Wrist swelling and tenderness
Introduction
Introduction The lower end of the humerus fracture is mainly characterized by swelling and tenderness of the wrist. Distal radial fractures 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.
Cause
Cause
Causes of swelling and tenderness of the wrist:
The disease is mostly caused by indirect violence. When falling, the hand touches the ground and the violence is transmitted upwards, resulting in a fracture of the lower end of the humerus. It is characterized by swelling of the wrist, tenderness, and limited movement of the hands and wrists. The majority of patients with distal radius fractures are injured in the wrist. The axial force is mostly transmitted through the central column and the lateral column through the scaphoid and lunate bone to the distal end of the humerus. Between the lunate bones, the force is mainly concentrated on the scaphoid ligament, which is easy to cause the scaphoid ligament injury and the separation of the boat and the moon. The distal joint surface of the humerus tends to be shattered. Because palmar flexion is not conducive to the repair of the dorsal structure, the ulnar deviation makes the separation of the scaphoid and the diaphragmatic muscles, which is easy to cause displacement of the temporal side, which is not conducive to improving the instability of the wrist joint.
Examine
an examination
Related inspection
CT examination of bone and joint and soft tissue
Examination and diagnosis of swelling and tenderness of the wrist:
First, the symptoms
The lower end of the humerus fracture refers to a fracture within 3 cm from the articular surface of the lower end of the humerus. This site is the junction of the cancellous bone and the dense bone. It is a weak anatomical site. Once subjected to external force, it is easy to fracture. The articular surface of the lower end of the humerus is from the dorsal to the volar side, and the concave surface from the lateral side to the ulnar side, forming a palm dip angle (10 degrees - 15 degrees) and a dip angle (20 degrees - 25 degrees). The stalk stalk side and the ulna are small. The ulnar humerus constitutes the ulnar and ankle joint, together with the upper ulnar joint, constitutes the anatomical basis of the rotation of the forearm. The styloid process of the humerus is located at a distance of 1-1.5 cm from the plane of the ulnar styloid process. The ulnar and the lower end of the humerus form a proximal column of the wrist. s. The main manifestations are swelling of the wrist, tenderness, and restricted movement of the hands and wrists.
Second, diagnosis
1. Straight fracture
Local pain and swelling after injury can lead to a new typical deformity posture, that is, a "silver fork" deformity on the side, and a "gun-like" deformity on the front side, and the local tenderness is obvious, and the wrist joint is disordered. The X-ray film showed that the distal end of the fracture was displaced to the iliac crest and the dorsal side, and the proximal volar side was displaced. Therefore, typical deformity signs were observed, which may be accompanied by dislocation of the lower ankle joint.
2, flexion fracture
After the injury, the wrist was drooping, local swelling, subcutaneous ecchymosis on the back of the wrist, limited wrist activity, and obvious tenderness in the examination. X-ray film can be found in typical displacement, near tonnage to the dorsal position, distally folded end to the volar side, the temporal side of the displacement, and the direction of the extension of the fracture is opposite, becoming an anti-Colles fracture or Smith fracture.
3, distal radius fracture of the articular surface with wrist dislocation
Clinically, it is similar to the "silver fork" deformity and corresponding signs of Colles fracture. X-ray film can be found as a typical shift. When falling, the wrist flexes with a hand on the back of the hand, and the vertebral articular surface fracture of the lower end of the humerus and the shift of the wrist to the volar side can occur. These fractures are rare, clinically long leakage or misdiagnosis of wrist dislocation, as long as careful reading of X-ray diagnosis is not difficult.
Diagnosis
Differential diagnosis
Differential diagnosis of swelling and tenderness of the wrist:
The main manifestations of this disease are swelling of the wrist, tenderness, limited movement of the hands and wrists, etc., which have the same performance as many bone or joint injuries, so it is clinically necessary to distinguish with many diseases, but generally use X-ray examination. Can be diagnosed. What needs to be diagnosed with this disease is:
1. fracture of the humerus shaft;
2, humeral neck fracture;
3, humeral head fractures;
4, wrist dislocation and so on.
First, the symptoms
The lower end of the humerus fracture refers to a fracture within 3 cm from the articular surface of the lower end of the humerus. This site is the junction of the cancellous bone and the dense bone. It is a weak anatomical site. Once subjected to external force, it is easy to fracture. The articular surface of the lower end of the humerus is from the dorsal to the volar side, and the concave surface from the lateral side to the ulnar side, forming a palm dip angle (10 degrees - 15 degrees) and a dip angle (20 degrees - 25 degrees). The stalk stalk side and the ulna are small. The ulnar humerus constitutes the ulnar and ankle joint, together with the upper ulnar joint, constitutes the anatomical basis of the rotation of the forearm. The styloid process of the humerus is located at a distance of 1-1.5 cm from the plane of the ulnar styloid process. The ulnar and the lower end of the humerus form a proximal column of the wrist. s. The main manifestations are swelling of the wrist, tenderness, and restricted movement of the hands and wrists.
Second, diagnosis
1. Straight fracture
Local pain and swelling after injury can lead to a new typical deformity posture, that is, a "silver fork" deformity on the side, and a "gun-like" deformity on the front side, and the local tenderness is obvious, and the wrist joint is disordered. The X-ray film showed that the distal end of the fracture was displaced to the iliac crest and the dorsal side, and the proximal volar side was displaced. Therefore, typical deformity signs were observed, which may be accompanied by dislocation of the lower ankle joint.
2, flexion fracture
After the injury, the wrist was drooping, local swelling, subcutaneous ecchymosis on the back of the wrist, limited wrist activity, and obvious tenderness in the examination. X-ray film can be found in typical displacement, near tonnage to the dorsal position, distally folded end to the volar side, the temporal side of the displacement, and the direction of the extension of the fracture is opposite, becoming an anti-Colles fracture or Smith fracture.
3, distal radius fracture of the articular surface with wrist dislocation
Clinically, it is similar to the "silver fork" deformity and corresponding signs of Colles fracture. X-ray film can be found as a typical shift. When falling, the wrist flexes with a hand on the back of the hand, and the vertebral articular surface fracture of the lower end of the humerus and the shift of the wrist to the volar side can occur. These fractures are rare, clinically long leakage or misdiagnosis of wrist dislocation, as long as careful reading of X-ray diagnosis is not difficult.
