外科精品教学课件（重庆医科大学）Dislocation of Joints关节脱位-邓忠良.pptVIP

Dislocation of Joints Zhong-Liang Deng MD, PhD, Prof. Dept. of Orthopedics Second Affiliated Hospital Chongqing Medical University The unstable position Dashboard Injuriesposterior dislocation MECHANISMS OF INJURY A, this patient sustained an anterior dislocation of hip, the lower extremity abducted, B, passengers in the back seat of car --posterior dislocation. Wearing a seabelt may have prevent the forward thrust of the knee against the front seat of the car. The anterior dislocation of hip With wide abduction, impact of knee against dashboard (both) hip. Complications of hip dislocation Avascular necrosis Traumatic arthritis myositis ossifications -Heterotopic ossifications Sciatic nerve injury -Late sciatic nerve palsy Recurrent dislocation Thromboembolism Joint stiffness * * Definition Joint Dislocation Joint Subluxation Joint Sprain refers to damage or tearing of ligaments or a joint capsule Muscle strain Classification Traumatic dislocation excessive force is applied to a joint Pathological dislocation Fresh dislocation Old dislocation Habitual or Recurrent Dislocation Congenital dislocation Treatment Reduction Immobilization Rehabilitation Traction-counter-traction technique Specific maneuvers Dislocation of the Shoulder Joint Anatomy Deltoid m. Anterior (forward) : Over 95% Sub-glenoid Sub-coracoid Subclavicular Intrathoracic or retroperitoneal : very rare Types Superior dislocation(Upward ) Posterior (backward) Posterior dislocations are occasionally due to electrocution or seizure and may be caused by strength imbalance of the rotator cuff muscles. Posterior dislocations often go unnoticed, especially in an elderly patient Inferior (downward) Inferior dislocation is the least likely form, occurring in less than 1% of all shoulder dislocation cases. This condition is also called luxatio erecta because the arm appears to be permanently held upward or behind the head It is caused by a hyper abduction of the arm that fo