Double fractures of the radius and ulna shaft

　　Double fractures of the radius and ulna shaft can occur with lateral displacement, overlap, rotation, and angular deformities, making treatment relatively complex. What causes double fractures of the radius and ulna shaft? This condition is caused by hand injuries, and different types of violence can lead to different types of fractures:

　　1. Direct violence:Commonly seen in blows or machine injuries, the fracture is transverse or comminuted, and the fracture line is on the same plane.

　　2. Indirect violence:When falling, the palm lands, and the force is transmitted upwards to cause a fracture of the radius at the middle or upper 1/3. The remaining force is transmitted diagonally downwards through the interosseous membrane to the ulna, causing a fracture of the ulna. Therefore, the fracture line of the ulna is lower than that of the radius. The fractures of the radius are mostly transverse or serrated, and the ulna is mostly short oblique.

　　3. Twisting violence:When falling, the body leans to one side, and the forearm is subjected to the action of longitudinal conduction and rotational torsion force, resulting in spiral double fractures of the ulna and radius. The direction of the fracture line is consistent, and there are often ulnar oblique fractures to the radial bone below.

　　Double fractures of the ulna and radius bone are mainly caused by traumatic factors. In addition to preventing trauma, the key is to prevent the complications of the disease. What are the complications of double fractures of the ulna and radius bone? With this question in mind, let's take a look at the introduction below.

　　What are the complications of double fractures of the ulna and radius bone? The following is an introduction to the complications of double fractures of the ulna and radius bone:

　　1. Infection;

　　Mainly related to the long exposure time of the wound after injury, incomplete debridement, and severe soft tissue injury.

　　2. Non-union of fractures;

　　The anatomical relationship between the ulna and radius is complex. The lower 1/3 segment of the ulna and radius is mainly surrounded by tendons, with poor blood supply to the surrounding soft tissues. Both ends of the ulna and radius form joints. During pronation and supination movements, the two ends of the bone move consistently around the ulna axis, without bearing rotational force. However, the ends of the ulna can twist relative to each other, affecting the healing of the fracture.粉碎性骨折 bone defects, severe soft tissue injury around the fracture; microvascular embolism of the periosteum, leading to periosteal necrosis and affecting ossification; improper methods and materials for internal fixation.

　　3. Forearm compartment syndrome;

　　Mostly due to severe soft tissue injury, improper manipulation during manual reduction,粗暴 surgery during open reduction, and failure to promptly and actively take various measures to reduce swelling and stop bleeding, causing the pressure within the muscle interval to continuously increase, as well as the tightness of splints and plaster during external fixation.

　　4. Limited rotation function of the forearm;

　　Commonly occur in patients with closed reduction, where the fracture ends have not reached anatomical reduction, cross-healing, or bridge connections between the two bones. The important reasons also include the contraction of the interosseous membrane, adhesion of soft tissue scars, and the contraction of the superior and inferior joint capsules.

　　5. Decubitus ulcers;

　　Mostly occur after closed reduction and reduction fractures, due to the shaping of plaster or the compression of bone separation pads. Local edema and poor skin blood supply are also important reasons.

　　Double fractures of the ulna and radius are the second most common in forearm fractures,仅次于桡骨远端骨折, and can occur with lateral displacement, overlap, rotation, and angular deformities, making treatment more complex.

　　Double fractures of the ulna and radius are the second most common in forearm fractures,仅次于桡骨远端骨折, and can occur with lateral displacement, overlap, rotation, and angular deformities, making treatment more complex.

　　The causes of double fractures of the ulna and radius bone are mainly due to hand trauma. Patients with this disease mainly present with local swelling, deformity, and tenderness. There may be crepitus and abnormal movement, with limited forearm movement. Children often have greenstick fractures, with angular deformities but no displacement of the bone ends. Sometimes, there are injuries to the median nerve or ulnar nerve, and the radial nerve, and attention should be paid to examination.

　　Double fractures of the ulna and radius mainly occur due to traumatic factors. In addition to preventing trauma, the key is to prevent complications of the disease, which can include the following preventive measures:

　　(1) The reduction should be accurate and strive to achieve anatomical reduction;

　　(2) Emphasis is placed on the timely and thorough application of antibiotics before and during surgery;

　　(3) Grasp the indications for surgery;

　　(4) Select internal fixation materials according to the principles of fracture fixation. The length of the steel plate should be greater than 5 times the diameter of the shaft, and the length of the intramedullary nail should exceed 8-10cm from the fracture end to achieve relatively firm fixation;

　　(5) When there is bone defect, try to transplant autologous cancellous bone;

　　(6) The best position for external fixation is to rotate the forearm 20 degrees posteriorly before fixation, so that the interosseous membrane is tense to prevent contraction, and the fixation is most stable. The function of the joint posterior rotation is also the best;

　　(7) During the operation, the operation should be gentle, and the stripping of the periosteum should be minimized;

　　(8) After the operation, elevate the affected limb appropriately and use diuretics reasonably to reduce swelling, and use antibiotics to prevent infection.

