Oblique fracture
Introduction
Introduction Oblique fractures are unstable fractures that are prone to displacement and are dangerous. They must be absolutely braked and handled with care. Unstable fracture refers to unstable bone fractures, such as oblique fractures, spiral fractures, and comminuted fractures. Partial or complete fracture of the bone due to trauma or pathology. Fracture refers to the interruption of bone integrity and continuity caused by other bone diseases, including osteomyelitis, fractures caused by bone tumors, and fractures caused by slight external force.
Cause
Cause
Partial or complete fracture of the bone due to trauma or pathology. Fracture refers to the interruption of bone integrity and continuity, and can also be caused by bone diseases, including fractures caused by osteomyelitis and bone tumors, and fractures are caused by slight external force.
1. Direct violence: If the car hits the calf and causes a fracture of the humerus;
2. Indirect violence: If suddenly collapsed, the quadriceps contraction will cause a fracture of the tibia;
3. Accumulative strain: If the marching distance is long, the second and third metatarsal fractures may occur.
Examine
an examination
Related inspection
General radiography examination of bone and joint soft tissue CT examination
Transverse, oblique and spiral fractures occur mostly in the trunk.
Systemic symptoms:
(1) Fever symptoms: There is a large amount of internal bleeding in the fracture. When the hematoma is absorbed, the body temperature is slightly increased, but it is generally not exceeded. When the open fracture temperature rises, the possibility of infection should be considered.
(2) Symptoms of shock: for multiple fractures, pelvic fractures, femoral fractures, spinal fractures, and severe open bone. Patients often suffer from shock due to extensive soft tissue damage, massive bleeding, severe pain, or complicated visceral injuries.
Local symptoms:
(1) Abnormal activity symptoms: In normal conditions, the parts of the limbs are inactive, and abnormal activities occur after the fracture.
(2) malformation symptoms: the displacement of the fracture segment can change the shape of the affected limb, mainly showing shortening.
(3) Bone rubbing or bone rubbing symptoms: After the fracture, when the two fracture ends rub against each other, bone squeak or bone rubbing may be generated.
Diagnosis
Differential diagnosis
(1) According to whether the fracture is connected with the outside world, it can be divided into:
1. Open fracture:
The skin and mucous membranes near the fracture are ruptured. The fracture of the bladder and the urethra caused by the pubic fracture and the fracture of the rectum caused by the fracture of the tailbone are all open fractures. Such fractures are contaminated by communication with the outside world.
2. Closed fracture:
The skin or mucosa of the fracture is intact and does not communicate with the outside world. Such fractures are not contaminated.
(2) Classification according to the degree of fracture:
1. Complete fracture:
The integrity or continuity of the bone is completely interrupted, and the fracture of the tubular bone forms a distal, nearly two or more fracture segments. Transverse, oblique, spiral and comminuted fractures are all complete fractures.
2. Incomplete fracture:
The integrity or continuity of the bone is only partially interrupted, such as fractures of the skull, scapula and long bones, and children's green branch fractures are incomplete fractures.
(3) Classification according to the shape of the fracture:
1. Transverse, oblique and spiral fractures: occur mostly in the backbone.
2. Comminuted fracture: The bone is broken into two or more pieces, called comminuted fracture. When the fracture line is "T" or "Y", it is also called "T" fracture or "Y" fracture.
3. Compression fracture: The cancellous bone is deformed by compression, such as the vertebral body and the calcaneus.
4. Star-shaped fractures: Due to the direct impact of violence on the bone surface, such as the skull and tibia may have a star-shaped fracture.
5. Deformed fracture: If the skull is partially sunken due to external force.
6. Embedding fractures occur at the junction of the cortical bone and cancellous bone at the distal end of the long tube. After the fracture, the cortical bone is inserted into the cancellous bone, which can occur in the neck of the femur and the surgical neck of the humerus.
7. Crack fracture: If there is a long bone or a skull injury, there may be a fracture line, but not all bones.
8. Green branch fracture: mostly occurs in children, partial bone fracture, periosteum and part of bone are not broken.
9. Osteophyte separation: Through the fracture of the epiphysis, the section of the epiphysis can have a variety of bone tissue, which is a kind of fracture.
(4) Classification according to anatomical parts: vertebral body fractures of the spine, accessory fractures, bone fractures of long bones, osteophyte separation, metaphyseal fractures, intra-articular fractures, etc.
(5) According to whether the bone tissue before fracture is normal:
1. Traumatic fracture: a normal bone structure, a fracture caused by violence, called a traumatic fracture.
2. Pathological fracture: pathological fracture is different from general traumatic fracture. It is characterized by the fact that before the fracture occurs, the bone itself has internal factors that affect its structural firmness. These internal factors make the bone structure weak. A fracture can be caused by a slight external force that is insufficient to cause a normal bone fracture.
(6) Classification according to the degree of fracture stability:
1. Stability fracture: After fracture reduction, the external fixation is not easy to occur after re-displacement. Such as fracture fracture, green branch fracture, insertion fracture, long bone transverse fracture, compression fracture.
2. Unstable fractures: Unstable fractures after fracture reduction are called unstable bone fractures, such as oblique fractures, spiral fractures, and comminuted fractures. The femoral shaft is a transverse fracture. Due to the strong pulling force of the muscle, it can not maintain a good correspondence, and it is also an unstable fracture.
(7) Classification according to the time after the fracture:
1. Fresh fractures: new fractures and fractures that are not fully fibrous, may also be reset, within 2 to 3 weeks.
2. Old fractures: fractures of more than three weeks after injury, the three-week time limit is not constant, such as elbow fractures in children, it is difficult to recover more than 10 days. Transverse, oblique and spiral fractures occur mostly in the trunk.
