2018-8-23_肘部筋伤_资料教程.pptxVIP

肘部筋伤Elbow Diseases林江豪 LIM CHIANG HOU23/8/2013Elbow joint is composed by Brachial ulnar joint, the brachioradialis joints, ulnar proximal joint, and surrounded by the joint capsule. 肘关节是复合关节，由肱尺关节、肱桡关节、桡尺近侧关节组成，有共同的关节囊包绕。Flexion range is 140 degree while pronation and supination range is 140 to 150 degree.屈伸运动范围约为140o, 旋前和旋后运动的范围约为140o～150o。Causes Direct force of hit 直接暴力的打击Indirect force (causes more sprain) 间接暴力 (致伤较多见)Pathogenesis If overdoing forearm exercise during daily life, or wrong position when throwing exercise, also can cause elbow joint sprain. 在日常工作和生活中做前臂过度拧扭动作，以及做投掷运动时姿势不正确，均有可能造成肘关节扭伤Pathological changesAfter injury can cause synovial, joint capsule and ligament damage or tear off, then local part will be filled with blood, edema. For those serious case, there will be bleeding in the joint, which affecting the function of joint. 受伤后可因滑膜、关节囊、韧带等组织的扭挫或撕裂，引起局部充血、水肿、严重者关节内出血、渗出，影响肘关节的功能。diagnosisObvious trauma sign, elbow joint is at half flexed position. 有明显的外伤史，肘关节处于半屈伸位Elbow joint will be swollen pain and dysfunction, sometimes occur bruises or petechie. 肘部呈弥散性肿胀疼痛，功能障碍，有时出现青紫瘀斑多以桡后侧较明显，压痛点往往在肘关节的内后方和内侧副韧带附着部。 more obvious on posterior of radial side, tender point always located at internal posterior side or internal lateral side of ligament attachment. To confirm whether myositis ossificans occur at the same time through X ray examination. 可通过X线检查，确定是否合并骨化性肌炎。If serious case, the sprain have to be differentiate with fracture, as the annular ligament tear can cause radius bone dislocate and upper part of ulnar bone fracture. 严重的扭挫伤要与骨折相区别，环状韧带的断裂常使桡骨头脱位合并尺骨上段骨折treatmenttuina manipulation Weigh-straightening manipulation – physician placed patient’s wrist of the affected part under his armpit, the palm is facing upward while elbow facing down. Then physician put his both hands over the elbow part and shake it softly with upward and outward motion for 1 to 2 times, if there is any adjustment will heard the sound. 掂挺法：术者将患侧腕部夹于腋下，掌心朝上，肘尖朝下，术者双手掌环握肘部