Adduction fracture

Introduction Adduction fractures are often caused by indirect violence. When the palm or elbow touches the ground when falling, the force is transmitted upward along the upper limb, hitting the shoulder, and the body is dumped to the front side, causing an adduction fracture. A fracture is a complete or partial break in the structure of a bone or bone. More common in children and the elderly, young and middle-aged people also happen. Patients often have fractures in one part, and a few are multiple fractures. After timely treatment, most patients can restore their original functions. A small number of patients may have different degrees of sequelae. After the fracture occurs, they may be sent directly to the hospital. Hospitals or ambulances, patients far away from the hospital, must be handled simply to prevent aggravation of the condition on the way to the hospital, and even cause irreversible consequences.

Cause

When the hand falls or the elbow touches the ground, the upper limb is adducted, the proximal end of the fracture is abducted, and the distal end is adducted, forming an outward angular deformity. Less common.

There are three main reasons for the occurrence of fractures:

(1) Direct violence

When violence directly affects a part of the bone and causes fracture of the part, it often causes fracture of the injured part, often accompanied by different degrees of soft tissue destruction. For example, the wheel hits the lower leg and the humeral shaft fracture occurs at the impact.

(2) Indirect violence

Indirect violence occurs through longitudinal conduction, leverage or torsion to fracture in the distance. When the foot falls from a height, the trunk flexes forward rapidly due to gravity, and the vertebral body at the junction of the thoracolumbar spine is subjected to folding force. The role of compression fracture (conduction).

(3) Accumulative strain damage

Long-term, repeated, minor direct or indirect injury can cause a specific part of the limb to fracture, such as long-distance marching easy to cause second, third metatarsal and lower third of the humerus fracture.

an examination

Related inspection

Bone palpation

Clinical manifestations of adductal fractures: After injury, the shoulders were swollen, painful, subcutaneous ecchymosis, the upper arm was deformed in the internal position, and the movement was disordered.

X-ray examination is of great value in the diagnosis and treatment of fractures:

All suspected fractures should be routinely X-ray film examination, which can be found in clinically difficult to find incomplete fractures, deep fractures, intra-articular fractures and small avulsion fractures, even if clinically manifested as obvious fractures X-ray film examination is also necessary to help understand the type and specific conditions of the fracture, and has guiding significance for treatment.

The X-ray film should include positive and lateral positions. The well must include adjacent joints. Sometimes it is necessary to add oblique position, tangential position or x-ray film of the corresponding part of the healthy side. After reading the x-ray film carefully, the following points should be identified:

(1) The fracture is invasive or pathological.

(2) Whether the fracture is displaced and how to shift.

(3) Whether the fracture alignment is satisfactory to the line and whether it needs to be rectified.

(4) Whether the fracture is fresh or old.

(5) Whether there is damage to the joint or bone injury.

Differential diagnosis

Etiology

Abductive fractures: upper limb abduction during fall, palms on the ground, and indirect violent upward conduction leading to fractures. The proximal end of the fracture is adducted and distally abducted, forming a forward or inward angular deformity or a misaligned deformity. More common in clinical practice.

Adduction fracture: Contrary to abduction fracture, the hand or elbow touches the ground when the fall, the upper limb adducts, the proximal end of the fracture abducts, the distal adduction, forming an outward angular deformity. Less common.

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