桡骨小头半脱位PPT.pptx

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;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?attempt in 95% of patients who underwent randomization to hyperpronation as?compared with 77% of patients who underwent randomization to supination.在一项研究中，随机予以过度旋前手法首次复位成功的比例是95%，而旋后手法则为77%。Supination Technique旋后手法To perform the supination technique, seat the child on the parent or caregiver’s lap,with the child facing you. Clasp both the hand and elbow of the affected arm (图. 3).采用旋后手法时，让孩子坐在家长或监护人的大腿上面对着操作者。扣住患肢的手和肘。Your fingers or thumb should overlie the radial head. Neither the positioning ofyour fingers or thumb nor the starting position of the affected arm is critical to thesuccess of the procedure.操作者的手指后大拇指应压在桡骨头上。无论是操作者的手指或大拇指位置或患肢的初始位置对于复位成功都至关重要。;Supinate and flex the forearm until you feel the ligament?move back into position (图. 4). You may feel or hear a click as the ligament is reduced.旋前屈曲前臂直到感觉环状韧带移回至正常位置。环状韧带复位时操作者可以感觉或听到轻微的咔哒声。If the reduction is successful, the child should be pain free and able to move?the arm normally in 5 to 30 minutes, including being able to reach for an object abovethe head.如果复位成功，孩子便会不痛并能在5-30分钟内自如活动，包括碰触高过头顶的物体。Hyperpronation Technique过度旋前法Hyperpronation can be th