Pronation of the forearm
Introduction
Introduction The forearm has a pronation deformity, which can not be a clinical manifestation of the radial nerve injury during exercise. The phrenic nerve is close to the diaphysis in the lower third of the humerus, where the phrenic nerve is vulnerable to injury. The phrenic nerve is close to the diaphysis in the lower third of the humerus, where the phrenic nerve is vulnerable to injury. Excessive osteophyte growth and anterior dislocation of the humerus can compress the phrenic nerve. Inadvertent surgery can also hurt this nerve. When the upper arm is injured by the sacral nerve, each extensor muscle is extensively sacral, triceps, diaphragm, sacral long and short extensor muscle, supinator muscle, extension finger muscle, ulnar wrist extensor muscle and index finger, little finger intrinsic extensor muscle Uniform. Therefore, the wrist is drooping, the thumb and each finger are drooping, and the knuckles cannot be extended. The forearm has a pronation deformity, can not be rotated, and the thumb is deformed.
Cause
Cause
1. Because the phrenic nerve is close to the tibia in the upper arm, it is also closer to the tibia in the forearm, so the fracture is often injured at the same time; it is often buried in the epiphysis during the fracture healing process.
2. Pull or compress to injure them. For example, the upper limbs are abducted for too long or the upper head of the head pillow falls asleep.
3. Gunshot wounds, cut injuries. Injury directly during wartime or in the corner.
4. Surgical injury: for example, a humeral head resection or a tibial surgery.
5. Excessive growth of the epiphysis or dislocation of the humeral head can also compress the phrenic nerve.
Examine
an examination
Related inspection
CT examination of bone and joint and soft tissue for limbs CT examination forearm ruler test
First, the disease mainly has the following two aspects of clinical manifestations:
(1) Exercise: When the upper arm sacral nerve is injured, each extensor muscle is extensively sacral, triceps, diaphragm, iliac crest, extensor muscle, supinator, total finger muscle, ulnar wrist extensor and index finger The small intrinsic extensor muscles are uniform. Therefore, the wrist is drooping, the thumb and each finger are drooping, and the knuckles cannot be extended. The forearm has a pronation deformity, can not be rotated, and the thumb is deformed.
When examining the triceps and the wrist muscles, they should be performed in the direction of anti-gravity. The thumb loses its abduction, it does not stabilize the metacarpophalangeal joint, and the thumb function is severely impaired. Due to the ulnar wrist extensor and the temporal extension of the wrist, the wrist is difficult to move to the sides. The dorsal muscles of the forearm are atrophied. In the dorsal forearm of the forearm, most of the sacral nerve injury is the injury of the interosseous nerve. The sensation and triceps muscles are not affected. The longissimus dorsi muscle is good. Other extensors are even.
(2) Feeling: After the sacral nerve injury, the left and right sides of the back of the hand, the two half fingers of the temporal side, the upper arm and the posterior arm of the forearm are sensory.
Second, the basis of diagnosis
1. Have a history of trauma.
2. Those who have complete injuries above the elbow, can not stretch the wrist, stretch the thumb, stretch the fingers and abduct the thumb, showing a deformed wrist. Feeling handicap at the back of the tiger's mouth.
3. Those who have complete injuries below the elbow, have no effect, can not stretch the thumb, abduction of the thumb and extension of the fingers, no vertical wrist deformity.
4. EMG examination is helpful for diagnosis.
Diagnosis
Differential diagnosis
The diagnosis of this disease needs to be identified with the following two diseases:
1. Ulnar nerve injury: After the ulnar nerve injury, in addition to the sensation disappeared on the ulnar side of the hand, the ring and the little finger metacarpophalangeal joint are overextended, and the interphalangeal joint flexes in a claw shape. The thumb cannot be adducted, and the other four fingers cannot be outreached and adducted.
2, median nerve injury: humeral supracondylar fracture can cause compression injury of the median nerve, often recover spontaneously after fracture reduction. After the injury, the thumb, the middle finger and the middle finger can not be flexed, the thumb can not be abducted and the palm, and the three fingers of the palm side of the hand feel the obstacle.
