Carpal spear deformity
Introduction
Introduction to the stab-shaped deformity of the wrist gun The distal end of the spur-like deformity fracture is displaced to the temporal side with the hand, and the axis of the middle finger is not in the same plane as the axis of the tibia. It is a unique malformation of the Coles' fracture, which is one of the most common fractures in the human body, accounting for 10% of all fractures, with the majority of the elderly and adults. Most of them fall flat, the palms of the hands and the wrists are in the extension of the back and the inner rotation of the forearms, so that the violence is concentrated on the cancellous bone of the distal radius and causes fracture. basic knowledge The proportion of illness: 0.003% Susceptible people: good for the elderly and adults Mode of infection: non-infectious Complications: fractures, swelling
Cause
Cause of a stab-shaped deformity of a wrist gun
Causes:
Mostly caused by indirect violence.
Pathogenesis
Most of them fall flat, the palms of the hands and the wrists are in the extension of the back and the inner rotation of the forearms, so that the violence is concentrated on the cancellous bone of the distal radius and causes fracture. In this state, the distal end of the fracture must have a displacement to the dorsal and temporal sides. At this time, the ulnar styloid process may be accompanied by a fracture, and the triangular fibrocartilage disc may also tear.
Prevention
Wrist gun tattoo deformity prevention
The disease is caused by a mostly flat fall, palm support, wrist joints in the extension of the back and forearm rotation, so that the violence is concentrated in the cancellous bone of the distal radius and cause fracture. Therefore, pay attention to living habits, high-risk workers, such as construction workers, mining workers, and teachers and workers are likely to cause damage, and should pay attention to protect themselves during the work process. Pay attention to calmness and avoid emotional conflicts leading to the disease. Secondly, early detection, early diagnosis and early treatment are also important for the prevention of this disease.
Complication
Wrist gun stab malformation complications Complications, fracture, swelling
1. Injuries are often accompanied by shoulder and elbow joint contusion plus pain at the fracture site. The activity of the affected limb is reduced, and the shoulder and elbow joints will be stiff for a long time.
2. Fracture deformity can suppress the symptoms of median nerve compression in the carpal tunnel. As the fracture is corrected, it can be gradually restored.
3. The long extensor tendon rupture of the thumb is usually occurring 4 weeks after the injury, sometimes later. There are two possible causes of the fracture, one is caused by the original injury, and the other is the fracture and the Lister nodule, which is broken by the wear on the uneven bone surface.
4. Fracture repair or fixation failure can lead to fracture malformation.
5. Sudeck bone atrophy (reflex sympathetic bone atrophy, post-traumatic bone atrophy) can occur.
6. Can be combined with the scaphoid bone fracture at the same time, should pay attention to the examination, so as not to miss the diagnosis.
Symptom
Wrist gun stab deformity symptoms common symptoms joint swelling autonomic dysfunction severe pain
The patient's wrist stretched down, and the palm of the hand fell to the ground. The wrist felt severe pain, and did not dare to move. The swelling was especially swollen with local swelling. Sometimes the subcutaneous congestion was seen. The finger was in a semi-flexed rest position, and the fist was not allowed to make a fist. The hand can relieve some pain, such as proximal fracture pressure and median nerve, there are signs of median nerve dysfunction such as finger numbness.
Examine
Examination of the stab-shaped deformity of the wrist gun
X-ray photography, the humerus is transversely cut at about 3.0cm from the articular surface, and the distal segment of the anterior segment is displaced to the temporal side. It can be inserted into the proximal segment and the distance between the lower ankle joint is increased (separated). The lower end of the humerus is inclined to the ulnar side, and the normal inclination is 20°25°. After the fracture, it can be reduced to 5°15° or even disappear. On the lateral position piece, the distal end of the humerus is displaced to the dorsal side. Reduced or disappeared, normal is 10 ° ~ 15 °.
Diagnosis
Diagnosis and identification of wrist gun stab deformity
diagnosis
Diagnosis can be performed based on clinical manifestations and examinations.
Differential diagnosis
Silver fork-shaped malformation: the distal end of the fracture is displaced to the dorsal side with the hand, and there is a depression on the proximal side.
Gun-shaped deformity: the distal end of the fracture is displaced to the temporal side with the hand, and the axis of the middle finger is not in the same plane as the axis of the tibia.
