radial head fracture

Introduction

Introduction to radial head fracture A small head fracture of the humerus is an elbow injury that is easy to occur in adults. Usually, the pain is mild, and it is easy to be misdiagnosed clinically. The head and neck fractures of the humeral head account for about 6% of the elbow injury and belong to intra-articular fractures. basic knowledge The proportion of the disease: the probability of the population is 0.003% Susceptible people: adults Mode of infection: non-infectious Complications: muscle atrophy

Cause

Cause of humeral head fracture

(1) Causes of the disease

Mostly caused by indirect violence.

(two) pathogenesis

The fracture of the radial head often occurs when the fall is flat or sports. When the fall, the elbow joint is straightened and the palm of the shoulder is placed outside the shoulder joint, so that the elbow joint is placed in the valgus of the strength, causing the humeral head to violently hit the humerus. Head, causing a fracture of the humeral head, sometimes this similar violence may lead to a fracture of the humeral head or an injury to the medial side of the elbow, such as avulsion fracture of the medial epicondyle of the humerus.

Because the humeral head and the neck are not arranged in a straight line, but are eccentrically connected to the neck to the temporal side, the trabecular bone of the lateral 1/3 of the humeral head is not perpendicular to the neck and the stem, forming a mechanical In the weak part, when the external force causes the humeral head to hit the small head, the 1/3 of the trabecular bone of the humeral head is not perpendicular to the neck and the cadre, forming a mechanical weak part. When the external force causes the humeral head to hit the small head, the humeral head is outside. /3 lack of anti-shearing force, so the chance of fracture in this part is significantly increased.

Prevention

Radial head fracture prevention

First, practice and strengthen the body: should actively continue to exercise for a long time, increase the time in outdoor activities, breathe more fresh air, promote systemic blood circulation and metabolism. You can choose to walk, jog, tai chi, health exercises and other items. Multiple activities can make the calcium in the blood more in the bones, thus improving the hardness of the bone and effectively reducing the occurrence of fractures.

Second, more sun: Sun can promote the synthesis of vitamin D, and calcium metabolism depends on the role of vitamin D; ultraviolet light in the sun can promote the formation and absorption of calcium in the body, maintain normal calcium and phosphorus metabolism, increase calcium in bones And improve the hardness of the bone.

Third, the first disease prevention: the elderly should not go to places where there are many people and cars, rain, snow or water on the ground, do not go out when icing, so as not to fall and fracture. Do not climb ladders or climb high activities. It is not advisable to walk on steep slopes. Because the elderly have weak limbs, they are slow to respond and fall easily.

Fourth, diet adjustment: Eat more vegetables, protein and vitamin-rich diet, can prevent the occurrence and development of osteoporosis. The early diet of the fracture should be light, in order to facilitate the swelling of the sputum, the late should be partial taste, choose the right diet to adjust the liver and kidney, which is conducive to the healing of the fracture and the recovery of function.

Complication

Radial head fracture complications Complications muscle atrophy

Foreign body ossification may occur when the soft tissue injury is severe. Can also be more common diseases:

1. Swelling occurred locally after swelling and trauma, reached a peak after 72 hours, and then the swelling gradually subsided.

2. Plaster compression simple fractures by manual reduction of cast immobilization, as the swelling of the limbs gradually worsens, gypsum compression will occur, resulting in obvious swelling, bruising, numbness, etc. at the end of the limb such as fingers, toes, etc., should go to the medical institution in time. Release the decompression to avoid limb compression and necrosis.

3. The joints are stiff and the limbs are fixed for a long time, the veins and lymphatic drainage are not smooth, the fibrous exudation and fibrin deposition in the joint cavity, fibrin adhesion occurs, and the soft tissue contracture around the joints causes joint movement disorder. This is the most common complication of fractures and joint injuries.

4. Muscle atrophy Once the limb is fixed or lacks exercise, muscle atrophy occurs. The active search of the muscle can reduce the degree of muscle atrophy. The specific method is: if the joint can move, you can do the isometric contraction of the muscle (ie muscle but force) It does not produce motion) and isotonic contraction (muscle force and action). If the joint is fixed, it can be exercised in equal length.

5. Congenital pneumonia occurs mostly in patients who have been bedridden for a long time due to fractures, especially those with frail fractures and old and weak, and sometimes with chronic diseases, which may endanger the lives of patients. Get out of bed early.

Symptom

Symptoms of humeral head fracture Common symptoms Forearm supination function limited linear fracture Elbow dislocation Abduction fracture residual strain fracture

The main clinical manifestations of radial head fractures are elbow joint dysfunction and localized swelling and tenderness of the lateral elbow, especially for the forearm supination. The anterior and lateral X-ray films of the elbow can be diagnosed and can determine the fracture type and fracture. The classification can represent the degree of injury and can provide a basis for selecting a treatment method. If necessary, a bilateral contrast film can be used to identify.

The humeral head fractures are Mason classification, Keonconen classification, Morrey classification, etc., and the Mason classification is accepted by everyone:

Type I: a linear fracture, that is, a non-displaced fracture, the fracture line can pass through the edge of the humeral head or be cleft.

Type II: a displaced fracture with a separate marginal fracture.

Type III: a comminuted fracture with or without displacement or a collapsed fracture.

Type IV: fracture of the humeral head with dislocation of the elbow.

Examine

Examination of humeral head fracture

1. Ordinary X-ray film: Orthotopic and lateral X-ray films can often make a relatively clear diagnosis of fractures. However, if only the "fat pad sign" appears, and there is no obvious visible fracture, the X-ray film of the humeral head is helpful for diagnosis. X-ray films showed a fracture of the humeral head when there was a fracture in front of the elbow joint. Elbow valgus stress and forearm axial stress X-rays help to check the stability of the elbow and forearm.

2. CT scan: scanning of the radial, sagittal and coronal fractures of the radial head helps to assess the extent of the fracture, the size of the bone, the displacement and the degree of comminution. When considering open reduction and internal fixation (ORIF), a regular CT scan should be performed to better understand the fracture. Sometimes a CT scan can also cancel the ORIF plan because sometimes the CT scan shows a more severe fracture or displacement than a conventional X-ray film.

Diagnosis

Diagnosis and diagnosis of radial head fracture

diagnosis

Traumatic history, elbow joint dysfunction and localized swelling and tenderness of the lateral elbow, especially for the forearm supination, the X-ray can confirm the fracture and classification.

Differential diagnosis

Radial head fractures need to be identified with the following diseases:

1. The fracture of the fracture has no displacement or displacement of less than 1 mm. A type of fracture that is usually caused by a direct blow or a slight impact, sprain, and the like.

2. Chapped fractures Longitudinal fractures of the humeral head, the displacement of the fracture block is greater than 1mm.

3. The inserted fracture end is inserted into the fracture end, or it is like a cap.

4. Smashing fractures smashed the bones.

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