Decker Nicole, Taqi Muhammad, Norse Ashley

机构信息

University Hospitals or Cleveland, Regional Hospital

King Edward Medical University, Lahore, Pakistan

Abstract

The elbow is among the most frequently dislocated large joints and represents the most commonly dislocated large joint in the pediatric population; however, anterior elbow dislocations are rare injuries in both adults and children. On a basic level, the elbow is comprised of the articulation between the distal humerus with the proximal radius and ulna. Elbow dislocations are described by the direction of the proximal ulna relative to the humerus. Therefore, an anterior dislocation is described as a proximal ulna being forced anterior to the distal humerus with or without the proximal radius. The mechanism of an anterior elbow dislocation is usually a fall on a flexed elbow with anterior force on the proximal ulna. An elbow dislocation can be categorized as simple or complex based on whether or not a fracture is present. A simple dislocation involves injury to ligamentous or capsular structures, whereas complex dislocations include fractures of the surrounding bony structures. Anterior elbow dislocations are commonly termed complex due to their high association with fractures. Management of elbow dislocations should be an immediate closed reduction and stabilization. Operative fixation is usually required if the patient has recurrent instability, fracture, or neurovascular compromise.

摘要

肘关节是最常发生脱位的大关节之一,也是儿科人群中最常见的大关节脱位部位;然而,成人和儿童的肘关节前脱位均属罕见损伤。从基本层面来看,肘关节由肱骨远端与桡骨近端及尺骨近端之间的关节构成。肘关节脱位是根据尺骨近端相对于肱骨的方向来描述的。因此,前脱位是指尺骨近端在有或无桡骨近端的情况下被强行推至肱骨远端前方。肘关节前脱位的机制通常是屈肘时摔倒,尺骨近端受到向前的力。根据是否存在骨折,肘关节脱位可分为单纯性或复杂性。单纯性脱位涉及韧带或关节囊结构损伤,而复杂性脱位包括周围骨质结构骨折。肘关节前脱位因其与骨折的高关联性,通常被称为复杂性脱位。肘关节脱位的处理应立即进行闭合复位和固定。如果患者存在复发性不稳定、骨折或神经血管损伤,则通常需要手术固定。

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