Crane's fracture

Introduction to Cray's fracture Pouteaul talked about this type of fracture in 783. In 1814, Abraham Colles described it in detail. Since then, it has been said that this type of fracture is a Colles fracture, and it is still used today. Colles fracture refers to a cancellous bone fracture that occurs at the distal end of the humerus and is displaced to the dorsal side. Colles fracture is one of the most common fractures in the human body, accounting for 6.7 to 11% of all fractures. It occurs mostly in middle-aged and elderly, and more women than men. Colles fracture refers to a cancellous bone fracture that occurs at the distal end of the humerus and is displaced to the dorsal side. Colles fracture is one of the most common fractures in the human body, accounting for 6.7 to 11% of all fractures. It occurs mostly in middle-aged and elderly, and more women than men. basic knowledge The proportion of illness: 0.025% Susceptible population: mostly occurs in middle-aged and elderly, more women than men Mode of infection: non-infectious Complications: dislocation of the lower ankle joint

Cause of Klein's fracture

Colles fractures are mostly caused by indirect violence, which is common in falls, elbow extension, forearm pronation, wrist extension, and palm injury. Stress acts on the distal end of the humerus, causing fractures in this fragile part.

Frykman performed static and kinetic tests on fresh corpses to clarify the occurrence of fractures. A trial of distal radius fractures occurred in 32 of 48 limb specimens. In the static test, it was confirmed that the wrist was between 40 and 90 degrees of dorsiflexion, and the cancellous bone fracture at the distal end of the humerus was generated. For males, the applied load of the fracture was greater than that of the female. The angle of the wrist back is related to the required load force. The smaller the back extension angle, the smaller the load force required to cause the fracture, and vice versa. When the wrist extension is less than 40°, the experiment produces a fracture of the proximal forearm; when the wrist extension is greater than 90°, a wrist fracture is often produced. In the kinetic test, it was also confirmed that the occurrence of cancellous bone fracture at the distal end of the humerus was closely related to the direction of the force.

From the characteristics of the x-ray film of the fracture, it may be that the cortical bone of the distal humerus is fractured under the action of tension, while the dorsal system is subjected to compressive stress, and the insertion and comminution of cancellous bone occurs.

C0lles fractures are less common in direct violence. In the early years, when the car still had to be cranked, the handle bounced and hit the back side of the distal end of the humerus, causing such fractures to be seen.

Klein fracture prevention

Pay attention to production and life safety, avoid trauma and violence, and ensure personal safety is the key to prevent this disease.

Klein fracture complications Complications of the lower ankle joint dislocation

Although the Colles fracture is a simple and common injury, multiple complications can occur. More common is:

Wrist nerve injury

The carpal tunnel is compressed due to fracture deformity, and there is a symptom of median nerve compression. Ulnar nerve symptoms can also occur when the cannula is compressed. This kind of nerve damage. Mostly, it is a sensory disorder. When the deformity is corrected, it can gradually recover.

2. Extension of the longus tendon rupture

This tendon break usually occurs four weeks after the injury and sometimes later. There may be two reasons for the extension of the longissimus tendon rupture: one is the original injury, the injury and the tendon blood supply, causing the tendon of the tendon to be broken; the first is the fracture and the Lister nodule, which is often on the uneven bony groove. Friction and damage to break.

3.Sudeck, s bone atrophy

Or reflex sympathetic bone atrophy, post-traumatic bone atrophy. It is characterized by pain, swelling of the wrist and fingers, redness and thinning of the skin, and general decalcification and looseness of the bone. The onset of the disease is sometimes sudden, but it is often caused by a lack of active activity after the fracture.

4. Shoulder syndrome

Similar to the above, but the spread is so wide that the shoulder joint is also stiff. Once it happens, treatment is extremely difficult.

5. Fracture malunion

Failure to fix the fixation caused by various reasons can lead to fracture malformation. The incidence is higher.

In general, the deformity is lighter, the wrist dysfunction is not significant, and the patient can be safe in this state without further treatment. If the deformity is heavier, the dislocation of the lower ankle joint will cause the forearm rotation disorder and the movement pain of the wrist. This condition can be improved by the ulnar head resection.

Cray's fracture symptoms Common symptoms Wrist pain Wrist swelling Swelling wrist swelling and palm flexion...

After the injury, the wrist is painful and swollen rapidly, often affecting l/3 under the back of the hand and the forearm. If the fracture is severely displaced, a fork-like deformity may occur. The wrist joint, the forearm rotates, and the movement of the fingers is limited by pain.

There is tenderness at the distal end of the humerus, which can reach the far-folded end that is displaced to the dorsal aspect of the ankle. If the comminuted fracture is broken, the bone can be touched. Careful examination revealed abnormal relationship between the stem and ulna of the ulna, such as the sacral styloid and the ulnar styloid at the same level or the ulnar styloid protruded more distally than the sacral styloid process.

There are many types of fractures, and the following are widely used:

1. Tayler and Persons are divided into two groups according to the presence or absence of the lower ankle joint and fibrocartilage disc damage. There is a fibrous cartilage disc injury that is further subdivided according to whether the comminuted fracture.

2. Nissen-issen Lie (1939) is divided into five groups according to whether the fracture involves joint surface, the degree of joint damage, the direction and extent of displacement: crack fracture, no displacement; extra-articular fracture, lateral displacement of the fracture to the dorsal side Position; comminuted fracture, one or several fracture lines reach the joint; the fracture has a dislocation, the sacral styloid fracture; the fracture is displaced to the volar.

3. Later Gartland and Werley (1951) divided them into three categories based on joint damage. Lidstrom (1959) also classified it into three categories based on the direction and extent of displacement, joint involvement and degree of comminution.

4. In view of the damage of the articular surface and the injury of the lower ankle joint, whether there is a fracture at the distal end of the ulna is closely related to the prognosis. Therefore, it is worth recommending a detailed and reasonable classification of Frykman. According to this classification, distal radius fractures can be divided into eight categories:

(1) extra-articular fractures, no distal ulnar fractures;

(2) extra-articular fractures with distal ulnar fractures;

(3) intra-articular fractures affect the ankle joint but no distal ulnar fracture;

(4) intra-articular fractures affect the ankle joint, combined with distal ulnar fractures;

(5) intra-articular fractures affect the lower ankle joint but no distal ulnar fracture;

6 intra-articular fractures affect the lower ankle joint, combined with distal ulnar fractures;

7 intra-articular fractures affect the ankle joint and the lower ankle joint, but no distal ulnar fracture;

(8) intra-articular fractures, involving the ankle joint and the lower ankle joint, combined with distal ulnar fracture.

Examination of Klein's fracture

X-ray inspection, the typical misalignment is as follows:

1. The distal radius fracture block is displaced to the dorsal side;

2. The distal radius fracture block is displaced to the temporal side;

3. The fracture is angled to the volar side;

4. The humerus is shortened, and the dorsal bone of the fracture is embedded or crushed;

5. The distal radius fracture block is supinated.

The above dislocations constitute a typical fork-shaped deformity, which causes the palm tilt angle and the ulnar angle to decrease or be negative.

X-ray films are often associated with ulnar styloid fractures, and the fractured ulnar styloid processes are separated to varying degrees, and severely displaced to the temporal side. If there is no ulnar styloid fracture, and the distal end of the humerus is displaced to the temporal side, it indicates the tear of the triangular fibrocartilage disc.

Diagnosis and diagnosis of Cray's fracture

According to the X-ray film, the distal end of the fracture was displaced to the dorsal side of the ankle, and the proximal end was displaced to the volar side for diagnosis.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.