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[小儿肘关节单纯脱位:非手术治疗及与罕见病理相关的并发症。4例系列报道]

[Isolated elbow dislocation in pediatric patients: non-operative treatment and complications associated with an infrequent pathology. Series of 4 cases].

作者信息

Larrague Catalina, Campelo Diego, Díaz Dilernia Fernando, Bosio Santiago, Maenza Rubén, Puigdevall Miguel

机构信息

Hospital Italiano de Buenos Aires, Instituto de Ortopedia y Traumatología "Carlos E. Ottolenghi". Buenos Aires, Argentina.

出版信息

Arch Argent Pediatr. 2021 Apr;119(2):e133-e137. doi: 10.5546/aap.2021.e133.

Abstract

Even though the elbow is the most often dislocated joint in children, this injury accounts for 3-6 % of elbow pathology. Dislocations without associated fractures are extremely rare. They result from a fall onto an outstretched hand. The patient is always referred with a painful joint, movement impairment and even clinical deformity. Acute treatment aims to achieve quick reduction and adequate joint stability, avoiding neurovascular injuries. We sought to analyze the functional outcomes and the complications after non-operative treatment. Our 4 patients Luxaciones puras de codo en pacientes pediátricos: tratamiento conservador y complicaciones asociadas a una patología poco prevalente. Serie de 4 casos Isolated elbow dislocation in pediatric patients: non-operative treatment and complications associated with an infrequent pathology. Series of 4 cases had excellent functional results at the latest follow-up, and one of them suffered from a median nerve palsy without further consequences. In our experience, these injuries presented excellent outcomes and we would like to highlight the importance of a quick and precise neurovascular examination with the possibility of non-surgical management of nerve injuries. A short period of immobilization with early rehabilitation should be indicated to avoid joint stiffness.

摘要

尽管肘关节是儿童最常发生脱位的关节,但这种损伤仅占肘部病变的3%至6%。无相关骨折的脱位极为罕见。其由手掌伸展着地摔倒所致。患者就诊时总是伴有关节疼痛、活动受限甚至临床畸形。急性治疗旨在迅速复位并确保关节充分稳定,避免神经血管损伤。我们试图分析非手术治疗后的功能结局及并发症。我们的4例小儿单纯性肘关节脱位:保守治疗及与罕见病理相关的并发症。4例病例系列小儿孤立性肘关节脱位:非手术治疗及与罕见病理相关的并发症。4例病例系列在最近一次随访时功能结果极佳,其中1例患有正中神经麻痹,但未产生进一步后果。根据我们的经验,这些损伤预后良好,我们想强调快速精确的神经血管检查以及神经损伤非手术处理可能性的重要性。应进行短期固定并尽早康复,以避免关节僵硬。

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