中英双字幕(选中以下链接,搜索之后即可查看)
https://www.bilibili.com/video/BV1SS4y1T78U/
机器翻译字幕，仅供参考：
in this video we will discuss our
在本视频中，我们将讨论我们
technique for a closed reduction of
用于闭合复位
simple elbow dislocations
简单肘关节脱位的技术
as well as the associated elbow hematoma
以及用于术前镇痛的相关肘部血肿
block procedure
阻滞程序
for pre procedure analgesia a brief
background on elbow dislocations
肘部脱位的简要背景
they are the number one most common
它们是儿童中最常见的
dislocation in children and number two
脱位第一
in adults behind shoulders
，成人中最常见的脱位第二 肩
the most common age group is 10 to 20
后部 最常见的年龄组是 10 至 20
year olds
岁
and they account for 10 to 25 percent of
，占肘部损伤的 10% 至 25%
injuries of the elbow
about 80 percent are posterior lateral
约 80% 为后外侧
dislocations and around 25 percent have
脱位，约 25%
concomitant（/kənˈkɑːmɪtənt/adj. 相伴的；） fractures
伴有骨折
elbow dislocations can be categorized
肘关节脱位可
into simple
分为简单型
or complex complex elbow dislocations
或复杂型 肘关节
are associated with fracture and have
脱位与骨折有关，并且具有
three main mechanisms
三种主要机制
that lead to three different patterns of
，导致三种不同的损伤模式，
injuries as displayed here
如此处所示
complex level dislocations are beyond
复杂水平脱位超出
the scope of this video
了本视频的范围
and we will focus on simple elbow
，我们将重点关注简单的肘关节
dislocations or those without associated
脱位或
fracture
which are nearly always posterior
几乎总是在后部没有相关骨折的肘关节脱位
lateral dislocations
横向位错
first we will describe our procedure for
首先我们将 de 划出我们
the elbow hematoma block
的肘部血肿阻滞程序，
for pre-procedure analgesia for the
用于术前镇痛，以
reduction
the ebola hematoma block involves using
减少埃博拉血肿阻滞涉及
the lateral portal（/ˈpɔːrtl/n. 正门；门户网站，入口站点） to the elbow
使用肘部外侧入口
indications for aspiration only include
抽吸适应症仅包括
diagnosis
诊断
asceptic arthritis or gout of the elbow
无菌性关节炎或肘部痛风
indications for aspiration and hematoma
抽吸适应症和血肿
block are for pain control
阻滞用于疼痛
the two main scenarios are a radial head
控制两种主要情况是桡骨头
fracture to provide pain relief
骨折以缓解疼痛
to adequately assess range of motion and
以充分评估运动范围和
presence of a mechanical block to motion
运动的机械阻滞的存在
as well as elbow dislocations to provide
以及肘关节脱位以
analgesia during close reduction
在紧密复位期间提供镇痛
the lateral portal is also used during
外侧入口也用于
elbow arthroscopy
肘关节镜检查
here we have two lateral x-rays of the
这里我们 有两次肘部侧位 X 光片，
elbow demonstrating the location of the
显示
hematoma block
血肿块
in the non-dislocated elbow the hematoma
在非脱位肘部的位置 血肿块
block will be performed in the lateral
将
soft spot of the elbow
在肘部尖端之间的肘部外侧软点进行
between the tip of the olecranon（ 鹰嘴） the
，
lateral epicondyle
外上髁
and the radial head these can be
和桡骨头这些 可以
palpated easily on most patients
在大多数患者身上轻松触诊
and guide the placement of your needle
并指导您的针的放置
in a dislocated elbow
i na 肘关节脱位
the anatomy is skewed however these
解剖结构偏斜，但
landmarks can still be palpated and the
仍可触及这些标志，并且鉴于肘关节脱位的性质，
soft spine of the joint is usually a
关节的软脊柱通常
larger area
面积较大
given the dislocated nature of the elbow
it can be helpful to mark out these
landmarks
on the patient to guide your needle
placement in between
在
the tip of the olecranon lateral
鹰嘴外上髁的尖端
epicondyle
and radial head this following image
和桡骨头之间，下图
demonstrates where the soft spot is in
显示了该患者肘关节脱位的软点
relation to the underlying
与潜在
bony anatomy in this patient with an
骨骼解剖结构的关系，
elbow dislocation
as with most aspirations or injections
与大多数抽吸或注射一样
there are risks to this procedure
，此过程存在风险，
including infection hydrogenic chondral
包括感染氢 软骨
injury
损伤
bleeding and lidocaine toxicity which
出血和利多卡因毒性，
can be avoided with aspiration prior to
可在注射前通过抽吸避免，
injection to ensure that you are not in
以确保您
a vascular structure
不在血管
the adequate supply should be gathered
结构中 应在手术前收集足够的供应
prior to procedure including lidocaine（ /ˈlaɪdəkeɪn/）
，包括
without epinephrine（/ˌepɪˈnefrɪn/）
不含肾上腺素的利多卡因
one to 23 gauge needle for skin
用于皮肤麻醉的 1 至 23 号针头
anesthesia
one 18 gauge needle for the joint
1 个 18 号针头 用于联合
aspiration and
抽吸和
lidocaine injection and two 10 cc
利多卡因注射和两个 10 cc
syringes
注射器
appropriate setup informed consent and
适当的设置 应进行知情同意和
timeout should be performed
暂停
the patient should be seated with their
患者应坐在
elbow at the level of the examiner's
elbow while the examiner is standing
检查者站立时肘部与检查者肘部齐平
this is in anticipation of the future
这是预期未来的
closed reduction
闭合复位
allow for the patient's elbow to sit in
