Tibial condyle fracture
Introduction
Introduction to the humerus fracture The humerus fracture accounted for approximately 0.38% of the total body fracture. It is a more common fracture. It occurs in young adults, and there are more male patients than females. The fracture of the humerus is more common than the fracture of the medial malleolus. The humeral condyle fracture is an intra-articular fracture, and the fracture affects the proximal humerus articular surface. Severe cases may also have meniscus and joint ligament injury. Therefore, the fracture of the humerus is easy to cause dysfunction of the knee joint. In order to achieve maximum recovery, when dealing with such a fracture, different treatments should be used depending on the severity of the injury, the type of injury, and the condition of the combined injury. basic knowledge The proportion of illness: 0.005%--0.007% Susceptible people: good for young adults, more male patients than females Mode of infection: non-infectious Complications: Traumatic arthritis, swelling, meniscus injury, knee ligament injury, humeral condyle fracture, nonunion
Cause
Causes of humeral condyle fracture
External force (30%):
Because the direction, size, and duration of the external force are different from those of the patient at the time of injury, there are many classification methods for the humeral condyle fracture. The commonly used methods are as follows:
(1) The fractures of single iliac crest are mostly caused by extra-bone stress, and are divided into cleft palate type and collapse type. The former fracture line will be separated from one iliac crest. The latter is mainly the trabecular bone fracture joint surface collapse, and the valgus injury is more common. The medial collateral ligament injury caused by severe humerus fractures, sometimes combined with the upper humerus fracture or common peroneal nerve injury.
(2) The fracture of the double ankle is often caused by vertical pressure. If it is accompanied by valgus stress, the injury on one side is heavier and the fracture is vertical compression. The bone damage may be heavier, but the ligament injury is often not combined. The prognosis is better after reduction.
(3) compression and comminuted fracture of the tibial plateau. This type of injury is the heaviest in the fracture of the humerus.
The upper part of the upper part of the humerus is spongy bone. There is no strong support under the outer edge. It becomes a weak point of the bone and is prone to fracture. Direct and indirect external force can cause fracture of the humerus. The direct external force is caused by the impact of the car bumper. Indirect external force is caused by the fall of the two feet on the ground, the compression of the humerus, or the fracture of the knee joint ligament caused by the internal and external tumbling stress. Because the contralateral lower limb is protected on the inside, the varus stress is not easy to occur, so the external malleolus fracture is more. Fracture in the internal hemorrhoids.
Knee joint straightness injury (30%):
When the knee joint is injured, it causes multiple fractures of the single iliac crest. In the flexion position, the fracture is mostly confined to the middle or the posterior part of the humerus. The knee joint flexes the external rotation of the calf and the valgus stress causes injury. The anterior fracture of the ankle, and vice versa, can cause a fracture of the medial malleolus.
Vertical compression force (20%):
Vertical compression forces often cause T-shaped or Y-shaped double-ankle fractures, and torsional stress can also be associated with ligament injury.
Beijing Jishuitan Hospital classifies the humeral condyle fractures according to the fracture mechanism and the degree of injury as follows:
(1) Eversion-type valgus stress is the most common, accounting for about 70% of such fractures, and is further divided into 4 degrees according to the degree of injury.
I degree: external or external fissure or compression fracture without displacement or slight displacement, the compression joint surface does not exceed 0.5cm.
II degree: the lateral 1/3 of the lateral malleolus of the humerus was displaced laterally, and the medial 2/3 articular surface was compressed by the lateral femoral condyle, no more than 1 cm.
III degree: fracture of the bilateral ankle, the external ankle fracture is the same as the second degree, but the compression fracture is more than 1cm, often comminuted or even affecting the intercondylar spine. The humerus tendon widens beyond the humeral condyle, the articular surface is intact, and the internal malleolus fracture line is obliquely outward. The upper part is compressed by the external malleolus.
