Heel walking

Introduction The fracture of the tibia is mainly characterized by swelling of the back of the foot, weight-bearing toe and walking with the heel. Pain on one or both sides, not red or swollen, inconvenient to walk. It is caused by lesions in the bones, joints, bursae, fascia, etc. of the heel. It is common in pelvic fasciitis, which often occurs in Jiuli or walking workers. The violence that causes the fracture of the tibia can be caused by sprains or conduction, but more cases are caused by direct impact or impact of heavy objects. Therefore, except for the first metatarsal, there are few single shots. And many of them are associated with dislocation.

Cause

(1) Causes of the disease

Direct violence, impact, sprain and indirect external forces can cause injury.

(two) pathogenesis

The humerus is between the tibia and the phalanges. The 1-3 humerus and the heel, the distance, the boat and the cuneiform bone form the inner longitudinal arch. The 4, 5 humerus, the calcaneus and the tibia constitute the lateral longitudinal arch. The five humerus and cuneiform bones in the shape show a wide back side and a narrow ventral side, which are connected to each other to form a transverse arch of the foot (like an arch shape). The bones have strong ligament connections to each other to maintain the shape of the foot and the physiological functions of the arches. Based on this feature, in the treatment of humeral injuries, attention must be paid to the maintenance and recovery of the arch.

The violence that causes the fracture of the tibia can be caused by sprains or conduction, but more cases are caused by direct impact or impact of heavy objects. Therefore, except for the first metatarsal, there are few single shots. And many of them are associated with dislocation.

an examination

Related inspection

General radiography examination joint examination

1. Symptoms: Mainly manifested as swelling of the back of the foot, weight of the toe and walking with the heel. If there is more subcutaneous hemorrhage, the back of the foot can be highly swollen.

2. Clinical manifestations of tibia-fighting fractures: mainly local pain, tenderness, fatigue, weakness and symptoms such as continued marching restriction; X-ray plain film is difficult to show early, fracture line appears after 2 to 3 weeks, and periosteal hyperplasia The reaction changes.

Type:

1 humeral head fracture: mostly due to direct violence, the frontal articular surface is also affected at the same time, clinically less common. 2 humeral neck fracture: more than the former, the head easily displaced to the temporal side after fracture, need to be reset.

3 humeral shaft fractures: also caused by external impact or extrusion, more common, often more than one tibia occurs simultaneously.

4 humeral basal fractures: may be caused by direct violence or foot sprains, especially the fifth humeral basal fracture, more than 90% caused by the sacral short muscle traction caused by varus injury, this should be noted Osteophytes (children's patients) and sesamoids are identified.

5 tibia march fractures: also known as march fatigue fractures, more common in the 2nd and 3rd humeral backbone, long-distance marching soldiers are more common, it is often called a march fracture. Repeated, overloaded compressive stress acts on the longitudinal arch of the foot to form a fracture. The 2nd and 3rd metatarsals are the most stressed, but their bone strength is not as strong as the first metatarsal, so it is easy to fracture here.

The diagnosis of humeral fractures is generally easy, the history of trauma is more clear, and the bone is superficial and easy to check, and the X-ray film is generally clear; but the fracture of the humerus base can be caused by improper X-ray projection angle. It is difficult to identify, and it should be based on clinical diagnosis.

Differential diagnosis

Differential diagnosis of heel walking:

1. Intermittent claudication: Intermittent claudication refers to the patient's walking from the beginning, or after a long journey (usually hundreds of meters), unilateral or bilateral back pain, leg weakness, even lower, but a little bit, but slightly After sitting or sitting down for a while, the symptoms can be quickly relieved or disappeared, and the patient can continue to walk. After a while, the above symptoms reappear. Because in this process, the limp appears intermittently, so it is called intermittent limp.

2, lower limb towing gait: lower limb towing gait is a clinical manifestation of cortical spinal cord lesions in gait abnormalities.

3, gait instability: gait instability means that the patient walks unsteadily, or see the movement is not flexible, the legs are wide when walking; or can not walk straight when walking, suddenly left and right; or walking when the step is short The two upper limbs do not swing back and forth. They are slow when they first walk, and they are getting faster and faster, and they are "sweeping gait."

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