The elbow joint is a typical compound joint. The joint capsule is thin and loose at the front and back, with tension on both sides. The elbow joint is also one of the most prone to dislocations in the human body, with an annual incidence of about 0.006% to 0.008%, of which 49% may be associated with fractures. Elbow joint dislocation combined with radial head fracture and coronary process fracture is a type of injury due to the special anatomical structure of the elbow joint and difficult treatment. Even if an experienced orthopedic clinician performs timely and effective treatment, the patient's prognosis is still not ideal.
• There are different stages of instability in the elbow joint. The final stage is dislocation.
• In stage 1, the ulna is subluxated and the lateral ulnar collateral ligament is torn.
• In the second stage, there are more injuries, in which the crown protrudes from the tackle and there are more ligament injuries.
• In stage 3, the coronal process ends with a true dislocation behind the humerus, possibly tearing the ulnar collateral ligament, resulting in a very unstable float-the elbow.
• Chronic excessive valgus can cause osteochondral lesions on the outside of the elbow. This is the result of repeated impact and shear forces. External epicondylitis is also known as tennis elbow, but in 95% of cases, it can be seen by non-tennis players. This is due to the chronic stress of common extensor tendons, which results in partial tearing and degeneration of the tendons. Usually, the radial wrist extensor muscle is the component involved. In more severe cases, the LCL will tear, which responds poorly to conservative treatment.
Tennis elbow (external epicondylitis of the humerus) is an inflammation of the tendon at the beginning of the extensor of the forearm outside the elbow. The pain is caused by a chronic tear caused by repeated forearm extensor muscles. The patient may feel pain in the affected area when grasping or lifting objects hard. Tennis elbow is a typical example of overwork syndrome. Tennis and badminton players are more common, and housewives, bricklayers, carpenters, etc. who have repeatedly exerted themselves for elbow activities for a long time are also susceptible to this disease. Tennis elbows are mostly chronic diseases, often recurring. At the beginning of the symptoms, they only feel the pain on the outside of the elbow joint. The pain outside the elbow can sometimes radiate up or down. It feels sore and the muscles of the forearm are tense and unwilling to move. The pain of gripping movements (such as twisting a towel, gripping a dumbbell, gripping a racket, twisting a screw, or making a fist, etc.) is more painful. The tenderness point at the lateral epicondyle of the humerus, the flexion of the forearm flexion of the forearm increased, and the pain during the inflammatory period also increased during the rainy days. This part of people who have "tennis elbow" has one thing in common: the usage rate of elbow flexion and extension is very frequent, and it is also accompanied by pronation and pronation of the forearm and flexion and extension of the wrist joint, and the transition from radial abduction to the ulnar side The process of adduction.
Tennis elbow is usually painful of the extensor carpal extensor tendon and is inflamed at the lateral epicondyle of the humerus, especially the highest incidence of the short extensor carpi radialis because this point is the starting point of the short extensor carpi radialis, so this point is inflamed It is caused by inflammation caused by radial extensor wrist short extensor strain. After this muscle is inflamed, there will be slight differences in muscle tension and daily activities and compensation, so tennis elbow pain for a long time will cause a slight misalignment of the humeral and radial joints. Instant high-intensity exertion, especially when the muscle is performing eccentric contraction, can easily cause strain on the muscle, for example, the action of playing a backhand while playing tennis. Long-term low-intensity, repeated use produces muscle fatigue, such as: repeated fist movements (such as moving objects, lifting things, writing with a strong pen, washing and wringing clothes) or finger extensions (such as typing, using a mouse ). When the muscle is overused, it will cause a slight misalignment of the brachio-radial joint.
Evaluation of "tennis elbow"
1. Mills test: the forearm extensor stretch test. The evaluator passively straightens the subject's elbow joint, protrudes the forearm, and flexes the palm of the hand. At this time, the wrist extensor muscle and the finger extensor muscle are tense. If the pain is caused by the external epicondyle of the humerus, it is positive. Tennis elbow.
2. Cozen test: the forearm extensor tension test. The evaluator held the patient's upper limb, and the subject performed a fist, forearm pronation, wrist upturn, and radial scoliosis. At the same time, the evaluator applies resistance; if a painful sensation occurs in the lateral epicondyle of the humerus, the reaction is positive. This method further tensions the extensor muscles than the previous method, and can be detected in mild cases.
In addition to rest, cold therapy in the acute phase, hyperthermia in the chronic phase, drug therapy, electrotherapy, massage, etc., you can also use the eblow brace to apply a long-term pressure to the abdominal muscles of the wrist extensor muscles, and use the principle of reaction force to reduce the tightness of the muscles.
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