桡骨小头半脱位.pptxVIP

桡骨头半脱位;What‘s 桡骨头半脱位？;专业回答;大多数孩子的病史中可能有过被牵拉的情况; 环状韧带 嵌压的环状韧带;首先，明确孩子的病史及体检与诊断一致。The child’s history may include a witnessed event of?forceful traction; however, other mechanisms of injury have also been described.孩子的病史中可能有过被牵拉的情况；然而，其它的损失机制也有描述过。Physical examination should reveal pseudoparalysis, with the child voluntarilykeeping the limb still to minimize discomfort.体格检查会发现假性神经麻痹，而孩子为了减少不适会自主保持上肢制动。There will also be pain with movement,?most often related to supination and pronation rather than to flexion and?extension.活动时疼痛，旋前或旋后较屈伸更易产生。In most cases there will be tenderness to palpation on the lateral side of?the elbow; however, absence of this tenderness does not rule out the diagnosis.多数情况下触诊肘关节外侧可及虚空感，即使未及虚空感也不能排除该诊断。An?affected child holds the elbow in a slightly flexed position, with the hand pronated.受伤的孩童将被迫保持肘关节轻微屈曲位并维持手掌旋前位。Further examination should also reveal a normal-looking elbow without effusion,bruising, or obvious deformity.更进一步的检查则会发现肘关节外形正常，无突出，无挫伤或明显的畸形。Radiographs are almost always normal in cases of?pulled elbow, so radiography should be reserved for cases in which the diagnosis is?not clear.;牵拉肘的影像学检查几乎都是正常的，所以只有在诊断不明确时才考虑进行影像学检查。However, positioning the elbow in preparation for radiography is often?therapeutic in reducing the displacement.然而，在放置体位来进行影像学检查时，往往对复位移位有帮助。Contraindications禁忌征The contraindications to performing a reduction are few and are usually easilyRecognized.复位的禁忌征很少且容易鉴别。If a child has a history and physical examination that are consistent?with fracture, such as deformity, swelling, or bruising of the elbow or a history of?a fall onto the arm from a substantial height, then a radiograph should be obtained?to evaluate for fracture.如果孩子的病史或体格检查与骨折吻合，比如畸形，肿胀或肘关节挫伤或有高处摔落手臂着地的外伤史，则应行影像学检查来判断是否骨折。If the radiograph does not reveal fracture or effusion, then?reduction may be considered.如果影像学检查未发现骨折或突出，则可以考虑手法复位。;In one study, reduction was achieved on the first?at