Double fracture of ulna and radius
Introduction
Introduction to the double fracture of the radius and ulna This kind of fracture is the second in the forearm fracture, which is second only to the distal radius fracture. The treatment is complicated and the prognosis is poor. It is one of the clinical problems and should be paid attention to. basic knowledge The proportion of sickness: 0.45% Susceptible people: no specific people Mode of infection: non-infectious Complications: crush syndrome
Cause
Causes of double fracture of radius and ulna
(1) Causes of the disease
Caused by direct violence and indirect violence.
(two) pathogenesis
1. In addition to direct combat, direct impact, collision and forearm landing, the mechanical compression injury caused by work injury also accounts for a considerable proportion, and the latter soft tissue damage is serious, easy to cause open fracture, and the fracture is often multi-stage or comminuted Therefore, it increases the difficulty of treatment and is a direct factor that constitutes a poor prognosis. However, the direct impact of the fracture line is at the same level as the external force point, with a horizontal fold, a wedge fold is more common, and the prognosis is better.
2. Indirect violence is when the hand falls to the ground and the external force is transmitted from the bottom to the top. From the distal part of the humerus through the interosseous membrane to the ulna, the double fracture of the radius and ulna is formed, which can also be caused by the distortion of the external force. Conduction is from the upper part of the humerus to the lower end of the ulna. Therefore, the plane of the humeral shaft fracture is generally higher than the plane of the ulnar fracture. It is more common in oblique, spiral and short oblique.
Prevention
Prevention of double fracture of radius and ulna
For patients who have been injured for 1 to 2 weeks, the diet needs to be light, easy to absorb and digest. They should be given more vegetables, fruits, fish soup, eggs, soy products, etc., and should be mainly steamed or stewed. Eat spicy, greasy and fried foods. In particular, you can eat more honey and bananas, because most patients in bed will have symptoms such as constipation, these foods can help defecation.
Complication
Complications of the ulnar and radial fractures Complications
In severe cases, it may be complicated by crush syndrome or ischemic contracture.
Symptom
Symptoms of the ulnar and radial fractures of the ulna and the tibia. Common symptoms. Forearm supination function limited forearm rotation pain, sacral stem, localized pain, forearm trauma, pain, sacral styloid process
In addition to pay attention to general fracture symptoms, attention should be paid to the presence or absence of blood vessels, nerves and muscle tissue associated with injuries, especially those who are smashed by the machine. Soft tissue damage may be more serious than bone damage, which may cause crush syndrome or ischemia. Sexual contractures, etc., must be repeatedly emphasized during clinical examinations.
Type
1. Stable type refers to transverse fractures that are not easily displaced after fracture reduction, short oblique type and incomplete fractures that do not need to be reset, green branch fractures and fractures, etc. This type is suitable for non-surgical treatment, but clinically, With the exception of child cases, this is rare, especially among adults.
2. Unstable type refers to the difficulty in maintaining the fracture end of the fracture after the reduction, including the oblique, spiral and comminuted fractures, or the upper and lower ulnar joint instability, or the double fracture of the ulnar and radial bones (Figure 1), Because of its instability, it is more difficult to treat. According to the history of trauma, clinical manifestations and X-ray examination, it can be diagnosed.
Examine
Examination of the double fracture of the radius and ulna
X-ray positive, lateral plain film examination can not only confirm the diagnosis, but also contribute to the classification, follow-up observation and contrast of the effect, should be taken routinely, and include the upper jaw and the lower jaw joint to prevent missed diagnosis.
Diagnosis
Diagnosis and diagnosis of double fracture of radius and ulna
In addition to paying attention to general fracture symptoms, attention should be paid to the presence or absence of blood vessels, nerves and muscle tissue. Especially in the case of machine squeezing, the damage of soft tissue may be more serious than the damage of bone, which may cause crush syndrome or ischemic contracture, which must be repeatedly emphasized during clinical examination.
According to the characteristics of the fracture and the requirements of clinical treatment, it is generally divided into:
1. Stable type refers to transverse fractures, short oblique types, incomplete fractures, green branch fractures and fractures that are not easily repositioned after fracture reduction. This type is suitable for non-surgical treatment. However, clinically, except for children, this situation is rare, especially those with higher adult violence.
2. Unstable type refers to the difficulty in maintaining the fracture end of the fracture after the reduction of the manipulative method, including oblique, spiral and comminuted fractures, or unstable upper and lower ankle joints, or double fractures of the ulnar and radial bones. Because of its instability, it is more difficult to treat.
According to the history of trauma, clinical manifestations and X-ray examination, it can be diagnosed.
