radial capitulum epiphysis separation
Introduction
Introduction to the separation of the humeral small skull The separation of the small skull of the humerus is caused by the abduction of the shoulder joint during the fall, the elbow joint is straight and valgus, and the small head of the humerus is caused by the small head of the humerus. It is common in the elbow joint injury of children. basic knowledge Probability ratio: Susceptible people: children. Mode of infection: non-infectious Complications: elbow varus deformity
Cause
Separation of the sacral skull
Fall (35%):
The small sacral sacral sacral separation is caused by the shoulder abduction during the fall, the elbow joint is straight and valgus, and the humeral head hits the humeral head. The injury mechanism is similar to that of the radial head fracture. Most of them belong to Salter-Harris type II and type I. damage.
Pathology (30%):
Separation of the small skull of the humerus occurs mostly when it falls or falls during sports. When falling, the elbow joint is straightened and the palm of the hand is placed on the outside of the shoulder joint, so that the elbow joint is placed in the valgus position of the strength, causing the humeral head to violently hit the small head of the humerus, causing a fracture of the humeral head. Sometimes, this similar violence may result in a fracture of the humeral head or an injury to the medial side of the elbow, such as avulsion fracture of the medial epicondyle of the humerus.
Since the humeral head and its neck and stem are not arranged in a straight line, but are eccentrically connected to the neck to the temporal side, the trabecular bone of the lateral 1/3 of the humeral head is not perpendicular to the neck and the stem, forming a mechanical Weak department. When an external force causes the humerus to hit the small head of the humerus, the 1/3 of the trabecular bone of the humeral head is not perpendicular to the neck and the cadre, forming a mechanically weak part. When the external force causes the humeral head to hit the small head, the outer 1/3 of the humeral head lacks the effect of resisting shear force, so the chance of fracture in this part is significantly increased.
Typing (25%):
The disease can be divided into 4 types: type I: wearing a cap type, about 50%, type II: compression type, type III: fragmentation type, type IV: compression fracture type.
Prevention
Separation prevention of humeral small skull
Pay attention to the safety of production and life, avoid trauma, and ensure personal safety. At the same time, it should be noted that functional exercise should be performed as soon as possible after surgery to restore the function of the affected limb.
Complication
Separation of humeral small skull spasm Complications elbow varus deformity
The influence of osteophyte separation on the growth and development of osteophytes and whether it can affect the bone end deformity depends on the location, extent and treatment of the injury. Early diagnosis and treatment can effectively prevent complications, but if the treatment is not timely or If the injury is heavier, other diseases may occur concurrently, such as elbow deformity and upper arm dysfunction.
Symptom
Symptoms of separation of the small skull of the humerus Common symptoms Elbow pain, swelling of the elbow, tenderness, swelling of the elbow and dysfunction
This disease mainly occurs after elbow injury, which is characterized by swelling of the elbow lateral, pain, compression and dysfunction. For these patients, X-ray examination should be performed to determine whether the sacral sacral sacral separation has occurred.
Examine
Examination of the separation of the small skull of the humerus
The auxiliary examination of this disease is mainly X-ray examination, and there are three points to note at the same time:
1. The distal radius of the humerus is separated from the dorsal or volar side. X-ray anterior slices are more likely to be separated from the epiphysis. Only the lateral slices can be seen. For this, the position of the child should be placed first. Secondly, the positional tablets of different angles can be added.
2, slight osteophyte separation, osteophyte displacement is not obvious, at this time on the X-ray film only see a slight cortical wrinkles, angled, this should be carefully read to prevent missed diagnosis.
3. If abnormal dry high-density shadows are found, the contralateral wrist joints should be compared for comparison. If there is no such change on the healthy side, the separation of the epiphyses can be diagnosed. It is recommended that the children should be reviewed regularly if there is osteophyte formation. , the diagnosis can be confirmed.
Diagnosis
Diagnostic diagnosis of humeral small skull
diagnosis
Diagnosis can be performed based on clinical manifestations and examinations.
Differential diagnosis
The disease needs to be differentiated from the dislocation of the humeral head, and the X-ray examination can be identified.
The dislocation of the radial head is mainly characterized by bilateral elbow asymmetry. Sometimes the flexion or activity is limited when the elbow joint is extended or flexed. The direction of the ulnar bending is related to the type of dislocation. For example, the anterior dislocation of the humerus head and the ulna protrude to the front. When the humerus is dislocated, the ulna protrudes backward; when the lateral dislocation, the ulna protrudes to the outside. When the humerus is dislocated, the flexion range of the elbow becomes smaller, and the humerus at the elbow can be dislocated and dislocated. Head, when the humeral head is dislocated, the elbow joint can not be fully extended, and the elbow can be licked and raised at the back of the elbow. The X-ray film shows that the longitudinal axis of the humerus on the lateral side of the elbow does not cross the humeral head. It has a dome shape, and the humeral neck forms a joint with the small head of the humerus, and the contact site can be pressed.
