【摘要】 目的:探讨成人创伤性桡骨头脱位的损伤机理。方法:对成人肘关节尸体标本进行动态模拟冲击试验和扭转试验。结果:冲击试验(7具)有4例发生桡骨头半脱位。扭转试验(6具)有5例发生桡骨头脱位。旋前暴力产生3例桡骨头前脱位;旋后暴力发生1例桡骨头外侧脱位,1例后脱位。结合临床7例桡骨头脱位,有5例肘部受到冲击加扭转的暴力,2例为单纯扭转暴力而发生。结论:1在上肢伸直位或轻度屈肘位,手掌尺侧撑地跌伤时,肘部受到冲击、旋转和内翻应力的作用下可发生桡骨头脱位。2当上肢受到单纯扭转暴力致前臂过度旋转时亦可发生桡骨头脱位。3桡骨头脱位的方向取决于受伤后肢体的位置及所受暴力的方向。更多还原

【Abstract】 Objective: To make an inquiry into the injured mechanism of traumatic dislocation of the radial head in an adult.Methods: The movable imitating impact test and twist test were made in the 13 elbows of corpses with the muscles stripped.The occurrence of dislocation of the radial head was observed and recorded.Results: Impact test showed that two anterior semi dislocation occurred in a position of slight elbow flexion and pronation as swing hammer impacte the area of medial of wrist palm;One posterior lateral semi dislocation occurred in a position of slight pronation and one posterior in a position of neutral.But in the three cases of impacting the area of middle or lateral of wrist palm and supination,other results can be observed. The twist test showed that the dislocation of radial head appeared when twist angle exceeded normal range of rotation.The prone violence brought about three cases of anterior dislocation of the radial head;The supine violence an lateral and one posterior dislocation of the radial head.Of all seven patients of dislocation of the radial head,there were five cases,whose elbows suffered from violence of impacting and twisting and two suffered from simple twisting violence.Conclusions: 1) When the arm extends or elbow slightly flexes and the medial of wrist palm hits the ground as the patient falls the body pivots around this extremity due to inertia and the elbow is influenced by impacted rotation and varus forces,which can produce dislocation of the radial head.2) When the forearm is impacted by simple twist force and hyper rotation the dislocation of the radial head also produces. 3) The dislocation direction depends on the position of the injured extremity and the direction of violence.The posterior dislocation of radial head is a rare injury due to the effect of the interosseous membrane and clinically the injury of forearm supinated appears less often.\;更多还原