创伤性桡骨头脱位机理分析及其诊治(附5例报告)

The pathogenesy and diagnosis of traumatic radial head dislocation: A report of 5 cases

报告了5例创伤性桡骨头脱位。结合临床资科和有关文献,提出本病是传导和扭转暴力造成,其损伤机制与伸直型孟氏骨折不同。对其诊断和鉴别诊断进行了讨论,认为根据典型的外伤史和受伤姿势及伤后体征,结合X线片容易确立诊断。治疗上首选手法整复,石膏固定患肢于高度屈肘、前臂旋后位。手术限于陈旧性脱位,或环状韧带撕裂并回缩手法复位失败者,且宜早期进行。

Five cases of traumatic redial head dislocation are reported in the paper. According to the clinical materials and related literature, the author suggested that the disease may be caused by a condicting and twisting violence, and the mechanism may be distinguished from that of the extensive Monteggia's frac- ture. The diagnosis and differential diagnosis of the disease are discussed. Ac- cording to its typical history, position, post-wound signs and x-ray findings, the disease is easy to be diagnosed. In treatment, manual manipulation should be first selected and the affected limb should be fixed with plaster bangdage in high-elbow-flexion and forearm-supination positions. Surgical intervention should be used only for old cases or cases of annulare ligament laceration which are unresponsive to manual reduction, and performed as early as pos sible.