关节脱位英文课件

Clinical manifestation
※Dugas sign:
L. A. Dugas, Philadelphia, 1857, 10: 175-179.
X-ray
Radiography
Subcoracoid dislocation
Diagnosis
History Clinical manifestation X-ray
Classification
Traumatic dislocation excessive force is applied to a joint
Pathological dislocation
Congenital dislocation 先天性脱位
Fresh dislocation (within 2 weeks) 新鲜脱位 Old dislocation (more than 2 weeks) 陈旧性脱位 Habitual or Recurrent Dislocation 习惯性脱位
Outline
➢ Anatomy ➢ Etiology ➢ Classification ➢ Clinical manifestation and Diagnosis ➢ Treatment ➢ Complication
Epidemiology
The shoulder is the most commonly dislocated joint in the body
X-ray Re-check
Reduction Maneuver
Kocher Maneuver 1870
假体选择
Reduction Maneuver
Hippocrates Maneuver
(460-377 BC)
Immobilization
3-4 weeks
Rehabilitation
➢ Range of Motion
✓ Ligament
韧带
✓ Rotator cuff 肩袖
✓ muscles
肌肉
Feature of Anatomy
• No strong bony stability • Relies on soft tissues for stability
Greatest Range of Motion
Less Stability
Bony Structure
Anatomy
Articular surface ratio= 3~4 ：1
Humeral head 肱骨头
Glenoid 关节盂
Soft tissue
Posterior
Anatomy
Anterior
✓ Glenoid labrum 关节盂
✓ Joint capsule 关节囊
Pain
Swelling Loss of function
Clinical manifestation
Specific Sign
Deformity Square shoulder
方肩畸形
Empty of glenoid fossa 关节盂空虚
Elastic fixation 弹性固定
Dugas sign
➢ Muscle strength
Complication
• Bankart lesion Bankart损伤

• Rotator cuff tear 肩袖损伤
• Fracture
骨折
• Nerve injury
神经损伤
Bankart lesion
发病率：肩关节前脱位最常见的病理性损伤，53%-100% 定义：前下关节囊盂唇复合体从关节盂的附着点撕脱
High risk of dislocation
Etiology
Traumatic
96%
Etiology
Atraumatic
ligamentous laxity 韧带松弛症
Anterior dislocation
Classification
Posterior dislocation
Inferior dislocation
Treatment
Reduction Immobilization
Traction-counter-traction technique Specific maneuvers
Rehabilitation
What happened to the Baseball player?
Dislocation of the Shoulder
※ Anterior dislocation: Over 95%
Anterior dislocation
Subcoracoid 喙突下脱位
Subglenoid 盂下脱位
Subclavicular 锁骨下脱位
Intrathoracic 胸腔内脱位
Clinical manifestation
General Symptom
Treatment
Reduction Immobilization Rehabilitation
Reduction
Pre-reduction
Intra-reduction
Post-reduction
Diagnosis Make an agreement Stay relaxed
Local anaesthesia General anaesthesia
Patients with a previous shoulder dislocation are more prone to redislocation.
Younger patients (teenagers and those aged 20 years) have a much higher frequency of redislocation than patients in their 50s and 60s.
Dislocation of the Joints
Definition
Joint Dislocation
关节脱位
an abnormal separation of the joint
Joint Subluxation
关节半脱位
partial dislocation
Joint Sprain
关节扭伤
refers to damage or tearing of ligaments or a joint capsule