允许患者肘部
the most comfortable position of flexion
坐在 最舒适的屈曲位置
which provides the largest joint volume
，提供最大的关节体积
and the larger joint entry point
和更大的关节入口点
assemble all supplies to prevent delays
组装所有用品，以防止
during the procedure this is a video
手术过程中出现延误 这是一个肘部血肿块的视频
demonstration of the elbow hematoma
演示，首先是肘部的
block
first this lateral soft spot to the
这个外侧软点，然后
elbow is prepped with chloraprep
用 chloraprep 溶液准备好
solution
next the skin is anesthetized with a 21
用 21
to 23 gauge needle
到 23 号针头
and a few cc's of lidocaine
和几 cc 的利多卡因麻醉皮肤
a wheel of lidocaine is injected in the
，在 sub-q 组织中注射一个利多卡因轮
sub-q tissue
and then a 10-cc syringe that is empty
，然后将带有 18 号针头的 10 cc 空注射器
with an 18-gauge needle is inserted into
the lateral soft spot of the elbow
插入外侧 肘部软点进入肘关节
into the elbow joint
once in the joint the hematoma should be
一旦进入关节，应吸出血肿
aspirated
and it can be necessary to change the
，可能需要更换
direction of the needle a few times
针头方向几次
to break up old hematoma
以打破旧血肿
once all the hematoma is aspirated the
一旦所有血肿被吸出
10cc syringe is detached from the 18
10cc 注射器与 18 号针头分离，该
gauge needle
针头
which should be left in the joint
应留在关节
the 10cc syringe with the lidocaine is
中 10cc 注射器与利多卡因
then attached to the 18 gauge needle
然后连接到 18 号针头
and the lidocaine is injected into the
上 利多卡因注射到
elbow joint there should be no
肘关节 应该没有
resistance as the ladder is injected
阻力 因为梯子被注射
into the elbow joint
到肘关节
gauze can be used to tamper nod the
纱布可以用来篡改点头
injection site
注射部位
next we will describe our technique for
接下来我们将描述我们的
closed reduction of the simple elbow
闭合复位简单肘关节
dislocation
脱位
the closed reduction of an elbow
的技术 闭合复位 肘关节
dislocation involves three main
脱位涉及三个主要
components axial traction distal to the
部分 肘关节远端的轴向牵引
elbow
肘关节
counter attraction proximal to the elbow
近端的反吸引
and gradual flexion of the elbow
和肘关节的逐渐弯曲
there are a variety of maneuvers that
can be performed however most require
可以执行多种操作，但大多数需要
additional help
in the following video we will
在以下视频中提供额外帮助，我们将
demonstrate our method for performing
展示我们的方法 一个人进行
close reduction of elbow dislocations
近距复位肘关节脱位
with one person
，
the patient should be seated and
患者应坐下并
positioned at a height
定位 位于
that allows the examiner to place their
允许检查者将
elbow in the patient's elbow comfortably
肘部舒适地放在患者肘部的高度
the patient's injured hand is gripped by
患者受伤的手
the examiner's contralateral hand
被检查者的对侧手抓住
and the examiner's elbow is placed in
，检查者的肘部放置
the patient's anacubital fossa
在患者的肘窝内
counter traction will be provided by the
由
examiner's elbow in the anticubicle
检查者的肘部提供反向牵引力 额叶
fossa
窝
actual traction will be pulled through
实际牵引将
the hand and gradual flexion will be
通过手拉，并由检查者自己的肘部逐渐弯曲来
provided
by the gradual flexion of the examiner's
提供逐渐弯曲 在
own elbow a palpable as well as audible （ /ˈɔːdəb(ə)l/adj. 听得见的）
肘部闭合复位期间应听到可触及和可听见的咔嗒声
clunk
should be heard during the closed
reduction of the elbow
复位后
following reduction the patient's elbow
should be taken
应采取患者肘部
through a range of motion to assess the
通过一系列运动来评估
stable range of motion of that elbow
肘部
in both flexion and extension and prono
在屈伸和前
supination
旋后的稳定运动范围
and these should be documented in the
，这些应该记录在
assessment dry gauze is placed over the
评估
hematoma block site
and then a posterior slab long arm
splint should be applied
中
the patient should be immobilized in a
应用患者应将肘部固定在
comfortable stable position of elbow
舒适稳定的位置
flexion
and the splint should extend past the
wrist to prevent chronal supination if
the patient's elbow is extremely
如果患者的肘部非常
unstable
不稳定
it will tend to dislocate in extension
，则肘部在伸展时会脱臼
and may require immobilization at
，可能需要在
greater than 90 degrees of elbow flexion
大于 90 度的肘部屈曲
in addition the wrist may need to be
时进行固定，此外，手腕可能需要
positioned in pronation for lateral
旋前定位 对于外侧
injuries
损伤
or supination for medial injuries the
或旋后 对于内侧损伤，
patient's extremity should then be
placed in a sling for comfort
为了舒适起见，应将患者的四肢置于吊带中，
and they should be instructed to avoid
并应指导他们避免
heavy lifting with that upper extremity
用该上肢
anything greater than five pounds the
举重超过 5 磅
following x-rays demonstrate
以下的 X 光片显示
post-reduction
复位后的
x-rays of the elbow and a long arm
X 光片 肘部和长臂
splint
夹板
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