Radius fracture
Introduction
Introduction to tibia fracture Tibial fractures occur mostly at the distal end and are extremely common, accounting for about 1/10 of the usual fractures. More common in older women, children and youth. The fracture occurred in the range of 2 to 3 cm distal to the humerus. Often accompanied by damage to the wrist joint and the lower ankle joint. The sacral radius is one of the forearm bones and is divided into one body and two ends. The upper end forms an oblate humeral head, and the top of the head has a concave humeral head concave, which is associated with the humeral head. There is an annular articular surface around the humeral head, which is associated with the ulnar notch. The humeral head is smooth and thin under the humeral neck, and there is a large rough ridge in the lower part of the neck. It is the ridge of the biceps. The medial edge is sharp, also known as the interosseous ridge, which is opposite to the ulna. The rough surface of the midpoint of the lateral side is the pronated round muscle trochanter. The lower end is particularly inflated, approximately cubic. The distal side is smoothly concave, which is the wrist joint surface and is associated with the proximal wrist bone. The inner side has an ulnar notch, which is associated with the ulnar head. The outer side protrudes downward, called the sacral styloid process, which is about 1 to 1.5 cm lower than the ulnar styloid process. basic knowledge The proportion of illness: 0.012% Susceptible people: no specific population Mode of infection: non-infectious Complications: median nerve injury joint dislocation
Cause
Cause of humeral fracture
Caused by trauma (90%):
1. Straight fracture (colles fracture)
Most common, mostly caused by indirect violence. It was described in detail by A. Colles in 1814. When the fall, the wrist is in the extension of the back and the forearm is in the prone position, the palm of the hand is on the ground, and the violence is concentrated on the cancellous bone at the distal end of the humerus to cause a fracture. The distal end of the fracture was displaced to the dorsal and temporal sides. Children can be separated for osteophytes; in the elderly due to osteoporosis, a slight external force can cause fractures and often comminuted fractures, and the fracture ends are shortened by the compression. The comminuted fracture may involve the articular surface or the avulsion fracture of the ulnar styloid process and the dislocation of the lower ankle joint.
2. Flexion fracture (Smith fracture)
Less common, first described by RWSmith in 1874. The cause of the fracture is the opposite of the straight type fracture, so it is also called the anti-Corley fracture. When falling, the back of the hand is on the ground, and the distal end of the fracture is displaced to the volar and ulnar sides.
3. Balton fracture (Barton fracture)
Refers to the longitudinal oblique fracture of the distal radius of the humerus, accompanied by dislocation of the wrist. It was first described by JR Barton in 1838. When the person fell, the palm of the hand or the back of the hand hit the ground, and the violence was transmitted upwards. The fracture of the humerus was caused by the impact of the proximal carpal bone. The fracture piece of the articular cartilage was formed on the volar or dorsal side of the lower end of the humerus. Proximal displacement, and dislocation or subluxation of the wrist.
Prevention
Prevention of tibia fracture
Pay attention to production and life safety, avoid trauma and violence, and ensure personal safety is the key to prevent this disease.
Complication
Coma bone fracture complications Complications, median nerve injury, joint dislocation
Median nerve injury
Delayed extension of the flexor tendon rupture; non-union of the fracture.
2. Infection
Mainly related to the wound exposure time after injury, debridement is not complete and soft tissue damage is serious.
Symptom
Symptoms of humeral fractures Common symptoms Wrist swelling, tenderness, joint pain, joint deformity
The wrist is swollen and tender, and the movements of the hands and wrists are limited. Straight fractures have typical fork-like and gun-like deformities, and the ulnar and radial styloid processes are in the same plane, and the ruler test is positive. The buckling fracture is the opposite of the straight type. Pay attention to whether the median nerve is damaged.
Examine
Examination of the fracture of the tibia
X-rays clearly show the fracture and its type. In the straight type, the distal end of the humerus fracture is displaced to the dorsal aspect, and the inclination angle of the volar and ulnar sides of the joint surface becomes small, disappears, or even reverses. The distal end of the humerus fracture is inserted into the proximal side, and some of the ulnar styloid fractures and the lower ankle joint are separated. The flexion fracture was displaced to the volar side of the distal end of the humerus. For elderly patients with mild external injury, a bone density test should be performed to understand the loosening of the fracture.
Diagnosis
Diagnosis and diagnosis of tibia fracture
Differential diagnosis:
Distal humerus fracture
Refers to a fracture of the cancellous bone at the distal end of the humerus and a fracture that is displaced to the dorsal side. Colles fracture is one of the most common fractures, accounting for 6.7% of all fractures. Most occur in middle-aged and older women.
2. Tibial neck fracture
It is rare, often associated with humeral head fractures, or single, the injury mechanism and diagnosis and treatment requirements are similar.
3. Lower tibiofibular fracture
It refers to a fracture within 3 cm from the articular surface of the lower end of the humerus. This part is the junction of cancellous bone and dense bone. It is a weak anatomical area. Once subjected to external force, it is easy to fracture.
4. Radial head fracture
It is a common elbow injury, accounting for 0.8% of the total body fracture, about 1 / 3 patients with other parts of the joint injury. A small head fracture of the humerus is an intra-articular fracture. If there is a displacement, it should be cut open and internal fixation to restore the anatomical position and early activity to restore the elbow flexion and forearm rotation.
5. Radial head fracture
It is an elbow injury that is easy for adults to occur. Usually the pain is mild and it is easy to be misdiagnosed clinically.
6. humeral shaft fracture
Separate humeral shaft fractures account for only 12% of the total number of forearm fractures, mostly in young adults.
