Open reduction of proximal radius fractures

The proximal humerus fracture accounted for more than 1% of the fracture in children, mostly in children with close to closure of the epiphysis, 9 to 14 years old. There were no significant differences in gender and left and right sides. The most commonly used type is the Jeffrey type. Treatment includes: 1 simple fixation without resetting; 2 closed closure of manipulation; 3 reduction of percutaneous sled; 4 reduction of intramedullary needle sled; 5 open reduction and internal fixation; 6 humeral head or small head scrap. There are many factors that determine the method of treatment, including the extent of fracture displacement, the relationship with other injuries, the age of the sick child, and the time after injury. This section focuses on methods of closed closure and open reduction. Treatment of diseases: humeral head fractures Indication Open reduction of the proximal humerus fracture is applicable to: 1. After the fracture, the humeral head is completely displaced. 2. After the fracture, the small head of the humerus is displaced inward. Preoperative preparation Regular preoperative examination. Surgical procedure Incision A oblique incision was made from the posterior margin of the upper iliac crest to the 5 cm below the olecranon. Cut the skin, subcutaneous tissue and deep fascia to reveal the elbow muscle, ulnar wrist extensor and finger extension. 2. revealing the humerus neck The joint capsule can be revealed by separating the elbow muscle from the ulnar wrist extensor muscle. Then the joint capsule was cut longitudinally to check the damage of the head and neck of the humerus. 3. Reset and internal fixation After exposing the head and neck of the humerus, the elbow joint was flexed by 90°, and a Kirschner wire was drilled from the proximal section of the fracture to the proximal end by hand. The small head of the humerus was worn out of the skin, and the Kirschner tail of the fracture section was The end retains 0.5 cm for a reset. At this time, the humeral head is reset and prevented from rotating, the forearm is rotated to dissect the fracture end, and then the Kirschner wire is inserted into the distal medulla of the fracture 6-8 cm, and the fracture end is in close contact, and the joint capsule is carefully sutured. Annular ligament, layered suture incision. The Kirschner wire is kept 1 to 1.5 cm outside the skin for later removal.