Radial Condyle Fracture

　　Most humeral condyle fractures are caused by indirect violence, where the hand is the first to land when falling, and the external force collides with the humeral condyle along the radius, causing a fracture. The fracture line extends from the inner lower part to the outer upper and posterior, and the fracture fragment may include the distal humerus epiphysis, the humeral trochlea epiphysis, the lateral part of the trochlea, and a part of the diaphysis above the humeral trochlea. According to the condition of the fracture fragment displacement, it can be divided into non-displaced fractures, mildly displaced fractures, and transfer-dislocation fractures.

　　1, Non-displaced fractures

　　The effect of the violence is small, only causing a fracture, such as a crack fracture or a very slightly displaced humeral condyle fracture.

　　2, Mildly displaced fractures

　　The fracture fragment moves outward, or has a rotational displacement of 45 degrees or less, while the fracture fragment is still between the humeral trochlea and the proximal humerus fracture surface.

　　3, Transfer-dislocation fractures

　　Transfer-dislocation fractures can be divided into posterior transfer-dislocation type and anterior transfer-dislocation type. The posterior transfer-dislocation type is also known as the extension transfer-dislocation type, which is relatively common. The anterior transfer-dislocation type is also known as the flexion transfer-dislocation type, which is rare.

　　Most humeral condyle fractures are caused by indirect violence, and humeral condyle fractures belong to intra-articular fractures, which may be complicated with the following diseases:

　　One, elbow varus deformity:Damage to the distal radial epiphysis cartilage plate after the injury can lead to early closure, causing the unequal development of the distal humerus and resulting in elbow varus, with the distal humerus showing a fish-tail deformity.

　　Two, ulnar neuritis or palsy:Either due to the traction of the varus deformity of the elbow or the impact of the olecranon of the ulna on the ulnar nerve, both can lead to ulnar neuritis.

　　Three, non-union of fractures:The factors for non-union of fractures are the formation of local fibrous adhesions after the fracture is re-displaced. Therefore, if there is a re-displacement within two weeks after the fracture, surgical reduction should be performed immediately, and it should not be delayed until the bone does not unite, in order to avoid difficulties in surgery and postoperative functional disabilities.

　　Four, delayed cubital neuritis:Cubital nerve palsy often occurs secondary to elbow varus, caused by long-term traction and stimulation of the cubital nerve. In addition to correcting the varus deformity, cubital nerve anterior transfer surgery should be performed when cubital nerve stimulation signs appear.

　　Common symptoms after the fracture of the humeral condyle include swelling of the lateral elbow joint, which gradually spreads and can affect the entire joint. The swelling in the fracture-dislocation type is the most severe. Bruises may appear on the lateral elbow, which can gradually spread to the wrist. Blisters may appear on the skin 2 to 3 days after the injury. There may be significant tenderness on the lateral elbow, even pain around the distal humerus. Displaced fractures may cause the feeling of bone grinding and movable bone fragments. Elbow varus deformity may occur, with the elbow broadening, the three points behind the elbow changing, and the loss of elbow joint movement. Pain may worsen during passive movement, while rotational function is generally not limited.

　　The main way to prevent humeral condyle fracture is to prevent elbow trauma, especially to prevent falls, collisions, traffic accidents, and other injuries.

　　Attention should be paid to not working too hard, not carrying heavy objects for a long time, not washing too many clothes at one time, and preventing the injury of the humeral epicondyle fascia, and paying attention to physical exercise in daily life, actively moving the upper limb joints, and strengthening muscle strength, which helps prevent the occurrence of this disease.

　　There is also the nursing care for the middle and late stages after a fracture, which can effectively relieve shoulder joint adhesions and increase the range of motion of the shoulder joint through some tendinous manipulation and functional exercise in traditional Chinese medicine, and achieve satisfactory therapeutic effects on the rehabilitation of shoulder joint function after humeral surgical neck fracture, and improve the quality of life of patients.

　　The auxiliary examination methods for humeral condyle fracture mainly include:

　　X-ray examination shows that the fracture line of the humeral head often exceeds 1/2 of the ossification nucleus, or does not pass through the ossification nucleus of the head, but passes through the cartilage between the humeral head and the articular groove at the diaphyseal end, resulting in a fracture line. The fracture fragments can dislocate to the lateral side. In the case of fracture dislocation X-ray films, the anteroposterior view shows that the fracture fragments along with the ulna and radius can dislocate to the radial or ulnar side, and the lateral view shows that they can dislocate to the posterior side, and occasionally there may be forward displacement. The humeral condyle fracture is manifested in various ways on X-ray films, and the manifestations are often different in the same type of fracture.

