关节脱位jointdislocation中山大学外科学

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1、JointDislocationandPeripheralNerveInjuryRONGLi-minThe3rdaffiliatedhospitalofSunYat-senuniversityJointdislocationDefinitionJointdislocation,orluxationAdislocationisaseparation of twoboneswheretheymeetatajointOftencausedbyasuddenimpacttothejointAdislocationmayalsoca

2、useligamentornervedamageSubluxation（半脱位）isapartialdislocationClassificationTraumatic,Congenital（先天性）,PathologicComplete,subluxationAnterio-posterio-lateral-central-Acute,old,habitual(shoulders)Close,openbilateraldislocationofthehipbecauseoftrafficaccidentCongenital

3、dislocationofthehip（先天性髋关节脱位）Shenton’slineRheumatoidarthritis（类风湿性关节炎）ofthewristandhands.SubluxationandulnardeviationatthemetacarpophalangealjointOccurrencethemostcommonsitesShouldersElbowsHipsFingersAnkles(mostlikelybeaccompaniedbyafracture)KneesWristsSymptomsofaJ

4、ointDislocationIntensePainSwellingImmobilityoftheaffectedjointDeformityNOMENCLATUREFORDISLOCATIONSNametheJOINTNamethedislocationbythepositionoftheDISTALFRAGMENTinrelationtotheproximalfragmentAddFRACTUREtothenameifthereisaperiarticularfracture.AddOPENifawoundcommuni

5、cateswiththedislocationComplicationsFractureNerve,vascularinjuryBonenecrosisTraumaticarthritisGaleazziinjuryMonteggiainjuryTreatmentCloseReductionImmobilizeRehabilitationprogramSurgicalreductionLigamentreconstructionHipjointdislocationAllismaneuver(提拉法)Bigelow‘sman

6、euver（问号法）AftercareTraction(4weeks)Bed(2weeks)Walkstick(2weeks)Ambulate(8weekslat)ShoulderinjuryAnteriordislocationoftheshoulderKocher'sHippocrate'sStimson'sElbowinjuryManipulativereductionOtherjointdislocationAcromioclavicularseparationCompletedislocationofaproxim

7、alinterphalangealjointLunatedislocationPerilunatedislocationNursemaid‘selbow(pulledelbow牵拉肘)ApartialdislocationofradialheadcommonintoddlersThemainsymptomisrefusaltousethearmCanbeeasilytreatedinadoctor'sofficewithoutthefollowingfirstaidsteps.ManualreductionPeripher

8、alnerveinjuryOrthopaedicsurgeryisnolongerlimitedtoinjuriesofthebone,bloodvessels,andskin,buthasexpandedtoincludenerveinjuryaswellAxon（轴索）Myelinsh