throwing fracture
Introduction
Introduction to throwing fracture Throwing is a violent high-speed track and field movement. Its movement mainly occurs in the shoulder and elbow joints, but it requires the cooperation of the joints and muscles of the lower limbs and the trunk. Throwing damage can occur in soldier bomb training, javelin, discus, hammer throw and other throwing items, as well as baseball (pen pitchers), tennis and other ball games. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: radial nerve injury
Cause
Throwing fracture cause
(1) Causes of the disease
The damage often occurs during the acceleration period of the upper arm and the deceleration period of the upper arm, which is caused by the uncoordinated contraction of the muscle during the throwing process and the abnormal range of the shoulder and elbow joint.
(two) pathogenesis
The fracture of the humerus usually occurs during the acceleration and deceleration of the upper arm of the throwing movement. The muscles of the active shoulder joint start from the trunk and stop at the upper middle segment of the humerus, which has a good protective effect on the proximal side of the upper arm, such as the abduction external muscle. Groups (delta, supraspinatus, infraspinatus, small round muscle) and the contractile movement of the adductor internal rotation muscle group (delta, pectoralis major, latissimus dorsi, large round muscle, subscapularis) Coordinating, the external torsional moment applied to the proximal end of the humerus produces a uniform internal rotation acceleration, which not only achieves a better throwing effect, but also relies on the inertial tension of the distal limb to cause a fracture of the tibia. On the contrary, if the relaxation and contraction movement of these muscles is not in order, such as the upper arm has not reached the maximum external rotation position during the lifting period or suddenly strong internal adduction and internal rotation during the continuous external rotation; or the muscle contraction is not synchronized, such as In the process of internal rotation, the muscle contraction is uncoordinated. If it is too fast, it will produce a huge internal rotation moment and internal rotation acceleration in the proximal part of the humerus, and the inertia of the distal limb cannot keep up with the internal rotation of the proximal tibia. Then bring muscles in the shoulders Below the point (below the midpoint of the humerus) generates a great torsional moment, the torsional moment with the centrifugal tensile force to the distal extremity, the resulting humeral fracture.
Prevention
Throwing fracture prevention
prevention:
The fundamental way to prevent throwing injuries is to cultivate the correct neuro-muscle group throwing reflexes and improve their coordination synchronism while maintaining the flexibility-stability of the joints of the body (especially the shoulders and elbows).
1. Pay attention to the warm-up activities before training.
2. Master the correct throwing action essentials.
3. Eliminate mental stress and fatigue.
4. Pay attention to the relaxation activities after training.
Complication
Throwing fracture complications Complications, radial nerve injury
Pay attention to whether the sacral nerve injury is combined.
Symptom
Throwing fracture symptoms Common symptoms deltoid pain scapula radioactive pain fascial pain forearm trauma post-shoulder pain and upper limb pain
The humeral throw fracture is a spiral unstable fracture caused by the combination of twisting force and tension. It is characterized by the internal rotation of the fracture in the proximal segment and the external rotation of the distal segment, causing the rotational separation between the ends. If the forearm is held up on the chest to relieve pain after the injury, the external rotation of the distal fracture segment is often partially compensated. At the same time, due to the traction of the upper arm muscle, the distal segment of the fracture often moves up, causing the upper arm. Short-formed deformity, because the epithelium only longitudinal tear and squat, not completely traversed, so there is still a restraining effect on the lateral displacement of the fracture end, lateral displacement is not large, because the phrenic nerve running in the posterior lateral Outside the periosteum, it is not easy to get stuck in the fracture end, so the chance of nerve injury is less, but if there is a large dislocation of the lateral side of the fracture, the periosteum of the fracture end is broken, and the tip of the fracture can be placed on the sacral nerve trunk, causing nerve damage.
Examine
Throwing a fracture
X-ray examination can show fractures of the affected limb and is mostly spiral. X-ray examination is of great value in the diagnosis and treatment of fractures:
All patients with suspected fractures should be routinely X-ray film examination, which can be found in clinically difficult to find incomplete fractures, deep fractures, intra-articular fractures and small avulsion fractures, even if they have clinically manifested as obvious fractures. X-ray film examination is also necessary to help understand the type and specific conditions of the fracture, and has guiding significance for treatment.
X-ray films should include positive and lateral positions, and the wells must include adjacent joints, and sometimes x-rays of oblique, tangent or corresponding parts of the contralateral side must be added. After reading the x-rays carefully, you should identify the following points:
(1) The fracture is invasive or pathological.
(2) Whether the fracture is displaced and how to shift.
(3) Whether the fracture alignment is satisfactory to the line and whether it needs to be rectified.
(4) Whether the fracture is fresh or old.
(5) Whether there is damage to the joint or bone injury.
Diagnosis
Diagnosis of throwing fracture
It should be differentiated from femoral injuries caused by other causes, such as a history of trauma, such as falls, impacts, etc. Its characteristics are:
1. Have a clear history of trauma, such as falls, impacts, etc.
2. The upper arm is obviously painful.
3. Swelling, freckle, blisters.
4. Upper arm deformity, abnormal activity.
5. May suffer from limbs combined with pulse touch, upper limb movement disorders.
Disease check
1, X-ray: X-ray examination can determine the type of fracture and fracture of the humerus, and determine the treatment.
2. Others: Other tests such as CT, MRI, EMG, ultrasound, etc., can be used to understand whether other tissue damage is combined.