　　Humeral condyle fracture is caused by traumatic factors. Paying attention to safety in production and life and avoiding injury is the key. Below, let's introduce which dietary habits can affect the healing of a fracture:

　　First, taboo on eating too many meat bones:Eating more meat bones by fracture patients will not only not promote early healing but may also delay the healing time of the fracture.

　　Second, taboo on partial diet:The key to ensuring the smooth healing of a fracture is nutrition.

　　Third, taboo on indigestible foods:Due to the restricted activity caused by the fixation of plaster or splints, and the swelling and pain at the injury site, as well as mental distress, the appetite of fracture patients is often poor, and constipation may occur occasionally.

　　Fourth, taboo on overeating sugar:After consuming a large amount of sugar, a rapid metabolism of glucose will occur, thus producing intermediate metabolic substances such as pyruvate and lactic acid, causing the body to be in an acidic poisoning state.

　　Fifth, taboo on long-term use of Sanqi tablets:Taking Sanqi tablets in the early stage of a fracture can constrict local blood vessels, shorten the coagulation time, and increase thrombin, which is very appropriate. However, after one week of fracture reduction, if Sanqi tablets are continued to be taken, the local blood vessels are in a state of constriction, and blood circulation is not smooth, which is unfavorable for fracture healing.

　　Sixth, taboo on drinking fruit juice after a fracture:The raw material of fruit juice is made by mixing sugar water, flavoring, pigments, and other ingredients. It does not contain the vitamins and minerals required by the human body. Due to its high sugar content, it presents a physiological acidic state in the body after consumption.

　　Humerus epicondylar fracture is a joint intra-articular fracture and an epiphyseal fracture, the fracture line passes through the epiphysis. Whether the reduction is satisfactory or not directly affects the integrity of the joint and the size of the bone bridge formed at the epiphysis and the degree of deformity. Therefore, regardless of the method adopted, it is required to achieve anatomical reduction or approximate anatomical reduction to avoid serious sequelae. The treatment methods for each type of fracture are as follows.

　　1. Fracture without Displacement

　　The elbow is flexed to 90°, and the forearm is supinated, fixed with a plaster splint for 4 weeks.

　　2. Lateral Displacement Type

　　Closed reduction should be performed. The elbow is extended and internally rotated, the lateral space is increased, the forearm is supinated, and the wrist is extended to relax the extensor muscles. Use the thumb to push the fracture fragment, if the fracture fragment moves outward and backward, the thumb pushes the bone fragment forward and inward to achieve reduction. Once confirmed by X-ray examination that the reduction is successful, a long arm posterior plaster splint or splint can be used to fix for 4 to 6 weeks, the fixation time depends on the stability after reduction, and the elbow can be extended or flexed and the forearm is supinated. This type of fracture is an unstable fracture. If the reduction fails or the reduction fails to achieve reduction after re-displacement, open reduction and internal fixation with 2 Kirschner wires should be performed.

　　3. Rotational Displacement Type, Fracture Dislocation Type

　　Closed reduction should be used. It is necessary to combine X-ray films to identify the position of the fracture fragments, so that the elbow joint is in an internal rotation and the forearm is supinated position. Use fingers to correct the rotated displacement of the fracture first, and then push it into the joint to achieve reduction. For those with lateral or posterior elbow joint dislocation, reduction should be performed simultaneously. Or first push the fracture fragment to the back of the elbow, then correct the rotation and push it into the joint to achieve reduction, the method and time of fixation are the same as those with lateral displacement. For those who fail to achieve closed reduction, open reduction should be performed to correct the rotational displacement of the fracture fragments. It may be necessary to preserve the soft tissue attached to the fracture fragment to prevent ischemic necrosis. Fixed with 2 Kirschner wires, the elbow joint is fixed with a plaster splint for 4 to 6 weeks after the operation, the steel needle is removed, the external fixation is removed, and the elbow joint is started to move.

　　4. Old Fractures

　　Generally, surgery is not recommended. For fractures with obvious displacement and non-union within 3 months, open reduction and internal fixation treatment should be adopted. As long as the reduction during the operation is satisfactory and the internal fixation is firm, and the patient actively exercises the function after the operation, the vast majority of patients can still achieve good results. Even if the elbow joint is stiff before the operation, some functional improvement can still be obtained after the operation.