桡骨(ráog)ǔ头半脱位邢台县医院(yīyuàn)骨科许浈铖第一页，共二十页。Whats‘桡骨(ráog)ǔ头半脱位？第二页，共二十页。专业(zhunyè)ā回答•牵拉肘，也被称作环状韧带移位或桡骨头半脱位，是儿童常见的骨科损伤。IntheUnitedStates,theincidenceofemergencydepartmentvisitsforpulledelbowisestimatedat2.7per1000personsyoungerthan18yearsofage.Themedianageatpresentationis2years.在美国，未成年人急诊就诊中牵拉肘的发生率大约在2.7/1000.相关报道(bàodào)的中位年龄为2岁。Theinjuryisuniquetoinfantsandyoungchildrenbecausetheradialheadislessbulbousthanitisinolderpersonsandmayeasilybecomedisplaced.牵拉肘特别常见于婴幼儿和青少年，因为幼儿的桡骨头还未发育像成人那样的圆球状桡骨头，所以很容易移位。Reductionofapulledelbowisasafeprocedurethatcanbeperformedintheoutpatientsetting.复位牵拉肘是相对安全的操作，完全可以在门诊进行。Theannularligamentencirclestheneckoftheradiusandholdsittightlyinplaceagainsttheulna),therebymaintainingthepositionoftheproximalradiusinrelationtotheulnaandthecapitellumofthedistalhumeruswhileallowing180-degreerotation.环状韧带包绕桡骨颈使其紧邻尺骨，从而维持桡骨与毗邻尺骨以及肱骨远端肱骨小头的相对位置，同时可以完成180°旋转。Whenthereisforcefullongitudinaltraction,suchaswhenachildispulledorliftedbythearm,theradialheadispulledunderneaththeannularligament.在强大的纵向（轴向）牵拉下，比如提拉幼儿手臂或用手臂引体向上时，桡骨头会被牵拉至环状韧带下方。第三页，共二十页。大多数孩子的病史中可能有过被牵拉(qinl)āā的情况第四页，共二十页。第五页，共二十页。环状韧带(rèndài)嵌压的环状韧带环状韧带包绕桡骨颈，并维持(wéichí)桡骨紧邻尺骨轴向牵拉时，桡骨(ráog)ǔ头包埋在环状韧带下第六页，共二十页。首先，明确孩子的病史及体检与诊断致。Thechild’shistorymayincludeawitnessedeventofforcefultraction;however,othermechanismsofinjuryhavealsobeendescribed.孩子的病史中可能有过被牵拉的情况；然而，其它的损失机制也有描述过。Physicalexaminationshouldrevealpseudoparalysis,withthechildvoluntarilykeepingthelimbstilltominimizediscomfort.体格检查会发现假性神经麻痹，而孩子为了减少不适会自主保持上肢制动。Ther...
