Humeral Condyle Fracture

　　Supracondylar humerus fractures are mostly caused by indirect violence. Supracondylar humerus fractures often occur in sports injuries, life injuries, and traffic accidents. Fractures are usually divided into extension and flexion types, and extension types are further divided into extension ulnar deviation and extension radial deviation types according to the situation of fracture displacement.

　　Supracondylar humerus fractures are a serious disease, usually caused by improper exercise. There are many symptoms caused by supracondylar humerus fractures, and the main complications include the following points:

　　1. Volkmann's ischemic contracture

　　It is a common and serious complication of supracondylar humerus fractures. The early symptoms include severe pain, disappearance or weakening of the radial artery pulse, poor peripheral circulation, pale and cold skin of the hand, severe pain when the fingers are passively extended and flexed, etc. The elbow should be extended immediately, the fixation and dressing should be loosened, and if there is no improvement in blood circulation after a short period of observation, the radial artery should be explored promptly. Constricted arteries can be treated with warm saline compresses, and the artery can be anesthetized with procaine. If there is actual vascular injury, surgical repair should be performed. In cases where the swelling of the forearm worsens and the intramuscular compartment pressure is high, the fasciotomy should be opened to relieve the intramuscular compartment pressure.

　　2. Elbow varus

　　It is a common late malformation of supracondylar fractures, with an incidence rate of 30%. One week after the reduction of the fracture, take an anteroposterior X-ray film to predict whether elbow varus will occur based on the distribution of callus around the fracture end. If it is predicted that elbow varus will occur, the bone should be gently corrected under sufficient anesthesia and fixed in extension. Elbow varus deformity does not affect the extension and flexion of the elbow joint, but affects appearance and patient psychology. If the deformity exceeds 20°, and the deformity is stable 1-2 years after the injury, supracondylar humerus lateral wedge osteotomy can be performed to correct the deformity.

　　3. Elbow varus

　　Elbow varus is rare and can be seen in cases of poor reduction of humeral epicondylar fractures. In severe cases, it can cause ulnar neuritis, and early nerve advancement or osteotomy correction should be performed.

　　4. Nerve injury

　　Median nerve injury is more common, while radial nerve and ulnar nerve injuries are rare, mainly due to local compression, traction, or contusion, with few cases of rupture. With most fractures, recovery can occur spontaneously within a few weeks after the injury. If there is no recovery after 8 weeks, consider surgical exploration and appropriate treatment.

　　5. Ossifying myositis

　　During the functional recovery period, strong passive extension and flexion of the elbow joint can lead to the formation of a large number of ossification blocks around the joint, causing the joint to swell again and the active flexion and extension activities to gradually decrease. In such cases, the joint should be immobilized for several weeks, and then the active flexion and extension activities of the joint should be restarted. It is rarely necessary to surgically remove hyperplastic osseous tissue in children.

　　Fractures of the supracondylar humerus can cause severe injury to patients, and for this reason, we need to identify them in a timely manner. The symptoms are relatively obvious and easy to identify, and there are generally the following manifestations:

　　1, Swelling, tenderness, and functional impairment of the elbow.

　　2, Abnormal movement and bone grinding sound locally.

　　3, Bruising or compression of the brachial artery can cause vascular spasm, pain, or disappearance of the pulse of the radial artery, pale skin on the hand, feeling cold and numb. Injury to the median nerve can cause dysfunction of the thumb opposition and sensory reduction or loss in the radial three and a half fingers.

　　Supracondylar fractures of the humerus are mostly caused by improper exercise or trauma in patients. Taking the following preventive measures can effectively alleviate the occurrence of fractures.

　　1, Pay attention to diet

　　Ensure normal diet, ensure sufficient nutrition intake by the body, ensure the development of bones, which can reduce the occurrence of fractures.

　　2, Wearing external protective devices

　　Recent reports show that joint protectors worn externally can effectively reduce the chance of accidental fractures. This also belongs to the preventive measures for fractures.

　　3, Moderate exercise

　　Moderate exercise can not only strengthen bone strength but also maintain muscle strength and good balance, reducing the chance of falling. This is also one of the preventive methods for fractures.

　　When a supracondylar fracture of the humerus occurs, it is necessary to send the patient to the hospital for diagnosis and treatment in a timely manner. The hospital usually adopts the following examination measures to confirm the disease:

　　1, X-rays can clearly define the type of fracture.

