Klein R, Laue F, Matthes G, Wölfl C
Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Marienhaus Klinikum Hetzelstift, Stiftstraße 10, 67435, Neustadt an der Weinstraße, Deutschland.
Klinik für Unfall- und Wiederherstellungschirurgie, Klinikum Ernst von Bergmann, Charlottenstr. 72, 14467, Potsdam, Deutschland.
Unfallchirurg. 2021 May;124(5):391-406. doi: 10.1007/s00113-021-01014-6.
Joint dislocations are always accompanied by rupture of the joint capsule. Depending on the forces exerted on the joint as well as individual bone quality, fractures (dislocation fractures) and injuries to ligaments occur. As blood vessels and nerves can also be damaged, reduction is an urgent measure. Only impaired peripheral perfusion, loss of motor function or sensation justify reduction without radiological documentation. As reduction can be a painful procedure, analgosedation is nearly always necessary. Evidence for superiority of individual maneuvers is weak. Reduction is followed by immobilization and documented by another control X‑ray. Follow-up treatment depends on concomitant injuries, age and individual demands on joint function. Even with correct follow-up treatment, deficits often persist. This article deals with the diagnostics and treatment of dislocations of the shoulder, elbow, hip, patella and knee.
关节脱位总是伴有关节囊破裂。根据作用于关节的力量以及个体骨质情况，会发生骨折（脱位骨折）和韧带损伤。由于血管和神经也可能受损，复位是一项紧急措施。只有外周灌注受损、运动功能丧失或感觉异常才可以在没有影像学记录的情况下进行复位。由于复位可能是一个痛苦的过程，几乎总是需要进行镇痛镇静。关于个别手法优越性的证据不足。复位后进行固定，并通过另一张对照X线片记录。后续治疗取决于伴随的损伤、年龄以及对关节功能的个体需求。即使进行了正确的后续治疗，功能缺陷往往仍然存在。本文论述肩关节、肘关节、髋关节、髌骨和膝关节脱位的诊断与治疗。
