Fracture of the lower end of the radius
Introduction
Introduction to the lower end of the humerus The lower end of the humerus fracture refers to a fracture within 3 cm from the articular surface of the lower end of the humerus. This site is the junction of the cancellous bone and the dense bone. It is a weak anatomical site. Once subjected to external force, it is easy to fracture. basic knowledge The proportion of sickness: 0.04%, more common in car accidents and school-age children Susceptible people: no special people Mode of infection: non-infectious Complications: median nerve injury femoral neck fracture
Cause
Causes of lower humerus fracture
Cause of disease
Mostly caused by indirect violence, when the fall, the hand touches the ground, the violence is transmitted upwards, and the lower end of the humerus is fractured.
Pathophysiology
Mostly caused by indirect violence, when the person falls, the hand touches the ground, the violence is transmitted upwards, and the lower end of the humerus is fractured. According to the mechanism of the injury, the straight type fracture, the flexion type fracture, the articular surface fracture and the wrist joint dislocation may occur.
1. Straight fractures Straight fractures are mostly in the back of the wrist, with the palms on the ground and the forearms prone.
Second, flexion fractures of flexion type fractures are often caused by injury of the wrist flexion on the back of the hand when falling, and can also be directly violently hit by the wrist, which is rarer than the straight type fracture.
Third, the distal radius of the articular surface fracture with wrist dislocation This is a special type of distal radius fracture. In the wrist extension, the forearm pronation position falls, the palm of the hand touches the ground, the violence is put into the carpal bone conduction, the back of the tibial joint fractures, and the wrist joint is also displaced to the dorsal side.
Prevention
Prevention of fracture of the lower end of the tibia
The disease is caused by traumatic factors, so pay attention to production and life safety, avoid trauma, and ensure personal safety is the key to prevent this disease.
Complication
Complications of the lower end of the humerus Complications median nerve injury femoral neck fracture
The disease is caused by traumatic factors, and the main complications are as follows:
1. Median nerve injury;
2. Delayed extension of the thumb muscle spasm;
3, femoral neck fracture.
Symptom
Symptoms of lower humerus fractures Common symptoms Wrist pain Pain in the temporal side of the wrist joint Swelling of the wrist and tenderness Wrist contusion
Mostly caused by indirect violence, when the person falls, the hand touches the ground, the violence is transmitted upwards, and the lower end of the humerus is fractured. According to the mechanism of the injury, the straight type fracture, the flexion type fracture, the articular surface fracture and the wrist joint dislocation may occur.
First, the local pain and swelling after the straight-type fracture injury, can give a new typical deformity posture, that is, the side view is a "silver fork" deformity, the front side is a "gun-like" deformity, the local tenderness is obvious, and the wrist joint movement disorder. The X-ray film showed that the distal end of the fracture was displaced to the iliac crest and the dorsal side, and the proximal volar side was displaced. Therefore, typical deformity signs were observed, which may be accompanied by dislocation of the lower ankle joint.
Second, after the fracture of the flexion fracture, the wrist is drooping, local swelling, subcutaneous ecchymosis on the back of the wrist, limited wrist activity, and obvious tenderness in the examination. X-ray film can be found in typical displacement, near tonnage to the dorsal position, distally folded end to the volar side, the temporal side of the displacement, and the direction of the extension of the fracture is opposite, becoming an anti-Colles fracture or Smith fracture.
Third, the distal radius of the articular surface fracture with wrist dislocation clinically showed a "silver fork" deformity similar to Colles fracture and the corresponding signs. X-ray film can be found as a typical shift. When falling, the wrist flexes with a hand on the back of the hand, and the vertebral articular surface fracture of the lower end of the humerus and the shift of the wrist to the volar side can occur. These fractures are rare, clinically often missed or misdiagnosed as wrist dislocation, as long as careful reading of X-ray film diagnosis is not difficult.
Examine
Examination of the lower end of the humerus
The auxiliary examination of this disease is mainly X-ray examination. The X-ray can clearly show the fracture and its type. In the straight type, the distal end of the humerus fracture is displaced to the dorsal aspect. The inclination angle of the volar and ulnar sides of the joint surface becomes smaller and disappears. In the reverse direction, the distal end of the humerus fracture is inserted into the proximal side, and some of the ulnar styloid fractures and the lower ankle joint are separated. The flexion fracture is displaced to the volar side of the distal radius, and the elderly patients with mild external force injury, A bone density test should be performed to understand the loosening of the fracture.
Diagnosis
Diagnosis and diagnosis of lower humerus fracture
diagnosis
X-ray examination is generally used to confirm the diagnosis.
Differential diagnosis
The main manifestations of this disease are swelling of the wrist, obvious tenderness, limited movement of the hands and wrists, etc., which have the same performance as many bone or joint injuries, so it is clinically necessary to distinguish with many diseases, and it needs to be differentiated from this disease. There are:
1. fracture of the humerus shaft;
2, humeral neck fracture;
3, humeral head fractures;
4, wrist dislocation.
