Pathology of the elbow joint disorder

2021-01-30 12:00 AM

Only encounter dislocation of the elbow before there is a fracture of the elbow, the ligaments have broken the biceps, the muscle clinging to the top of the bridge is touched or torn

Outline

The second most common elbow dislocation after the shoulder dislocation, accounting for 18 -

27% of total dislocations. May be found at all ages (from 5 to 76 years old) The ratio of men/women is 1/2.

Mechanism of dislocation: Usually by falling against the hand on the ground, when the elbow is extended, the head on the forearm bones is dislodged behind the head below the arm bone.

Classify

Come back

Accounting for about 90%, the head on 2 forearm bones that pop out of the joint is pulled upwards on the back of the head under the arm bone. If the 2 bones are not pulled straight up but tilted to the side, it will create a dislocation and skew inwards or outwards.

Usually, all ligaments are torn except the ligament. When the ligament of the ligament is broken, the rotational cap will pop out completely, the dislocation will be more complicated.

Discharge first

Only encounter dislocations of the elbow before a fracture of the elbow, the ligaments are broken (except for the ligament) of the biceps, the muscle clinging to the apex of the bridge is touched or torn. The cylindrical nerve can also be damaged.

Clinical symptoms

The elbows swell and swell very soon (because the ligaments are torn, causing hematoma). Forearms in 40 0-fold position, tummy slightly shortened forearms. The arm looks long.

Complete loss of muscle function, which is limited in passive movement (usually as low as 90 ° ). The stretching is normal, especially the lateral movements. The forearm shaft deviates inward or outward from the arm axis.

You can clearly feel the three bones: The elbow protrudes behind, the head below the arm bone protrudes first, the head above the bone is protruding back and out. Need to x-ray of the elbow joint straight, inclined for definitive diagnosis and find more joint lesions in the bone.

Symptoms

Need to examine carefully to detect complications of nerve, blood vessels.

Neurological complications

The most common sign is cylindrical nerve paralysis. In the emergency, discovered by loss of sensation in the fifth finger. Paralysis usually recovers within 4 weeks.

Vascular complications

Few rates 1 - 5% dislocated, often the arm artery is pinched, spasm or may be torn.

The principles of treatment

Anaesthesia should then be given to the patient to lie on their back, pass a bandage around the middle of the arm, give it to someone to pull it back, or tie it to a hook on the wall.

The woman, with her right hand, holds her thumb and the left hand grabs the other hands and pulls the forearm axis. The manipulator used his thumbs to push the elbow and the tip of the bone facing forward while the middle fingers pulled the head under the arm bone back.

After manipulating the arm-for-hand cast, incision vertically, the elbows are 90 0-fold for the forearm to lie, the dough holding time is 3 weeks. Need to check x-ray after cast because dislocation of the elbow can dislocate again in the cast. After removing the powder for patients to actively practice folding and stretching the elbows, do not massage the elbows because of fear of calcification of the edges of the joints.