Open reduction of elbow dislocation

Elbow dislocation is the most common, and its incidence is about half of the total dislocation of the four major joints. The elbow joint ulnar coronoid process is smaller than the olecranon, and the ability to resist the ulnar rearward displacement is worse than the ability to resist forward displacement. In addition, the lateral ligament is strong and the posterior joint capsule is relatively weak. Therefore, dislocation of the elbow joint is much more common than dislocation in other directions. The functional efficacy of open reduction of the elbow joint depends on the morning and evening of the surgical treatment. The earlier the operation, the better the functional recovery after surgery; if the dislocation time is too long, the effect on adults is not satisfactory. Therefore, joint angioplasty or arthrodesis should be considered at the same time of open reduction. Treatment of diseases: elbow joint dislocation elbow joint tuberculosis Indication 1. Children and adolescents during the development of the epiphysis. 2. Adults with short dislocation times or failed to close the reset. Contraindications Cloudy ossifying myositis is the only contraindication to surgery. At this point, surgery should be postponed until the ossifying myositis is still, and the bone density is increased and the contour is clear. Surgical procedure 1. Position: supine, elbow joint placed on the chest. 2. Incision and exposure: Inflatable tourniquet with upper arm of the injured limb, according to the posterior side of the elbow joint, the operation is performed (see the posterior side of the elbow joint for the surgery). The ulnar nerve is separated and protected first, and then the tongue is cut and turned down on the triceps triceps to prepare the tendon for suture. The triceps are then cut longitudinally on the posterior median line of the lower part of the humerus, reaching the periosteum, and the muscles, joint capsules and ligaments attached to the anterior and posterior humerus are removed under the periosteum. Since the ulnar nerve has been separated and pulled apart, the posterior and lateral dissection is safer, but care must be taken not to damage the sacral, venous, and median nerves. 3. Clearing the epiphysis and scar tissue: After separating the lower end of the humerus, the tibia and the olecranon are completely separated. For fresh dislocation, just remove the hematoma, granulation and a small amount of scar, and then reset the displaced fracture block. The old dislocation has a large number of callus formation behind the lower end of the humerus, which is similar to the cortical bone of the humeral shaft. If the dislocation time is short, these osteophytes can be peeled off with a periosteal stripper; if the time is too long, they must be removed with a bone knife. The same method is used to remove the semilunar incision of the ulna, and the scar tissue of the tibia coronal fossa. Generally, these parts are mostly scar tissue, and the removal is easier. In the process of removing the epiphysis, if the cartilage surface is severely damaged, arthroplasty or fusion should be considered. 4. Reset: If the epiphysis and scar tissue are completely removed, the reduction is easier. The assistant flexes and pulls the forearm, and the surgeon pushes the eagle's mouth forward, and the coronary sinus slides over the humeral block to reset. 5. Stop bleeding, suture: the tourniquet should be loosened before resetting to completely stop bleeding. After the reduction, the elbow joint was extended and flexed several times to test the stability after the reduction. The person maintains the elbow joint at a 90° flexion and sutures layer by layer. For triceps contractures, the triceps aponeurosis should be sutured.

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