　　Double fractures of the ulna and radius are the second most common in forearm fractures,仅次于桡骨远端骨折, and can occur with lateral displacement, overlap, rotation, and angular deformities, making treatment more complex.

　　In terms of diagnosis, the disease can be initially diagnosed based on its history of trauma and clinical manifestations, but some auxiliary examination methods should still be used to help further diagnosis. X-ray films can clearly identify the type and displacement of the fracture. The photograph should include the elbow and wrist joints to understand whether there is rotational displacement and dislocation of the proximal and distal radioulnar joints.

　　Double fractures of the ulna and radius are second only to distal radius fractures, which can occur with lateral displacement, overlap, rotation, and angular deformity, and the treatment is relatively complex. The treatment of double fractures of the ulna and radius requires a high degree of reduction, and the four types of deformities, including rotation, angular, lateral, and overlap, must be corrected, and the position after reduction must be maintained until healing, striving to restore the rotational function of the forearm. In addition to timely treatment, diet also plays a crucial role, so patients with double fractures of the ulna and radius should pay attention to the following aspects in their diet.

　　(1) Avoid blindly supplementing calcium

　　Calcium is an important raw material for bone formation. Some people think that supplementing more calcium after a fracture can accelerate the healing of broken bones. However, scientific research has found that increasing the intake of calcium does not accelerate the healing of broken bones, and for patients with long-term bed rest due to fractures, there is a potential risk of increased blood calcium levels, accompanied by decreased blood phosphorus levels. This is due to the fact that long-term bed rest, on the one hand, inhibits the absorption and utilization of calcium, and on the other hand, the reabsorption of calcium by the renal tubules increases. Therefore, for patients with fractures, the body does not lack calcium. As long as the functional exercise is strengthened and the activity is started as soon as possible according to the condition and the doctor's instructions, it can promote the absorption and utilization of calcium by the bone, accelerate the healing of broken bones.

　　Especially for patients who are bedridden after a fracture, blindly supplementing calcium is of no benefit and may even be harmful.

　　(2) Avoid eating too many meat bones

　　Some people believe that eating more meat bones after a fracture can promote early healing. However, this is not the case. Modern medicine has proven through multiple practices that eating more meat bones after a fracture not only does not promote early healing but may even delay the healing time of the fracture. 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 perform their functions under the condition of increasing bone collagen. The main components of meat bones are phosphorus and calcium. If a large amount of meat bones is consumed after a fracture, it will promote an increase in the inorganic component of the bone, causing a disorder in the proportion of organic matter in the bone, thus hindering the early healing of the fracture. However, fresh meat bone soup tastes delicious and has a stimulating effect on appetite, so eating a little is harmless.

　　Double fractures of the ulna and radius are the second most common in forearm fractures,仅次于桡骨远端骨折, and can occur with lateral displacement, overlap, rotation, and angular deformities, making treatment more complex.

　　The focus of treatment for this disease is reduction. There are two different situations:

　　1. Reduction is relatively difficult, with high requirements, and easy to dislocate after reduction.

　　(1) Most children with greenstick fractures have angular deformities. They can be corrected by gentle traction under appropriate anesthesia. Fix with cast for 6-8 weeks.石膏楔型切开法 can also be used to correct angular deformities.

　　(2) For displaced fractures, correct overlap and angular deformities by longitudinal traction first, and continue traction. If it is an upper one-third fracture (above the insertion point of the pronator teres), the forearm should be placed in supination; for middle and lower one-third fractures (below the insertion point of the pronator teres), the forearm should be placed in a neutral rotation position. To correct rotational deformities. Then, compress and separate the bones at the fracture site to restore the tension and normal space of the interosseous membrane. Finally, align the fracture ends completely. After reduction, fix with a long arm cast for 8-12 weeks. Cut and release immediately after the cast is formed. Pay attention to the blood circulation at the extremities during fixation to prevent ischemic contracture. After swelling subsides, adjust the tightness of the external fixation in a timely manner. Pay attention to observe and correct the recurrence of fracture displacement.

　　2. Open Reduction and Internal Fixation

　　Applicable to those with failed reduction or difficulty in fixation after reduction, multiple fractures of the upper limb. Fractures with interosseous membrane rupture; open fractures. Not long after the injury. Mildly contaminated; nonunion or malunion. Functional limitation.