Radial head subluxation
Introduction
Introduction to the humeral head subluxation The semi-dislocation of the humeral head is also called pulling the elbow. It is more common in children under 5 years old. Because the humeral head is not well developed, the annular ligament of the humerus neck is only a weak fibrous membrane. Once the forearm of the child is pulled, the tibia The head slides to the distal end; when returning to the original position, the upper part of the annular ligament is not retracted, and the card is pressed into the ankle joint, which is called the humeral head subluxation. As the child grows up, the humeral head develops well, the annular ligament also thickens and strengthens, and subluxation no longer occurs. basic knowledge The proportion of illness: 0.0003% Susceptible people: more common in children under 5 years old Mode of infection: non-infectious Complications: humeral head fracture
Cause
Cause of subluxation of the humeral head
Indirect violence (45%):
The disease is mostly caused by indirect violence. Such as: pulling the child's wrist with both hands to fall while walking; wearing the clothes, the child's wrist is pulled by the cuff; when rolling on the bed, the body presses the upper limb under the body, forcing the elbow joint to stretch and other external forces.
Direct violence (30%):
The articular surface of the bone and the longitudinal axis of the tibia have a certain degree of inclination, and its size is related to the rotation of the forearm. The change in inclination affects the up and down movement of the annular ligament. In the pronation of the forearm, the variability of the inclination undoubtedly makes it easy to dislocate.
When the elbow joint is straight or the forearm is suddenly pulled by the longitudinal movement of the rotating motion, the lower part of the annular ligament will have a horizontal tear, a slight downward movement, the ankle joint gap becomes larger, and the joint capsule and the upper part of the annular ligament are due to the joint cavity. The negative pressure action only needs to slide over the distal part of the humerus to tilt the distal end of the articular surface to be incarcerated in the tibial joint space, thereby preventing the reduction of the humeral head and causing the humeral head to subluxate.
Pathological mechanism:
When the humeral head slides to the distal end and returns to the original position, the upper part of the annular ligament is less than retracted, and the card is pressed into the ankle joint to become a subluxation of the humeral head. As the child grows up, the humeral head develops well, and the ligaments are also thickened and strengthened, and subluxation does not occur anymore.
Prevention
Radial head subluxation prevention
Admonish parents not to be violently pulled to avoid recurrence.
Prevention of humeral head subluxation in children:
1 When pulling the hand of the child at ordinary times, the sleeve should be pulled at the same time.
2 prevent falling servants.
3 adults and children should pay attention to the method when they are noisy, can not single (hand).
4 If the above performance occurs, parents can reset themselves. If they are not successful, they should go to the hospital.
5 Avoid repeated dislocations and form habits.
6 When wearing clothes, you should avoid pulling the hand in front of the hand and pull it at the same time as the sleeve.
Complication
Radial head subluxation complications Complications humeral head fracture
Although the humeral head subluxation injury is not heavy, it also affects the elbow joint function. Most patients need to be reset to get healing. However, generally, the effect is good after treatment, no complications occur, and some children who are not timely in the treatment may recover a little longer, but no complications occur.
Symptom
Symptoms of subluxation of the humeral head Common symptoms Elbow joint can not flex the joint pain Elbow dislocation
1. There is a history of upper limbs being pulled. Usually, young parents are taking children to the streets. The upper limbs of the children are lifted up. The upper limbs of the parents are drooping. When there is a step, the parents hands suddenly raise the hand of the child to help the children walk over the steps. Immediately after the symptoms appear, or use force to put a sweater on the child, the rough pulling force will also appear in the humeral head subluxation.
2, the child complained of elbow pain, refused to use the hand to take things and elbows, refused to touch others.
Examine
Examination of the humeral head subluxation
1. There is a history of upper limbs being pulled. Usually, young parents are taking children to the streets. The upper limbs of the children are lifted up, and the upper limbs of the parents are drooping. When there are steps, the parents hands suddenly raise the hands of the children to help the children walk over the steps. Immediately after the symptoms appear, or use force to put a sweater on the child, the rough pulling force will also appear in the humeral head subluxation.
2, the child complained of elbow pain, refused to use the hand to take things and elbows, refused to touch others.
3, check the signs are few, no swelling and deformity, elbow joint slightly flexed, there is tenderness at the head of the humerus.
4. X-ray examination is negative.
Diagnosis
Diagnosis and diagnosis of humeral head subluxation
diagnosis
Diagnosis can be performed based on clinical manifestations and examinations.
Differential diagnosis
In the differential diagnosis, the dislocation of the humeral head is distinguished from the subluxation of the humerus. First described by Fournier in 1671. The humeral head subluxation, also known as the elbow, is one of the common elbow injuries in infants and young children. The age of onset was 1 to 4 years old, of which the highest incidence rate was 2 to 3 years old, accounting for 62.5%.
