Gai's fracture

Introduction to Gai's fracture Galeazzifracture is a lower third of the humerus fracture combined with dislocation of the lower ankle joint. There have been many titles. As early as 1929, the legal person called the anti-Monts fracture, and later referred to as the Piedmont fracture, and Compbell called the fracture of the need, because it was believed that the injury must be treated surgically. Galaezzi described the damage in detail in 1934 and suggested pulling the thumb to rectify it. Since then, it has been customary to call this type of injury a Gai's fracture. Gai's fracture is a common injury that occurs six times more often than a Monteggia fracture. basic knowledge The proportion of illness: 0.03% Susceptible people: no specific population Mode of infection: non-infectious Complications: double fracture of the ulnar and radial bones

Cause of Gai's fracture

Cause

Direct external force injury is more common, and more common in children, its pathological changes are mainly characterized by multiple types of injuries in the distal arm of the distal arm with the elbow. Such as blows or machine wounds. The most common is the lower third of the humerus fracture combined with the dislocation of the lower ankle joint. Gai's fractures also occur in transmitted violence. For example, under the action of an external force, the distal end of the forearm is fractured due to the conduction of force, and multiple types of injuries are present in the ipsilateral elbow, but some individuals also affect the proximal humerus. Such a fracture can be caused by falling down on the hand.

Pathogenesis

It can be caused by directly hitting the back side of the tibia of the tibia; it can also be caused by the stress caused by the fall and the hand holding the ground: it can also be caused by the machine's smashing injury, and the damage mechanism is different. Different characteristics.

(1) Distal humeral branch fracture combined with ulnar small skull sputum separation:

Both occur in children. This type of damage is light and easy to reset.

(2) The lower third of the humerus fracture:

Mostly horizontal, short and oblique. There is obvious shortening and dislocation of the lower ankle joint. More caused by falling hands. When the forearm is injured in the anterior position, the distal end of the humerus is displaced to the dorsal side, and the person who is injured in the supination position is displaced to the volar side. The latter is more common in clinical practice. This type of injury is heavier. Lower ulnar ligament, triangular cartilage, interosseous membrane injury, ulnar styloid fracture.

(3) The lower third of the radius of the humerus fracture, the lower ankle joint dislocation and the fracture of the radius and ulna or the traumatic curvature of the radius and ulna:

Mostly caused by machine whiplash, the damage may be open injury. In addition to the lower ulnar ligament and triangular cartilage damage, the interosseous membrane injury is also heavier.

Gai's fracture prevention

Because the impact injury or machine stranging directly hits the back side of the tibia of the 1/3 of the sacral side; it can also cause fractures due to the fall and the stress during the hand support, so the prevention work begins with the details of life.

Gai's fracture complications Complications

Joint swelling can occur.

Symptoms of Gai's fractures Common symptoms Pain in the forearm and wrist Forearm supination function limited Forearm pronation deformity Oblique fracture Forearm rotation pain

It is positively correlated with the severity of the injury. The fractures with insignificant displacement are only pain, swelling and tenderness. If the displacement is obvious, the humerus will appear short, angular deformity, swelling of the lower ankle joint and obvious tenderness, ulnar head swelling. Out, nerves, blood vessels, and injuries are rare. Classification: This type of fracture is generally divided into the following three types:

1. Green branch type: occurs in children, the tibia is a green branch fracture, the ulna small head or osteophyte is separated, or the lower ankle joint is separated. This type of treatment is easier and the prognosis is good.

2. Simple type: for the distal radius fracture, accompanied by dislocation of the lower ankle joint, the fracture is mostly transverse, oblique or spiral, generally with significant displacement.

3. Double fracture type: In addition to the distal radius fracture and the submandibular joint dislocation, the ulnar shaft is often accompanied by a fracture, or the ulnar traumatic curvature caused by incomplete fracture, the latter case is caused by mechanical injury. It is more serious and often open injury. The treatment is more complicated. The direction of displacement of the fracture end of the double fracture depends mainly on the following three groups of muscles:

(1) Diaphragm: a shortened deformity that causes the fracture end.

(2) Spin the anterior muscle: make the distal humerus inward and close together.

(3) Stretching the thumb muscle and abducting the thumb muscle: Strengthening the effects of the above two groups of muscles.

Examination of Gai's fracture

The auxiliary examination method for this disease is mainly X-ray examination:

X-ray films showed a transverse or short oblique fracture at the junction of the lower third of the humerus. If the fracture of the humerus fracture is obvious, the lower ankle joint will be completely dislocated. On the anterior and posterior radiographs, the humerus is shortened, the distance between the distal and the ulna is reduced, and the humerus is close to the ulna. On the lateral position, the humeral head is angled to the volar side, and the ulnar head protrudes toward the dorsal side.

Diagnosis and identification of Gai's fracture

diagnosis

Different judgments were made based on the patient's history of trauma, local pain, swelling and tenderness. Displacement is not obvious, only pain, swelling and tenderness, and forearm rotation activity is limited. Apparent shift, the humerus appeared short and angular deformity, the lower ankle joint tenderness, ulnar head bulging. X-ray films showed a transverse or short oblique fracture at the junction of the lower third of the humerus. X-ray examination can confirm the diagnosis.

Differential diagnosis

The disease is generally not confused with other diseases.

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