Simple fracture

Introduction Simple fracture is a type of fracture of the forearm ulna and radius. Most of the violent effects on the forearm, mostly due to falls, hand landing, violent transmission to the humerus, and conduction to the ulna through the interosseous membrane, resulting in double fracture of the radius and ulna. Most of the fracture lines were oblique or short-slanted, with short overlap and displacement, and severe damage to the interstitial membrane. The fracture level was mostly higher than the ulna. Most of them are transverse, butterfly or comminuted fractures, often combined with elbow and humeral injuries, soft tissue damage is very serious.

Cause

The trauma mechanism is:

(1) Direct violence acts on the forearm, causing double fractures of the ulna and radius. The fracture lines are mostly in the same plane, mostly transverse, butterfly or comminuted fractures.

(2) Indirect violence on the forearm, mostly due to falls, hand landing, violence transmitted to the humerus, and conduction to the ulna through the interosseous membrane, resulting in double fracture of the radius and ulna. Most of the fracture lines were oblique or short-slanted, with short overlap and displacement, and severe damage to the interstitial membrane. The fracture level was mostly higher than the ulna.

(3) Reversing the violence, mostly for the forearm involved in the rotation of the machine, most of the fractures of the radius and ulna, often combined with elbow and humeral injuries, soft tissue damage is very serious.

an examination

Related inspection

Bone and joint soft tissue CT examination bone imaging

1. History: There is a clear history of trauma.

2. Signs:

(1) Malformation: The displacement of the fracture segment can change the shape of the affected limb, mainly showing shortening, angulation or rotation.

(2) Abnormal activity: In normal conditions, the part of the limb cannot move, and abnormal activity occurs after the fracture.

(3) Bone rubbing or bone rubbing: After the fracture, when the two fracture ends rub against each other, bone squeak or bone rubbing may be generated.

3. X-ray examination: visible fracture line.

4. Some joints can be examined by CT.

Differential diagnosis

Differential diagnosis of simple fractures:

(1) supracondylar fracture of the humerus: caused by indirect violence, fractures such as no displacement, more elbow pain, swelling, local tenderness, elbow joint dysfunction. When there is a displaced fracture, local pain and swelling are more obvious, and abnormal activities occur, and bone rubbing can be heard. Straight fractures often have a semi-extension in the elbow, protruding behind the elbow, and a shoe-elbow deformity. The proximal end of the fracture can be reached in front of the elbow. In patients with vascular injury (compression or irritation), the skin color of the hands may become pale or dark, the temperature becomes cold, the skin feels diminished, and the fingers or wrists are dysfunctional. The earliest and most common symptom is severe pain caused by passive stretching. In this case, X-ray films should be taken in time to confirm the diagnosis.

(2) External humeral fractures: After the fracture, there is rapid swelling, pain and limited activity on the lateral side of the joint, and sometimes the active bone can be touched. The elbow joint is semi-flexed and the pain is aggravated during exercise. X-ray film can be clearly diagnosed.

(3) , ulnar and dry fractures: also known as the hand bones or the forearm double fracture. Direct or indirect violence can cause fractures of the ankle and ulna, and the fractures occur mostly in the middle third and lower third of the forearm. Local pain and swelling after sacral and ulnar fractures, loss of forearm activity, and increased pain. Complete fracture with displacement, visible shortening, angulation or rotational deformity of the forearm, bone rubbing, loss of forearm rotation. Open fractures can be seen at the fracture end of the skin, the wound is generally small, and the exposed fracture end can sometimes be returned to the wound.

(4) Lower humerus fracture: The lower end of the humerus fracture refers to various fractures within 3 cm of the distal tibia. Direct and indirect violence can cause fractures of the lower end of the humerus, but indirect violence is the most common. After the fracture of the lower end of the humerus, there is obvious swelling and pain above the wrist joint. The lower end of the humerus has obvious tenderness. There is longitudinal slap pain. The pain is aggravated when the fingers make a fist movement. The wrist joint function is partially or completely lost. There are often typical deformities in the displaced fracture. If the displacement is obvious, the side of the hand can be seen as a "meal fork"-like deformity, and the front view can be a "gun-piercing"-like deformity. Wrist joint and finger flexion and flexion function are often affected to varying degrees, and some cases show severe comminuted fractures.

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