Radial neck fracture

　　Radial neck fracture is mainly caused by violence. When the carrying angle and the elbow joint are mostly in a natural hyperextension state, when falling and supporting the ground with the hand, the force is transmitted from far to near along the radius to the elbow. When it reaches the upper end of the radius, the radial head collides with the humeral head, causing fracture of the radial head, radial neck, or both. If the violence continues, there may also be fractures and dislocations of the olecranon of the ulna or the lateral epicondyle of the humerus.

　　Children due to the weakness of the proximal radius, violent force can cause separation of the capital ossicle or diaphyseal fracture, that is, radial neck fracture. If the violent force continues, the elbow joint will further be hyperextended, causing injury to the supporting structure of the medial collateral ligament of the elbow joint - medial collateral ligament injury or fracture of the radial tuberosity of the humerus; while in the extended elbow position, the olecranon of the ulna is tightly embedded in the olecranon fossa, which can cause olecranon fracture of the ulna; the pressure of the radial tuberosity on the ulna can lead to fractures of the upper segment of the ulna due to the influence of varus violence. The relationship between the radial nerve and the radial head is extremely close, so it is easy to be injured. The disease often complicates with fractures of the radial tuberosity of the humerus, olecranon of the ulna, and median nerve, ulnar nerve injury.

　　Radial neck fracture is not common, often associated with radial head fracture, and can also occur singly, mostly caused by external force. Common symptoms after fracture include:

　　1. PainRefers to the obvious pain, tenderness, and forearm rotation pain at the radial head.

　　2. Swelling:Less severe than general fractures and mostly limited to the radial head.

　　3. Limited rotational movementIn addition to the influence on the flexion and extension of the elbow joint, it is mainly manifested as a significant obstacle in the placement and movement of the forearm.

　　4. OtherAttention should be paid to whether there is a deep radial nerve injury.

　　Ensuring personal safety is the key to preventing this disease. One must pay attention to safety in production and life to avoid trauma. At the same time, attention should be paid to patients with elbow joint dislocation or fracture caused by traumatic factors, who should undergo X-ray examination to rule out the presence of this disease to avoid delaying treatment.

　　In addition to the history of trauma and clinical symptoms, radial neck fracture is mainly diagnosed and classified based on X-ray films. Analyzing the imaging findings, it is generally divided into the following four types.

　　1.无移位型Refers to the cracks and green branch fractures of the radial neck, this type is stable and generally does not require reduction. It is more common in children.

　　2.嵌顿型Refers to the distal end of the radius being embedded in the fracture, this type is also relatively stable.

　　3.歪戴帽型Refers to the fracture block of the radial head being obliquely tilted to one side after the radial neck fracture, resembling the posture of a person wearing a French hat.

　　4.粉碎型Refers to fractures of the radius, neck, and (or) head that are fragmented into three or more pieces.

　　X-ray film is the most basic X-ray examination method. In human body parts with good natural contrast, such as the chest and skeletal system, any abnormal density changes can be displayed on the film once they occur, and special examinations or contrast examinations are only supplemented when necessary. It is mainly used for the diagnosis of chest tumors, skeletal system tumors, digestive system tumors, urinary system tumors, intracranial tumors, and other conditions.

　　Issues to be aware of in diet for radial neck fracture:

　　1. Eat more fresh vegetables and fruits.

　　2. Eat more vegetables rich in vitamin C such as green peppers, tomatoes, amaranth, cabbage, radishes, etc., to promote the growth of calluses and the healing of wounds.

　　3. Supplement trace elements such as zinc, iron, and manganese. Animal liver, seafood, soybeans, sunflower seeds, and mushrooms contain more zinc; animal liver, eggs, beans, green leafy vegetables, and wheat flour contain more iron; oatmeal, turnips, yolks, and cheese contain more manganese.

　　4. Avoid blind supplementation of calcium. Increasing calcium intake does not accelerate the healing of broken bones, and for long-term bedridden fracture patients, there is a potential risk of increased blood calcium levels, accompanied by decreased blood phosphorus levels.

　　5. Avoid eating too much pork bone: Some people think that eating more pork bone 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 bone by fracture patients not only cannot promote early healing but can also delay the healing time of fractures.

　　6. Avoid eating yams, taros, glutinous rice, and other easily bloating or indigestible foods

　　8. Avoid not drinking water: Bedridden fracture patients have less activity and weakened intestinal peristalsis. If water intake is reduced, it is easy to cause constipation. Prolonged bed rest can also easily lead to urinary tract stones and urinary tract infections.

　　9. Avoid excessive consumption of sugar: After consuming a large amount of sugar, the body presents an acidic poisoning state. Alkaline calcium, magnesium, sodium ions, etc., will immediately be mobilized to participate in neutralization. Such a large consumption of calcium is not conducive to the recovery of fracture patients. At the same time, excessive sugar can also reduce the content of vitamin B1 in the body.

　　10. Avoid long-term use of Sanqi: In the early stage of radial neck fracture, taking Sanqi is beneficial for fracture healing. However, after the reduction of radial neck fracture for one week, if Sanqi is 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.

　　Classification and treatment of radial neck fractures:

　　1. For non-displaced and intrinsically displaced fractures: The upper limb cast or functional position of the cast is used to fix the elbow joint for 3 to 4 weeks.

　　2. For dislocations: First, apply manual reduction. Under local anesthesia, the surgeon places one thumb on the radial head and holds the patient's wrist with the other hand, performing rapid rotation movements inwards and outwards several times with slight traction. Generally, it can be reduced. For those with poor reduction, open reduction of the radial head can be performed, and internal fixation with screws may be necessary if needed. For those with unstable and comminuted fractures, radial head excision is required, but never excise the epiphysis in patients with epiphyseal injuries.