Radial neck fracture and radial head epiphysis separation
Introduction
Introduction to the separation of the radial neck fracture and the humeral skull Most of the radial neck fractures occur in juveniles and children whose bones are not closed, and therefore, the sacral skull is separated. In contrast, humeral head fractures rarely occur in children. The sacral skull center usually appears in 4 to 5 years old, and the closure time is 16 to 20 years old. The sacral skull is separated, and most of them belong to type II and type I of Salter-Harris classification. Good reset has no significant effect on future morphology and function. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: elbow valgus
Cause
Sedimentary neck fracture and sacral skull spasm
Causes:
Mostly caused by the transmission of violence.
Pathogenesis:
Elbow flexion during fall, forearm pronation, bottom-up and top-down violence to the elbow, causing the humeral head and the humeral head to collide with each other, and shearing forces from the inside to the outside and the outside to cause the humerus The small skull is separated, and the epiphysis is often accompanied by a tarsal plate and a metaphyseal triangular bone piece that is separated or displaced, and the periosteum is connected to the outside.
Prevention
Prevention of humeral neck fracture and sacral skull spasm
It is due to traumatic factors, so pay attention to the safety of production and life to avoid trauma is the key to prevent this disease. In addition, it is necessary to pay attention to the flexion and extension of the palmar joint after the reduction and fixation, and the active function of the shoulder joint such as "catch up the force" "Hands hold the sky" and other elbow joints do not prematurely prohibit the forearm rotation activity within 3 weeks of the straight type and special type is prohibited for the elbow flexion type is prohibited for elbow flexion activity after 3 weeks, the initial stability of the fracture can be gradually elbow joint extension Flexion activities such as "Xiaoyun hand", etc., but the forearm should always maintain a neutral position to prevent the rotation of the ulnar fracture. Otherwise, the fracture may be delayed or healed. After the splint is removed, the elbow flexion and extension activity is strengthened and the rotation activity begins. Anti-palm" "Twist your elbows" and so on.
Complication
Complications of humeral neck fracture and sacral skull spasm Complications elbow valgus under the ankle joint dislocation
1. Upper ankle joint fusion: It may be caused by severe primary injury or after resection of the radial head. The fusion site is mostly near the upper ankle joint.
2. Early closure of the epiphysis of the upper end of the humerus: Closed or open reduction after injury, can cause the proximal humerus to close the epiphysis, and the light elbow carrying angle is slightly enlarged, and obvious elbow valgus can occur.
3. Lower ankle joint dislocation: It is a complication after humeral head resection. The humerus can be displaced up to 3~5mm, but it is asymptomatic and requires no special treatment.
4. The humeral head is enlarged and the neck is thickened: it is more common, especially the lateral displacement is more common, but it has no obvious effect on the function in the future.
Symptom
Symptoms of humeral neck fracture and sacral skull spasm Common symptoms Elbow swelling, tenderness, skeletal dysplasia, immune dysfunction
Pain in the elbow, swelling and tenderness are confined to the outside of the elbow.
Classification of fractures:
There are many methods, such as Obrien classification (1965), Jeffery classification (1950), Wilkine classification (1984), Vugt classification (1985), etc. Vugt classification is based on the Wilkine classification to compare the tilt and displacement of the humeral head. Detailed description.
Type I: No fracture and no fracture of the humeral head.
Type II: The displacement is less than 1/2 of the diameter of the humeral shaft, or the fracture is less than 30°.
Type III: The displacement is greater than 1/2 of the diameter of the humeral shaft, or there is an inclination of 30° to 60°.
Type IV. Completely displaced or inclined from 60° to 90°.
History of trauma, lateral elbow pain, swelling and dysfunction, localized tenderness, X-ray can show the fracture of the radial neck or the separation of the sacral skull.
Examine
Examination of the separation of the humeral neck fracture and the sacral skull
No relevant laboratory tests.
X-ray films showed a fracture of the humeral neck or a sacral skull. The separation of the epiphysis was in the form of a cap, with an angle of 30° to 60° with the longitudinal axis of the humerus, or even 90°.
Diagnosis
Diagnostic diagnosis of humeral neck fracture and sacral skull
Diagnostic criteria: history of trauma, lateral elbow pain, swelling and dysfunction, localized tenderness, X-ray can show humeral neck fracture or sacral skull sputum separation.
Differential Diagnosis: Distal radial fracture refers to a fracture that occurs distal to the proximal rim of the anterior spine. Including: 1, Colles fracture. 2. Smith fracture. 3. Barton fracture. About 1/6 of the total body fracture. Occurs in middle-aged and older people, more common in women.
