acromion fracture
Introduction
Introduction to shoulder fracture Because the bone is strong and the bone is short, it is not easy to fracture, so it is rare in clinical practice. The reason may be that the direct external force hits the shoulder peak, the shoulder is landed when falling, or the violence is transmitted from the bottom to the top, or the leverage of the sacral bone forcing out. Common fractures are mostly located at the base of the shoulder or outside of the acromioclavicular joint. When the base of the shoulder is fractured, the distal fracture piece is pulled by the deltoid muscle and the upper limb gravity, and is displaced forward and downward. When the fracture occurs outside the acromioclavicular joint, the distal fracture piece is very small and has no displacement. The main symptoms are local pain swelling and upper limb movement limitation, especially hindering shoulder joint abduction. basic knowledge The proportion of the disease: the probability of the population is 0.07% Susceptible people: no specific population Mode of infection: non-infectious Complications: inflammation around the shoulder joint
Cause
Cause of acromion fracture
Direct violence (35%):
That is, from the vertical force above the shoulder peak, the fracture line is mostly located outside the acromioclavicular joint.
Indirect transmission of violence (30%):
When the shoulder falls out or the internal position falls, the fracture is caused by the leverage of the big tibial tuberosity, and the fracture line is mostly located at the base of the shoulder.
Prevention
Shoulder fracture prevention
Prevent violent injuries.
Complication
Acromial fracture complications Complications around the shoulder joint
If the poor reset can cause shoulder abduction limitation and inflammation around the shoulder joints and other consequences.
Symptom
Symptoms of shoulder fractures Common symptoms Hematoma formation upper extremity abduction lifting difficulty shoulder joint restricted subcutaneous hematoma
1. Local pain is obvious.
2. Swelling its superficial anatomical surface, so local swelling is obvious, often accompanied by subcutaneous congestion or hematoma formation.
3. Restricted abduction and lifting movements were restricted, and those without displacement fractures were lighter. Those with acromioclavicular joint dislocation or clavicular fracture were more obvious.
4. In addition to paying attention to the presence or absence of associated fractures, attention should be paid to the presence or absence of brachial plexus injury.
Examine
Shoulder fracture examination
No relevant laboratory tests.
The X-ray film is used to detect the type and characteristics of the fracture in the anterior position, oblique position and axillary position. Characteristic. On the anterior aspect of the shoulder joint, there is a small, scattered, uneven and irregular calcification in the supraspinatus tendon. This is different from the free body in the shoulder joint, because this calcification is farther away from the joint capsule. The sacral nodule is often more or less accompanied by sparse bone.
The sediment was observed under a microscope, which was observed to be an amorphous calculus surrounded by inflammatory cells, accompanied by foreign bodies giant cells. Culture without bacterial growth. Biochemical analysis is amorphous calcium carbonate and calcium phosphate, but cholesterol can also be found, but the uric acid test is negative, indicating that it is different from gout. In the early days, it was a toothpaste. It is generally believed that this deposit is caused by degeneration of fibrous tissue, but the true pathogenesis is still unclear.
Diagnosis
Diagnosis and diagnosis of shoulder fracture
Diagnose based on:
1. The history of trauma pays attention to the direction of external force.
2. The clinical manifestations are obvious in the shoulder.
3. X-ray film should be photographed after the front position, oblique position and armpit position, so that the type and characteristics of the fracture can be more comprehensively understood.
Attention should be paid to the identification of the ascending bones that have not been closed.
