Congenital fusion of the ulna and radius
Introduction
Introduction to Congenital Ruler and Tibia Fusion The congenital ulnar and ulnar fusion system is congenital fusion of the proximal ulna, and the forearm is fixed at a certain angle. Bilateral involvement accounted for 60%. There is no difference in the incidence of men and women. This malformation is dominantly inherited in some patients. During embryonic development, the ulnar bones are derived from mesoderm tissue. At the 5th week of the embryo, the ulnar and ulnar cartilage rods did not separate and the ossification or the mesoderm was filled between the ulnar and mandibular bones. Type II humeral head dislocation occurs in the late fetus. basic knowledge The proportion of illness: 0.003% Susceptible people: children Mode of infection: non-infectious Complications: gluteal muscle contracture
Cause
Congenital ulna and radius fusion cause
Cause (65%):
This malformation is dominantly inherited in some patients. During embryonic development, the ulnar bones are derived from the mesoderm. When the embryo is at the 5th week, there is no separation between the cartilage of the ulnar and ulna and the ossification or between the ulna and the ulna. When the mesoderm tissue is filled, the ulnar and ulnar fusion occurs, and the type II humeral head dislocation occurs in the late fetus.
Prevention
Congenital ulna and radius fusion prevention
The disease is a congenital disease, no effective preventive measures, early diagnosis and early treatment is the key to the prevention and treatment of this disease, parents should strengthen the usual attention to the child, when the child is found to be abnormal, the forearm rotation dysfunction, take the child to the regular hospital in time Visit to prevent delays. Pregnant women should be well-checked during pregnancy, age-appropriate marriage, do not marry early, early pregnancy, do not be too late marriage, late pregnancy, to avoid the baby's congenital deficiency, planned eugenics. Pregnant women should pay attention to temperament, maintain a happy mood, peace of mind, avoid cold and heat, prevent disease, use drugs with caution, ban tobacco and alcohol, and avoid the effects of poisoning, trauma and physical factors.
Complication
Congenital ulnar and iliac bone fusion complications Complications gluteal muscle contracture
This disease mainly produces some postoperative complications, so it should be closely observed early in the operation, be alert to the ischemic changes of the affected limb, raise the affected limb, if necessary, use appropriate amount of dehydrating agent, for those who have developed vascular crisis Lose the opportunity to cut the decompression to save the affected limb and ensure its function. If complications occur and treatment is not timely, it may be complicated by ischemic contracture and necrosis. In addition, it is necessary to pay attention to the child's tolerance to pain. Naturally active, the new bones are constantly damaged and the internal fixation is broken. Therefore, it is advisable to strengthen the postoperative protection. If necessary, fix it with plaster cast for 1 month, in order to achieve the first-stage healing and obtain satisfactory function.
Symptom
Congenital ulna and radius fusion symptoms Common symptoms Elbow joint can not flex the joint swelling Forearm has pronation deformity
There is no activity between the ulnar and metatarsal bones, the forearm is fixed in the pronated position, the function of the supination is lost, the extension of the elbow joint is blocked, and the wrist joint is free to move. The degree of influence of daily life is related to the position of the fixed deformity of the forearm. If the unilateral involvement is involved, the functional influence is small. The affected limb has a thin forearm and a curved shape. Due to dysplasia or anterior and posterior dislocation of the humeral head, a partial depression can be seen in the humeral head of the normal site. The malformation is generally divided into three types: the first type is a true congenital ulnar and ulnar fusion, the upper end of the ulnar and ulna is fused together, and there is no cortical bone in between, the humeral head and the ulna are integrated or the humeral head is completely absent, and the latter often involves On both sides, the humerus is curved and thicker than the ulna. There is generally no fusion between the distal ends of the radius and ulna, and the second type is. Type III is a layer of interosseous ligaments connected between the ulnar and ulna, which hinders the rotation of the forearm. This type is not true fusion, but the clinical manifestations are consistent.
Examine
Congenital ulnar and ulnar fusion
There are two main types of examinations for this disease:
1. Physical examination: There is no activity between the ulnar and radial bones. The forearm is fixed in the pronated position, the function of the supination is lost, the extension of the elbow joint is blocked, and the wrist joint can move freely.
2, X-ray film: the upper end of the ulna and iliac bones together, no cortical bone in between, the humeral head and ulna fusion or the humeral head is completely absent; or the humeral head is dislocated backward, the proximal end and the ulnar stem are fused.
Diagnosis
Congenital ulna and radius fusion diagnosis
The disease needs to be differentiated from patients with forearm rotation dysfunction after internal fixation of the ulnar and radial fractures. This symptom has a history of surgery, so the clinical identification is relatively simple. Secondly, when the injury is violent, the injury range is wide, the position of the external fixation of the limb after the internal fixation of the fracture is improper, the braking time is too long, and the surgical operation error is also the main cause of the rotation of the forearm. Therefore, the medical history should be carefully asked and the identification should be actively carried out.
