Anterior part of the tibiofibular syndesmosis
Introduction
Introduction to the joint separation of the underarm The axillary joint anterior separation is often accompanied by distal radius fractures, and the ankle fractures and anterior tibial tuberosity avulsion fractures occur simultaneously, resulting in instability of the ankle joint after injury. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: sexual dysfunction, mental disorder, pneumonia, atelectasis, urinary tract infection
Cause
Axillary joint anterior separation etiology
(1) Causes of the disease
Due to external rotation injury.
(two) pathogenesis
The axillary joint anterior separation is caused by external rotation injury. The anterior part of the talus pushes the external malleolus, causing it to be turned outwards and backwards. The common anterior tibial tuberosity is avulsed, but in most cases, the anterior tibial ligament itself tears. After the ligament, the synovial blind tube is torn and the interosseous ligament is broken. When the humerus is externally rotated, the posterior tibial ligament is also stressed, and the posterior lip of the humerus can be avulsed. This is considered by scholars to be The characteristics of external rotation injury, and suggest that the anterior and posterior iliac joints are also separated, the avulsed bone fragments are very small, rarely exceeding 1/4 of the articular surface.
The external rotation force is different in size, and the rupture depth of sputum combined from front to back is also different. If the injury persists, the sacral bone fracture will occur, and the fracture plane will be different. Very few anatomical neck fractures may occur (called Maisonneuve fracture). Most of them are distal humeral fractures. Some people call it a warp and sacral oblique or spiral fracture. Such cases may have a anterior tear of the superficial ligament, or a anterior or posterior humerus fracture, or a medial malleolus fracture. , or the deep and shallow layers of the triangular ligament are broken.
Prevention
Axillary joint anterior separation prevention
No special precautions.
Complication
Subgingival combined anterior separation complications Complications, sexual dysfunction, psychological disorders, pneumonitis, atelectasis
There may be severe motor dysfunction, often with bladder dysfunction, sexual dysfunction, psychological disorders. There may be pressure ulcers, pneumonia, atelectasis, urinary tract infections and stones and other complications and other lack of muscle exercise Bad effects.
Symptom
Axillary joint anterior separation symptoms Common symptoms Triangle ligament injury Nodular external spasm showed avulsion avulsion fracture Gastrocnemius tear
History of trauma, local swelling, pain, deformity, tenderness (+) and dysfunction.
According to the above analysis, the following fractures can be associated with the diagnosis of anterior tibiofibular joint fracture: distal radius fracture; transfemoral combined fracture; avulsion fracture of anterior tibial tuberosity; avulsion fracture of posterior lip of humerus; The medial joint space is widened.
In the calf rotation position, if the ankle joint and the calf are rotated 30°40°, the external ankle is concave on the orthotopic piece of the ankle joint, indicating that the humerus is in the external rotation position. The humerus should be examined to exclude the fracture of the tibia. Can be used to make the lateral position of the ankle joint when the foot is flexed. If the anterior space of the ankle joint is found to be non-parallel and widened, the anterior ligament tear of the infraorbital joint should be suspected.
Examine
Underarm joint separation front inspection
No relevant laboratory tests.
X-ray examination, under stress, can indirectly confirm ligament injury and display fracture.
Diagnosis
Axillary combined anterior separation diagnosis
Acupoint tablets are an important means for the diagnosis of subtalar joint separation. The overlapping shadows of normal tibia and anterior tibial tuberosity B~C, not less than 8mm, or not less than 1/3 of the width of the tibia, normal tibia joint gap A~B Should not exceed 3mm, such as the external rotation of the foot when the film is taken, the gap is reduced, the gap is clearly visible when the foot is rotated, the acupoint piece is photographed, the medial space of the ankle joint is the clearest, and there is widening, indicating that the anterior tear is combined with the anterior tear. And medial triangular ligament injury.
Lateral ankle joint: Under the stress, the tibia is pulled forward, the affected foot is pushed backward, the tibia is moved forward and the talus is moved backwards, so the lateral space of the ankle is widened in the lateral position.
