lateral humeral condyle neck fracture
Introduction
Introduction to external humeral neck fracture The external humerus neck is located 2 to 3 cm below the anatomical neck. It is the site of the junction of the cancellous bone and the humeral bone of the humerus. It is prone to fracture. All ages can occur, and there are more elderly people. The main manifestation of the patient is swelling of the shoulder, and bloody spots often appear on the front and the inside. When the fracture is misplaced, the upper arm is slightly shorter than the healthy side, and there may be abduction or adduction deformity. There is significant tenderness at the lower part of the large nodule, and the shoulder joint activity is limited. If the fracture end is inserted, the shoulder joint can be moved under protection. Pay attention to the identification of dislocation of the shoulder joint. If the brachial plexus, the iliac vein, and the radial nerve injury are combined, the corresponding signs may appear. The disease is caused by traumatic factors and there are no special precautions. On weekdays, we should pay attention to the safety of production and life and avoid trauma. basic knowledge The proportion of the disease: 0.5%-0.7% (the incidence of the disease caused by trauma patients is about 0.5%-0.7%) Susceptible people: good for the elderly Mode of infection: non-infectious Complications: frozen shoulder
Cause
Causes of external humeral neck fracture
Direct violence (25%):
Smaller direct violence can produce fractures; if the palm touches the ground during a fall, the smaller indirect violence is transmitted upwards, resulting in a non-displaced insertion fracture. Linear or interspersed with non-displaced fractures, suspending the affected limb with a triangle for 3 weeks, early functional exercise.
Abductive fractures (30%):
When the fall is performed, the upper limbs are abducted, the palms touch the ground, and the indirect violent conduction leads to the fracture. The proximal end of the fracture is adducted, and the distal abduction is formed into a forward or inward angulated deformity or misalignment deformity, which is more common in clinical practice.
Adduction fracture (30%):
In contrast to abduction fractures, adductive fractures are landing on the hand or elbow when falling, adducted in the upper extremity, abducted proximal to the fracture, and adducted distally, forming an outward angular deformity, which is less common.
Prevention
Prevention of external humeral neck fracture
The disease is caused by traumatic factors, no special precautions, and should pay attention to production and life safety and avoid trauma.
The prevention and treatment aspect is mainly the middle and late stage of nursing. Through some of the traditional Chinese medicine techniques and functional exercise, it can effectively loosen the shoulder joint adhesion, increase the mobility of the shoulder joint, and improve the shoulder joint function after the surgical neck fracture of the humerus. The quality of life has served a satisfactory therapeutic effect.
Complication
Complications of external humeral neck fracture Complications
The external humeral neck fracture is a fracture of the adjacent joint. The muscles around the shoulder joint are relatively developed, and the joint capsule and ligament are relatively loose. Therefore, soft tissue adhesion is likely to occur after the fracture, and the biceps tendonitis of the biceps muscle, especially the shoulder circumference. The incidence of inflammation is high, and the middle and late treatment is mainly the rehabilitation of shoulder function.
Symptom
External humeral neck fracture symptoms Common symptoms Shoulder joint activity limitation Blood nodules Shoulder joint pain
The patient's main manifestations are swelling of the shoulder. The anterior and medial side often have blood stasis. When the fracture is misplaced, the upper arm is slightly shorter than the healthy side, and there may be abduction or adduction malformation. The lower part of the lower nodule has obvious tenderness and shoulder joint activity. Restricted, if the fracture end is inserted, the shoulder joint can be moved under protection, pay attention to the identification of dislocation of the shoulder joint, such as combined brachial plexus, iliac vein and radial nerve injury, the corresponding signs can appear.
Examine
Examination of external humeral neck fracture
The auxiliary examination of this disease is mainly image examination, and its performance can be divided into three types: adduction or abduction, stretching and flexion.
1. Adduction or abduction type injury: This type is the most common. The fracture line seen in the X-ray anterior piece is transverse, the fracture is slightly inward or outward, and the distal end is adducted or abducted. There was no obvious forward or backward angulation on the slice, and the dislocation changed. The surgical neck fracture of the humerus often combined with the fracture of the peptide bone nodule, which was characterized by avulsion of the butterfly fracture.
2. Stretch type injury: It is the injury caused by indirect external force. The X-ray features the transverse line of the fracture line. The fracture is angled forward, the distal end is dislocated forward, the humeral head is backward, and the joint is facing backward.
3. Flexion type injury: It is a rare injury caused by indirect external force. The fracture is deformed backwards into an angular shape, and the distal end is displaced backward.
Diagnosis
Diagnosis and diagnosis of external humeral neck fracture
diagnosis
The diagnosis of this disease is mainly based on the patient's clinical manifestations and X-ray examination results, the history of the patient's hand or elbow landing injury or the history of direct violent shoulder injury, shoulder pain, increased activity, X-ray film can be diagnosed, and can be Shows the type of fracture and displacement.
Differential diagnosis
The fracture of the external humerus neck should be differentiated from the dislocation of the shoulder joint. The main points of identification are as follows:
1. Surgical neck fracture: The shoulder shape of the disease was normal, and it was negative when the chest was tested. There was no abnormality in the position of the humeral head during X-ray examination.
2, shoulder dislocation: the shoulder shape of the ankle dislocation is a square shoulder deformity, the chest test is positive, X-ray examination can be found abnormal position of the humeral head, mainly for displacement.
