Local swelling and deformation of the thigh

Introduction In the femoral shaft fracture, the swelling and deformation of the thigh were severe, the lower limbs were shortened, and there were obvious abnormal activities and bone rubbing when moving. Femoral shaft fracture is one of the most common fractures in the clinic, accounting for 6% of the total body fracture. The femur is the longest and largest bone in the human body and is one of the main weight-bearing bones of the lower limbs. If not treated properly, it will cause deformity and dysfunction of the lower limbs. The femoral shaft is the thickest tubular bone in the body and has the highest strength. Mostly due to high energy direct violence caused by fractures, but also caused by indirect violence. It is common for comminuted and transverse fractures.

Cause

The femoral shaft is the thickest tubular bone in the body and has the highest strength. Mostly due to high energy direct violence caused by fractures, but also caused by indirect violence. It is common for comminuted and transverse fractures. Traffic accidents are the main cause of injury, followed by industrial and agricultural trauma, life trauma and sports injuries. Fall fractures are mostly caused by indirect violence. Skew fractures or spiral fractures are common. Children with or without fractures may have incomplete or incomplete fractures. Direct violent blows or firearm injuries cause soft tissue damage around the fracture, bleeding, and the amount of internal bleeding in the closed fracture can reach 500 ~ 1000ml, and can be complicated by shock. If there is a combined injury to the head, chest, and abdomen and/or multiple fractures, shock is more likely to occur.

1. Upper 1/3 fracture of the femoral shaft: The proximal fracture piece is flexed, abducted, and externally rotated due to the traction of the iliopsoas, gluteus medius and external rotation. The distal fracture piece is adducted and displaced backwards and upwards due to the adductor muscle group, the quadriceps muscle group and the posterior muscle group.

2. 1/3 of the femoral shaft fracture: the proximal fracture piece is affected by part of the adductor muscle group at the same time. There is no special direction shift except for the flexion and external rotation. The distal fracture piece is pulled by the internal and external muscles. And there are often more obvious overlap shifts, and it is easy to form an angle outward.

3. The lower third of the femoral shaft fracture: the distal fracture piece is pulled obliquely by the gastrocnemius muscle, which can damage the blood vessels and nerves of the socket. Non-surgical treatment is difficult to reset and fix. The above displacement is not fixed, and the fracture piece can be displaced in various directions due to various external forces, muscle contraction, limb weight and handling. However, its inherent displacement mechanism has reference value for both the method of resetting and continuous traction therapy.

an examination

Related inspection

CT examination of bone and joint and soft tissue mammography mammography

In the history of trauma, the local swelling and deformation of the thighs are severe, the lower limbs are shortened, and there are obvious abnormal activities and bone rubs when moving. Blood pressure, pulse and respiration should be routinely measured to determine whether there is shock or other systemic complications and major organ injuries. At the same time, the color, temperature and flexion and extension of the toes should be carefully examined to determine if there are major blood vessels and/or nerves. damage. A small number of patients may have a femoral neck fracture or hip dislocation, and should not be missed during physical examination. X-ray positive lateral radiographs can identify the location, type and displacement characteristics of the fracture as a basis for treatment.

Differential diagnosis

Differential diagnosis of local swelling and deformation of the thigh:

1. Muscle soft tissue injury around the femoral shaft: mainly manifested as muscle traction injury, sprain, laceration, etc., local muscle swelling and tenderness, positive resistance test, limited lower limb activity, no longitudinal axis sputum pain, no bone Abnormal activity of rubbing or thighs.

2, femoral intertrochanteric fracture: this type of fracture is found in the femur size between the rotor, easy to identify.

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