acute patellar dislocation
Introduction
Introduction to acute patella dislocation Traumatic dislocation of the tibia can occur if there is a violent effect or a structural abnormality. Trauma is mainly caused by direct violence on the anterior medial, medial or lateral side of the humerus; occasionally the indirect violent quadriceps muscle contraction causes dislocation of the humerus outward. The quadriceps tendon ruptures and the dilated part tears, causing the tibia to dislocate downward. Direct violence often involves fractures in other areas, such as femoral and tibial fractures, blood in the joint cavity, etc. The direction of traumatic dislocation of the humerus depends on the direction of direct violence and the flexion and extension of the knee joint. basic knowledge The proportion of illness: 0.001% Susceptible population: a higher incidence among adults and adolescents Mode of infection: non-infectious Complications: recurrent patella dislocation osteoarthritis
Cause
Causes of acute patella dislocation
The role of violence (30%):
Or at the same time there is a structural abnormality, the traumatic dislocation of the tibia can occur, but it should be pointed out that the size of the violence may be quite different, and most of the potential bone, fascia or muscle structure abnormalities, such as the femoral condyle, the humerus Excessive external rotation, fibrous banding on the outside of the tibia, lack of or weak tibia fascia of the medial femoral muscle, increased Q angle, poor quadriceps strength, multiple joint relaxation.
Trauma (30%):
Strike in the anterior medial, medial or lateral aspect of the humerus; occasionally indirect violence, strong contraction of the quadriceps muscle causes dislocation of the humerus, tearing of the quadriceps tendon and tearing of the dilatation, resulting in dislocation of the humerus, direct violence Often combined with other parts of the fracture, such as femoral and tibial fractures, blood in the joint cavity and so on.
Traumatic patella dislocation (30%):
It is generally divided into 6 kinds of lateral, medial, superior, inferior, intra-articular and inter-temporal dislocation. If the violence comes from the medial or anterior medial side, the tibia is dislocated to the lateral side. The most common clinically, the violence comes from the lateral side, causing the humerus to be inward. Dislocation, clinically rare, the quadriceps tendon rupture and dilated tear can cause the inferior dislocation of the humerus, while the sacral fracture can lead to dislocation of the humerus, when the direct violence causes dislocation of the humerus, and the dislocated tibia is flexed and stretched in the knee. When the rotation occurs, the dislocation of the humerus joint and the dislocation of the femoral condyle can occur, which is extremely rare in clinical practice.
Prevention
Acute patella dislocation prevention
Rehabilitation should emphasize closed-chain exercise, including wall-to-wall exercises, that is, the patient squats about 40°, keeps the back against the wall for 15 to 20 seconds, and repeats 10 to 15 times. After the acute inflammatory response is relieved, use a 6-8 inch platform for side and front step-to-step exercises. Then carry out a small arc leg press exercise and use a fixed bicycle and stair machine for endurance exercise. When the patient's quadriceps and hamstring muscles return to normal and return to the agility required for physical activity, the patient can participate in physical activity. In general, the humerus fixation band is used for the first 2 to 3 months of participation in physical activity.
Complication
Acute patella dislocation complications Complications recurrent osteophyte dislocation osteoarthritis
Recurrent patellofemoral dislocation and advanced humeral subluxation may be associated with osteoarthritis.
Symptom
Acute patella dislocation symptoms Common symptoms Joint pain Knee joint pain Joint swelling anterior emptory sensation of humerus fracture
1. Patients with local dislocation of knee joints with acute dislocation of the patella come to the clinic because they have returned to their original position, so they only show general symptoms such as congestion and tenderness in the joints.
2. Deformed appearance There may be a small number of patients with elastic flexion deformity of the knee joint, anterior sacral sensation, and the tibia that can be dislocated to the outside of the knee joint.
Examine
Examination of acute patella dislocation
No relevant laboratory tests. X-ray films showed dislocation of the tibia and knees to varying degrees of swelling.
Diagnosis
Diagnosis and diagnosis of acute patella dislocation
Dislocation of the humerus can be divided into acute traumatic patellofemoral dislocation, recurrent patellofemoral dislocation and humeral subluxation. Recurrent patellofemoral dislocation can be achieved without correct treatment of the acute patella dislocation and congenital instability of the tibia, but the humeral subluxation It may be the result of traumatic dislocation, or it may be free of traumatic factors, but only due to dysplasia.
1. The medical history often has a history of trauma or a history of habitual dislocation.
2. Clinical manifestations of knee pain, tenderness and possible deformities in acute trauma.
3. Imaging examination of acute dislocation, there may be different degrees of swelling on the knee X-ray film, sometimes visible displacement of the tibia.
