肩峰锁骨关节脱位VIP免费

1CharacteristicsofShoulderCharacteristicsofShoulderProblemsProblemsCommonCommonComplexComplex––4joints4joints––4bones4bones––16muscles16musclesChallengingChallengingSubacromialSubacromialSpaceSpaceCoracoacromialCoracoacromialarcharchSubacromialSubacromialbursabursaSupraspinatusSupraspinatustendontendonLongBBtendonLongBBtendonCommonProblemsCommonProblemsGeneralGeneralstrain/sprainstrain/sprainImpingementImpingementRotatorcufftearRotatorcufftearTendonitisTendonitisAdhesiveAdhesivecapsulitiscapsulitisACarthritisACarthritisGHarthritisGHarthritisThoracicoutletThoracicoutletsyndromesyndromeBBtendonruptureBBtendonruptureBursitisBursitisOthersOthers肩峰鎖骨關節脫位肩峰鎖骨關節脫位症狀與徵兆–肩峰鎖骨關節處觸痛，主被動或阻抗式之外展活動均會痛，甚至不敢動。–會有出血、腫脹、發炎，外觀可能變形。–第二級的扭傷，在肩峰鎖骨關節處可以摸到凹陷（鎖骨略高於肩峰而形成一階梯狀變形）；–更嚴重時，階梯狀變形更為明顯而出現所謂的「琴鍵現象」－PianokeysignACJointSprainACJointSprain肩峰鎖骨關節脫位肩峰鎖骨關節脫位因直接撞擊或間接的傷害而造成扭傷。傷害可分三級–第一級僅有輕微腫痛；–第二級扭傷時，肩峰鎖骨韌帶已撕裂，但喙鎖韌帶尚稱完整；–第三級扭傷表示連喙鎖韌帶也斷裂，及產生肩峰鎖骨關節脫臼2SternoclavicularSternoclavicularJointSprainJointSprainClavicleFracturesClavicleFracturesShoulderInstabilityShoulderInstabilityDislocationandDislocationandsubluxationsubluxationDescriptionofInstabilityDescriptionofInstability––ClassicalDefinitionsClassicalDefinitionsTUBSTUBSAMBRIAMBRI––TwoendsofthespectrumTwoendsofthespectrum3MuscleContractionMuscleContractionForcecouples(humeralheadcentralization)Forcecouples(humeralheadcentralization)RCRC--DynamiccapsulartighteningDynamiccapsulartighteningBicepsBicepsBrachiiBrachiiLigamentoLigamento--muscularreflex(muscularreflex(proprioceptionproprioception––neuromuscularcontrol)neuromuscularcontrol)ShoulderInstabilityShoulderInstabilityDegreeofInstabilityDegreeofInstability––Dislocationvs.Dislocationvs.subluxationsubluxationChronologyofInstabilityChronologyofInstability––Acute(initialtraumaticevent)Acute(initialtraumaticevent)––Chronic(repeatedepisodes)Chronic(repeatedepisodes)Recurrent(<3)Recurrent(<3)盂肱關節脫位盂肱關節脫位向前脫位：肩被外展外旋，或直接撞擊–肩膀前側痛，手臂的位置被”卡”在略做外展（20）及外旋的姿勢。向下脫位：手臂外展時，外力的撞擊。–腋窩處鼓起，手臂被”卡”在外展約45的位置（可能會頂住血管而造成缺血）。向後脫位：做內旋動作而外力直接撞擊肩之前側，或跌倒時以手去撐地。–可自肩後觸摸到肱骨頭。手臂被“卡”在內收內旋姿勢，三角肌前部平，喙突變得突顯。肱肩胛肱肩胛關節關節盂肱關節脫位盂肱關節脫位症狀與徵兆–肩關節失去功能（不能動）、劇痛、腫脹。–外觀上明顯變形，圓滑的三角肌外型消失，肩峰下有凹陷等–傷者以健側手將傷肢撐在體側的位置，且抗拒任何試圖將手臂橫過胸前的動作。PathologywithShoulderInstabilityPathologywithShoulderInstabilityPlasticlengtheningofthePlasticlengtheningoftheligamentousligamentousstructuresstructuresCapsular(attachment)disruptionCapsular(attachment)disruptionMusclelengtheningMusclelengtheningBankartBankartlesionlesionHillHillsachssachslesionlesion4ShoulderImpingementShoulderImpingement22TypesTypes––SubacromialSubacromialPrimaryPrimarySecondarySecondary––Post...