upper humerus epiphysis separation
Introduction
Introduction to the separation of the upper humerus There are three epiphyses at the upper end of the humerus, namely the humeral head, the large nodules and the small nodules. The epiphysis occurs at the age of 1 year, 3 years, and 5 years. The bones of 5 to 8 years old merge into one epiphysis at the upper end of the humerus, to 19-21. The old bones are combined with the humeral shaft. Therefore, the separation of the upper epiphysis of the humerus is more common in 7 to 18 years old; in the future, the anatomical neck fracture of the humerus can occur. Since the upper end of the humerus is on the frontal plane, the metaphyseal end of the humerus forms a reclining angle of about 15°, and the center of the epiphysis is located on the inner posterior side of the tarsal plate. Therefore, the violent conduction along the humeral shaft acts on the tarsal plate, causing shear stress. The fracture line is oblique, the anterior lateral part is separated by the epiphyseal surface, and the posterior medial part passes through the metaphyseal end to form a triangular bone piece. The degree of inclination of the fracture line varies with age. The older the fracture line passes through the seesaw The shorter the transverse distance, the larger the metaphyseal fracture piece, and the longer the inclined surface distance, the more unstable the fracture end. basic knowledge The proportion of illness: 0.01%-0.03% Susceptible people: seen in teenagers Mode of infection: non-infectious Complications: ischemic necrosis
Cause
Separation of the epiphysis of the upper humerus
Causes:
This osteophyte separation is caused by the abduction and flexion of the upper extremities, the external rotation and the internal rotation, and the violent conduction along the humerus to the sacral or sacral neck.
Pathogenesis
When the upper end of the humerus is not closed before the age of 18, the anatomical structure is weak, and the bone can be separated by direct violence acting on the shoulder or by indirect violence of the elbow and the hand. When the external force is small, only The epiphyseal line is damaged, the broken end is not displaced, and when the force is large, the epiphysis is separated, and a triangular bone piece is often torn off. The dislocation of the iliac crest can be divided into stable type and unstable type. The former refers to There is no displacement at the end of the epiphysis; the latter points to the anterior angulation greater than 30°, and the anteroposterior displacement exceeds 1/4 of the transverse section, mostly older adolescents.
Prevention
Separation prevention of upper humerus epiphysis
Prevention work starts from the usual time. Be safe and prevent falls. Diet and attention to nutrition.
Complication
Complications of upper humerus epiphysis Complications ischemic necrosis
May be associated with ischemic necrosis of the humeral head.
Symptom
Symptoms of osteophyte separation on the upper end of the humerus Common symptoms Soft tissue swelling Joint pain Muscle tenderness
The age is under 18 years old, and individual cases can reach 20 years old.
1. Swelling: Because the fracture is located outside the joint, the local swelling is obvious, and there may be subcutaneous congestion.
2. Pain: Especially when the activity is active, accompanied by ring tenderness and conduction pain.
3. Activity is limited.
Examine
Examination of the separation of the upper humerus
No relevant laboratory tests.
X-ray films show fractures and displacement.
Diagnosis
Diagnosis and differentiation of upper humerus epiphysis
Mainly based on the history of trauma, the patient's age, clinical symptoms and X-ray films, etc., no displacement is based on the annular tenderness at the epiphyseal line, conduction of pain and soft tissue swelling shadow; etc. Easy to miss diagnosis.
This disease is generally not confused with other diseases.