　　2, Laboratory tests show an increase in white blood cells and neutrophils.

　　The degree of recovery from the supracondylar fracture of the humerus largely depends on the subsequent dietary care. To achieve a better recovery from the disease, it is recommended that patients pay attention to the following taboos.

　　1Early avoidance of sour, spicy, dry, and hot foods

　　It is not advisable to consume rich and nourishing foods too early, such as bone soup, fatty chickens, and stewed fish, otherwise, blood stasis will accumulate and be difficult to disperse, which will inevitably delay the course of the disease, slow down the growth of callus, and affect the recovery of joint function in the future.

　　Avoid eating too many pork bones

　　Some people believe that eating more pork bones after a fracture can promote early healing. In fact, this is not the case. Modern medicine has proven through multiple practices that eating more pork bones by fracture patients not only cannot promote early healing but may also delay the healing time of fractures. The reason for this is that the regeneration of bone after injury mainly relies on the functions of the periosteum and bone marrow, and the periosteum and bone marrow can only better exert their functions under the condition of increasing bone collagen. The main components of pork bones are phosphorus and calcium. If a large amount of them is consumed after a fracture, it will promote an increase in inorganic components within the bone, leading to a disorder in the proportion of organic matter within the bone. Therefore, it will hinder the early healing of fractures. However, the fresh pork bone soup tastes delicious and has a stimulating effect on appetite, so eating a little is harmless.

　　Avoid faddy eating habits

　　Fracture patients often have local edema, congestion, hemorrhage, and muscle tissue injury, and the body itself has resistance and repair capabilities for these conditions. The raw materials for the repair of tissues, the growth of muscle tissue in long bones, the formation of callus, and the removal of blood stasis and swelling rely on various nutrients. Therefore, it can be known that the key to the smooth healing of fractures is nutrition.

　　4. Avoid Indigestible Foods

　　Due to the restriction of movement caused by the fixation of plaster or splint, and the swelling and pain at the injury site, as well as mental anxiety, the appetite of fracture patients is often poor, and constipation may occur occasionally.

　　5. Avoid Excessive Sugar Intake

　　After consuming a large amount of sugar, glucose metabolism will be rapid, resulting in intermediate metabolic substances such as pyruvate and lactic acid, causing the body to be in an acidic poisoning state. At this time, alkaline calcium, magnesium, sodium ions, etc., will be immediately mobilized to participate in neutralization to prevent the blood from becoming acidic. Such a large consumption of calcium is not conducive to the recovery of fracture patients. At the same time, excessive sugar intake will also reduce the content of vitamin B1 in the body. Vitamin B1 is an essential substance for the conversion of sugar into energy in the body. Insufficient vitamin B1 greatly reduces the activity of nerves and muscles and also affects the recovery of function. Therefore, fracture patients should avoid eating excessive sugar.

　　6. Avoid Long-term Use of Sanqi Tablets

　　In the early stage of fracture, local internal hemorrhage occurs, blood stasis, swelling, and pain appear. At this time, taking Sanqi tablets can constrict local blood vessels, shorten the coagulation time, increase thrombin, which is very appropriate. However, after one week of fracture reduction, bleeding has stopped, and the damaged tissue begins to repair. Repair requires a large amount of blood supply. If Sanqi tablets are continued to be taken, the local blood vessels are in a state of constriction, blood circulation is not smooth, which is unfavorable for fracture healing.

　　Fracture of the humeral condyle is a relatively uncommon type of fracture disease with severe consequences. The treatment of humeral condyle fracture should be tailored to the condition and different treatment methods should be adopted. The specific classification methods are as follows:

　　1. Green Branch Fracture

　　If there is no displacement at the fracture end, and the anterior tilt angle disappears, no reduction is needed; if the anterior tilt angle increases, gentle manipulation reduction under brachial plexus or general anesthesia, and long arm cast fixation in the functional position for 3-4 weeks.

　　2. Fractures with Displacement

　　Manipulated reduction under brachial plexus or general anesthesia, long arm cast fixation for 4-6 weeks.

　　3. Traction Treatment

　　Applicable to fractures more than 24-48 hours, severe soft tissue swelling, with blisters formed, unable to be manipulated into position, or unstable after reduction.