IV degree: 2/3 compression of the medial lateral malleolus is the same as III degree, the internal ankle joint surface is intact, from the external compression fracture to the medial malleolus is a oblique fracture, the shortening displacement is obvious, the external iliac crest is 1/ 3 Keeping with the tibia (may have a crack fracture), and shifting to the proximal side, reaching the lateral side of the femoral condyle, dislocation, resulting in knee varus and internal rotation deformity.
(2) caused by varus varus stress, accounting for 18.2% of such fractures, humeral condyle compression or cleft palate fracture, no serious displacement, close to the knee extension injury, manifested as a fracture of the internal malleolus. The knee flexion injury is characterized by a fissure fracture of the medial condyle of the posterior tibial humerus, such as flexion of the knee and internal rotation of the calf, which is characterized by a anterior medial fracture of the medial malleolus.
(3) vertical injury caused by vertical injury, knee injury caused by the knee, internal and external sacral compression fractures or split fractures, and even comminuted fractures, often with fractures of the sacral spine, knee injury caused by the knee, only the second half of the humerus Lateral fracture.
Prevention
Prevention of humeral condyle fracture
The prevention of this disease is mainly postoperative prevention. Pay attention to the following two points:
1 Early activities can avoid the movement disorders and pain caused by adhesions in the joints, better shape the damaged joint surface, and start joint activity as soon as possible. The more serious the injury, the more active joints are needed.
2 Accurately resetting and maintaining the position of the fracture reduction can prevent joint instability and deformity.
Complication
Complications of humeral condyle fracture Complications, traumatic arthritis, swelling, meniscus injury, knee ligament injury, humeral condyle fracture, nonunion
The humeral condyle fracture is an intra-articular fracture, and the fracture affects the proximal humerus articular surface. The main complications of this disease are knee varus deformity and traumatic arthritis. In some serious cases, there may be different degrees of intra-articular hemorrhage. There are extensive or localized swelling, and there may be complicated meniscus and joint ligament injury. Therefore, the fracture of the humerus is easy to cause dysfunction of the knee joint. Other non-infectious complications include nonunion, deep vein thrombosis, and different Active ossification, joint stiffness, etc., require active treatment.
Symptom
Symptoms of humeral condyle fractures Common symptoms Joint pain, tibia, dry bone, non-continuous humeral pain, tibia, tenderness, thigh, local swelling, deformation, humeral swelling
Knee joint has a serious history of trauma, knee pain and tenderness after injury, dysfunction, not only the affected side of the calf can not bear weight, but also can not actively flexion and extension activities, severe cases can have varying degrees of intra-articular hemorrhage, and a wide range Or localized swelling, in addition, there may be different degrees of deformity, external malleolus fractures may appear knee valgus deformity, comminuted fractures, can touch bones, collateral ligaments, swelling, tenderness, indicating collateral ligament Injury, the front and rear drawer tests should be performed to exclude the damage of the cruciate ligament.
Examine
Examination of humeral condyle fracture
X-ray examination: suspected fracture of the upper end of the humerus, it is necessary to take a positive, lateral X-ray image to understand the extent and characteristics of the fracture, showing that the contour of the affected posterior humerus is very important, usually the upper part of the humerus and The positive lateral position of the knee joint and the oblique X-ray film on both sides, the positive position piece inclined to the foot by 10°15° can better display the platform, and the X-ray film under stress can show the collateral ligament and cruciate ligament injury. Or tear.
Diagnosis
Diagnosis and diagnosis of humeral condyle fracture
diagnosis
Suspected fractures of the upper end of the humerus, it is necessary to take a positive, lateral X-ray image to understand the extent and characteristics of the fracture, showing that the contour of the affected posterior humerus is very important.
Differential diagnosis
The main symptoms of this disease are joint pain and tenderness, dysfunction, not only the affected side of the calf can not bear weight, but also can not actively flexion and extension activities, etc., because the symptoms are not characteristic, need to be identified with diseases with similar symptoms, including :
1. Knee arthritis.
2, joint dislocation.
3, joint cysts and so on.
