小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 关节脱位的特征性姿势
- 疼痛
- 关节无法移动
- 触痛
- 肿胀
- 肩肘神经功能正常
- 髋关节脱位合并坐骨神经损伤
- 髋关节脱位合并股动脉、静脉或神经损伤
- 髋关节脱位并发损伤
- 髌骨脱位合并交叉韧带损伤
- 髌骨脱位合并半月板撕裂
- 髌骨脱位合并膝关节韧带损伤
- 髌骨脱位合并髌腱或股四头肌腱断裂
其他诊断因素
- 手指脱位周围瘀伤形成
- 髌骨脱位导致血肿形成
危险因素
- 运动伤
- 机动车辆事故
- 韧带松弛
- Ehlers-Danlos 综合征
- 青少年至 30 岁男性
- 61-80岁女性
- 原有关节不稳定病史
- 骨骼和肌肉发育不全
- Q角增大
- 胫骨扭转角过大
- 高位髌骨
诊断性检查
首要检查
- 肩关节X线平片
- 手指X线平片
- 膝关节X线平片
- 肘关节X线平片
- 骨盆X线平片
需考虑的检查
- 膝关节核磁扫描
- 肩关节核磁扫描
- 肘部 CT 扫描
- 骨盆CT扫描
- 膝关节或肩关节动脉造影
治疗流程
肩关节脱位
手指脱位
髌骨脱位
肘关节脱位
髋关节脱位
撰稿人
作者
Thomas M. DeBerardino, MD
The San Antonio Orthopaedic Group
San Antonio
TX
利益声明
TMD is a paid consultant and receives royalties from Arthrex, Inc. He serves on the Data Management Committee for Aesculap and is a paid consultant for Arthrex, Inc. and Emovi. TMD declares that none of these relationships relate to this topic.
鸣谢
Dr Thomas M. DeBerardino would like to gratefully acknowledge Dr Paul Novakovich and Dr Brent Ponce, previous contributors to this topic. PN and BP declare that they have no competing interests.
同行评议者
Daniel J. Solomon, MD
Co-director of Orthopedic Sports and Shoulder Service
Department of Orthopedic Surgery
Naval Medical Center San Diego
San Diego
CA
利益声明
DJS declares that he has no competing interests.
Matthew T. Provencher, MD
Assistant Director
Orthopaedic Shoulder and Sports Surgery
Naval Medical Center San Diego
San Diego
CA
利益声明
MTP declares that he has no competing interests.
Peter Cundy, MBBS, FRACS
Head of Orthopaedic Surgery
Women's & Children's Hospital
Adelaide
South Australia
Australia
利益声明
PC declares that he has no competing interests.
鉴别诊断
- 肱骨近端骨折
- 锁骨远端骨折
- 肩锁关节分离
更多 鉴别诊断指南
- ACR 适宜性标准：骨坏死
- 美国放射学会诊断标准：急性关节脱位膝关节创伤
更多 指南
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