zygomatic arch fracture
Introduction
Introduction to humeral arch fracture The humeral arch fracture is a fracture of the humerus complex centered on the humerus. It is usually a fracture of the tibia complex and the surrounding bone caused by a traffic accident or a fight. It can be single or accompanied by other parts. fracture. The humeral arch fracture mainly affects the facial shape and appearance of the patient. In some cases, the mouth opening is limited and affects oral function. The open reduction and fixation of the humeral arch fracture is very important for the prognosis. In order to balance the function and appearance, most of the patients now use a coronary incision or a semi-coronal incision with a small incision. Most of the patients can recover from the facial shape. To a more ideal form. Tibial and zygomatic fractures are one of the common fractures of the maxillofacial region. The humerus is associated with the maxilla, frontal, sphenoid and humerus. The humerus itself has few fractures. The fracture line often occurs in the surrounding weak bone, often forming a proximal bone fracture centered on the humerus. In the case of regional fractures, there are also known as iliac complex fractures and temporomandibular complex fractures. Because the zygomatic arch is composed of the condyle of the humerus and the condyle of the humerus, the simple zygomatic arch fracture often involves the two bones, so it is also included in the fracture of the humerus complex. basic knowledge The proportion of illness: 0.003%--0.004% Susceptible people: no specific population Mode of infection: non-infectious Complications: eyeball retraction
Cause
Causes of humeral arch fracture
The fracture of the humerus arch is similar to the cause of other fractures. The main cause is the external force acting directly or indirectly on the maxillofacial region, usually including injury, traffic injury, fall injury, and bullet wound.
In different countries and regions, the etiology, incidence and age of the fractures of the tibia and fibula are different, which is related to the local social, economic, political and educational factors of the population. In most parts of the world, the main cause of humeral humeral fracture is because of the bruises, motor vehicle traffic accidents account for a large proportion, and work injuries also account for a certain proportion. In recent years, with the increase in motor vehicle traffic accidents, the number of complicated humeral arch fractures has increased. In the fracture of the zygomatic arch caused by the bruise, the attack rate on the left side is much higher than that on the right side, which is related to the habit of using most right fists. Therefore, this characteristic feature is not found in the humeral arch fracture caused by other causes. Bilateral humerus and zygomatic arch fractures are more related to motor vehicle traffic accidents, and the general ratio is lower. In this sense, the fracture of the humerus and humerus caused by motor vehicle traffic accidents is often more serious than the bruises.
Prevention
Prevention of humeral arch fracture
The disease is mainly caused by external violence, so there is no special prevention method. Avoiding damage in production and life is the key to prevent this disease.
In addition, it should be noted that if the humerus and zygomatic arch fractures occur, they should be treated promptly. After the diagnosis is clear, they should be treated according to the situation.
Complication
Complications of humeral arch fracture Complications, eyeball retraction
In patients with this disease, severe cases may have depression and displacement deformity after fracture, causing many concurrent injuries:
1. The fracture site compresses the diaphragm or obstructs the movement of the condyle, resulting in limited mouth opening.
2, the tibia constitutes the majority of the external wall of the iliac crest and the infraorbital margin. After the fracture is displaced, the eyeball can be displaced and diplopia can be produced.
3, if the humeral fracture caused by the infraorbital nerve injury, it will cause numbness in the underarm area.
4. The relationship between the volume of the bony sputum and the eyeball is that the eyeball invagination is 0.89 mm for every 1 cm of the volume of the sputum. In addition, the soft tissue embedded in the maxillary sinus, fat atrophy and scar traction can also cause eyeball retraction.
Symptom
Symptoms of humeral humeral fractures Common symptoms Periorbital plaques, double eyesight, open mouth, tibia, frontal bone depression
1. The facial block collapses the deformity of the humerus and the zygomatic arch. The fracture block displacement depends mainly on the direction of the external force, and the invagination shift occurs. In the early post-injury, it can be seen that the face is collapsed, the sides are asymmetrical, and then due to local swelling, the collapse deformity may be concealed, which is easily mistaken for simple soft tissue damage. After the swelling disappeared, local collapse deformity appeared again. Typical simple zygomatic arch fractures may also have collapse deformities.
2, the mouth is limited due to the internal displacement of the fracture block, oppression of the diaphragm and masseter muscle, obstructing the movement of the coronoid, resulting in mouth pain and limited opening.
3. Double vision of the humerus constitutes the majority of the lateral wall and the inferior temporal margin. After the displacement of the tibia fracture, the eyeball displacement, the abductor muscle oozing and local edema and tearing of the oblique muscle in the fracture line are embedded in the fracture line, limiting eye movement and other reasons for diplopia.
4, neurological symptoms of the inferior nerve running part, just the junction of the maxillary humerus, therefore, the fracture of the maxillary process of the humerus can cause damage to the infraorbital nerve, causing numbness in the innervation area, such as Damage to the facial nerve branch, eyelid closure can occur.
5. Hemorrhagic ecchymosis occurs in the subcutaneous, orbital and conjunctival areas of the sacral humerus.
Examine
Examination of humeral arch fracture
The nasal sacral position and the zygomatic arch and the flat radiograph and CT film are often used to determine the location of the fracture and the relationship with the periorbital, maxillary sinus and infraorbital orifices. According to clinical features and imaging examination, diagnosis is not difficult. It is worth pointing out that because the fracture of the tibia is more common with the fracture of the adjacent bone, including the maxilla, the condyle of the humerus and the sphenoid bone, it is often called the humerus.
Diagnosis
Diagnosis and diagnosis of humeral arch fracture
The fracture of the humerus arch can be diagnosed according to the history, clinical features and X-ray examination.
Visual examination should pay attention to whether the pupils on both sides are on the same horizontal line. The patient is used for eye movement in each quadrant to observe whether there is limited eye movement. Observing whether the bilateral humerus is symmetrical should be compared from the top of the patient.
The palpation fracture may have tenderness and collapse displacement, and the frontal sulcus, the maxillary suture and the inferior temporal margin may have a sense of step. If you palpate from the vestibule to the posterior superior sulcus, you can check whether the gap between the humerus and the maxilla and the coronoid becomes smaller. These are all helpful in the diagnosis of tibial fracture.
Traditional X-ray examinations commonly use nasal sputum (Fahrenheit) and sacral tangential position. The fracture line and displacement of the humerus and the zygomatic arch can be seen. The structure of the orbit, maxillary sinus and infraorbital canal can be observed abnormally. The X-ray characteristic of the zygomatic arch fracture is M or V. In recent years, the three-dimensional CT reconstruction technique can reconstruct the three-dimensional image of the whole jaw and comprehensively display the information such as the shape and displacement of the fracture segment, which is beneficial to the diagnosis of the fracture and the formulation of the treatment plan.
