Does elbow dislocation need surgery?

summary

Elbow dislocation is the most common joint dislocation in the whole body. It is common among teenagers and is caused by indirect violence. For example, when a sudden fall occurs, the upper limbs abduct and the palms touch the ground, the violence is transmitted upward along the forearm, and the anterior and lower end of the humerus is forced by the body to break through the thin anterior wall of the joint capsule and move forward, resulting in dislocation of the elbow joint. After injury, the patient showed swelling, pain and obvious deformity of elbow joint, shortening of forearm, thickening of elbow joint circumference, touching the distal humerus in front of elbow, touching the olecranon behind elbow, and elastic fixation of elbow joint in half extension position. So does elbow dislocation need surgery? I'd like to share my views with you.

Does elbow dislocation need surgery?

First of all: dislocation of elbow joint or dislocation with fracture: the main treatment method is manual reduction. For some old fractures, manual reduction can be tried for those with short period. Simple dislocation of elbow joint. Take the sitting position, local or brachial plexus anesthesia, if the injury time is short (within 30 minutes) can not be anesthesia. Make the assistant grip the upper arm of the affected limb with both hands, and the operator grip the wrist with both hands, and bend the elbow joint for 60 minutes with traction °～ ninety °， And can slightly pronate, often can hear reset sound or reset vibration. After reduction, the elbow joint was fixed in functional position with upper limb plaster. Three weeks later, the plaster was removed, and active functional exercise was performed, supplemented by physical therapy if necessary, but strong passive activities were not suitable.

Secondly: old dislocation of elbow joint (early stage): manual reduction of old dislocation of elbow joint, under brachial plexus anesthesia, do gentle elbow extension and flexion activities, so that its adhesion is gradually released. Extend the elbow slowly and bend the elbow gradually under the action of traction. The surgeon presses the olecranon with both thumbs and pushes the lower end of the humerus backward to reset it. After X-ray confirmed reduction, the elbow joint was fixed with plaster of upper limb less than 90% ° After 3 weeks, the plaster was removed for functional exercise.

Finally, surgical treatment; Open reduction, brachial plexus anesthesia. The ulnar nerve was exposed and protected at the back of medial epicondyle of humerus. The triceps brachii tendon was treated with tongue incision. After the elbow joint was exposed, the surrounding soft tissue and scar tissue were stripped to remove the hematoma, granulation and scar in the joint cavity. Identify the relationship between the bone ends of the joint and reset it. Suture the tissue around the joint. In order to prevent re dislocation, a Kirschner wire can be used to fix from olecranon to the lower end of humerus and removed after 1-2 weeks.

matters needing attention

Different methods are used according to different periods. If elbow dislocation is not handled well, it will affect the future work and life. To find orthopedic experts in regular hospitals can effectively ensure the effect of surgery. In addition, the surgical treatment of elbow dislocation has its corresponding indications, should choose the appropriate surgical method to treat.