Radial neck fracture and radial head epiphysis separation

　　Radial neck fracture and radial head epiphysis separation are mostly caused by transmitted violence.

　　When falling, the elbow joint is flexed and the forearm is in supination. The force from below upward and from above downward is transmitted to the elbow, causing the humeral head and radial head to collide with each other and produce a shearing force from the inside and posterior to the outside, leading to radial head epiphysis separation. The epiphysis often has a triangular bone fragment separated or displaced with the periosteum connected on the lateral side.

　　The occurrence of radial neck fracture and radial head epiphysis separation is often associated with a history of trauma, localized tenderness in the lateral elbow, swelling, and limited dysfunction. X-ray can show radial neck fracture or radial head epiphysis separation. The common complications include:

　　1. Fusion of the upper radioulnar joint

　　It may be due to severe primary injury or the occurrence after radial head resection. The site of fusion is often near the upper radioulnar joint.

　　2. Early closure of the radial upper end epiphysis

　　After injury, closed reduction or open reduction can cause radial proximal epiphysis closure. In mild cases, the elbow carrying angle may slightly increase, and in severe cases, severe elbow varus may occur.

　　3. Subscapularis dislocation

　　It is a complication after radial head resection, with the radial bone upward displacement of 3 to 5mm, but most of them are asymptomatic and do not require special treatment.

　　4. Enlargement of the radial head and thickening of the neck

　　It is relatively common. Especially in cases with obvious lateral displacement, but it has no significant impact on future function.

　　The symptoms of radial neck fracture and radial head epiphysis separation include pain in the elbow, swelling, and dysfunction. Tenderness is localized to the lateral side. X-ray films show radial neck fracture or radial head epiphysis separation, which presents as a 'tilted hat' shape, at an angle of 30° to 60° with the longitudinal axis of the radial shaft, and in severe cases, up to 90°.

　　Radial neck fracture and radial head osteochondral separation are mostly caused by indirect or direct sudden violence. To prevent this kind of fracture, attention should be paid to the following aspects:

　　1. Develop good living habits

　　People with bad habits such as long-term smoking, excessive drinking, less movement and more sitting, and low calcium diet are prone to osteoporosis in old age. Therefore, it is necessary to quit smoking, reduce alcohol intake, avoid strong tea, and not eat too much high-protein food.

　　2. Encourage more activity

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

　　3. Home safety

　　Seventy-five percent of falls occur at home, especially in places like the bathroom and kitchen. Providing a safe home environment is very important for reducing the occurrence of fractures.

　　Radial neck fracture and radial head osteochondral separation require X-ray examination. X-ray films show radial neck fracture or radial head osteochondral separation, which presents as a "crooked hat" shape. The angle between the longitudinal axis of the radial shaft and the radial neck is 30° to 60°, and in some cases, up to 90°.

　　To ensure that the fractured bone heals as soon as possible after the fracture of the radial neck, it is first necessary to ensure the necessary nutrients for the growth of the broken bone in the diet. The requirements for diet at different stages after the fracture of the radial neck are different. What should be paid attention to in the diet after the operation of the radial neck fracture?

　　Early stage (1-2 weeks)

　　The injured area is bruised and swollen, the meridians are blocked, and the Qi and blood are stagnant. The treatment during this period focuses on promoting blood circulation and removing blood stasis, and on promoting Qi and dispersing stagnation. Traditional Chinese medicine believes that "if the blood stasis does not disappear, the bones cannot grow" and "if the blood stasis is removed, new bones will grow". It can be seen that removing swelling and blood stasis is the primary task for the healing of fractures. The early stage of fracture is mostly during the immobilization period. At this time, it is necessary to avoid eating greasy bone soup and a large amount of meat that is difficult to digest, as well as excessive calcium intake. The diet should be easy to digest and absorb, and tonifying should be delayed until the middle and late stages of the fracture to play a nourishing role. The principle of diet during the early stage of fracture should be light, such as vegetables, eggs, soy products, fruits, fish soup, lean meat, etc. It is forbidden to eat sour and spicy, dry and hot, and greasy foods, especially not to take greasy and nourishing foods such as bone soup, fatty chicken, and braised water fish too early, otherwise blood stasis will accumulate and it will 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. At this stage, food therapy can use Sanqi (Panax notoginseng) 10 grams, Danggui (Angelica sinensis) 10 grams, a pigeon, and all are cooked until soft, and the soup and meat are taken together, once a day, for 7-10 days. In the early stage of fracture, due to less movement and worry, Qi stagnation occurs, and there is often constipation. Bedridden patients are more prone to this. It is forbidden to eat foods that are easy to cause bloating or difficult to digest, such as taro, yam, glutinous rice, etc., and it is recommended to eat more vegetables rich in fiber and consume foods such as bananas and honey to promote defecation. If necessary, take laxative drugs such as 6-9 grams of Maren Wan (Pericarpium Citri Reticulatae) once or twice a day. Bedridden patients are prone to urinary tract infections and urinary tract stones, and it is recommended to drink more water for diuresis.

　　Mid stage (2-4 weeks)

　　Most of the ecchymosis is absorbed, and the treatment during this period focuses on harmonizing the营, alleviating pain, removing blood stasis and promoting new growth, and promoting bone union and tendons. At this time, the callus begins to grow, and after a period of bed rest, the body is in a high metabolic state, with significant loss of potassium, calcium, and other minerals. In terms of diet, it should gradually shift from light to moderate high-nutrition supplementation, actively intake vitamins, calcium, potassium, zinc, and other trace elements to meet the needs of callus growth. Initial diet can be supplemented with bone soup, Tianqi Stewed Chicken, animal liver, etc., to provide more vitamin A, D, calcium, and protein.食疗 can use 10 grams of Angelica sinensis, 15 grams of Lycium barbarum, 15 grams of Fructus fragrantosae, 10 grams of 续断, 250 grams of fresh pork rib or beef rib, cooked for more than 1 hour, eating soup and meat together, for 2 weeks.

　　Late stage (more than 5 weeks)

　　After 5 weeks of injury, the ecchymosis at the fracture site is basically absorbed, and callus formation has begun, which is the late stage of fracture. Treatment should focus on tonifying the liver and kidneys, promoting Qi and blood, to enhance the formation of more solid callus, and to relax the tendons and meridians, so that the adjacent joints of the fracture site can move freely and flexibly, restoring their previous function. In terms of diet, restrictions can be lifted, and the diet can be supplemented with old hen soup, pork bone soup, lamb bone soup, deer tendons soup, braised water fish, etc. Those who can drink can choose Du Zhong Bone Break Supplement Wine, Chicken Spleen藤 Wine, Tiger Bone Papaya Wine, etc.食疗 can use 10 grams of Lycium barbarum, 15 grams of Fructus fragrantosae, 10 grams of续断, 50 grams of Coix seed. First decoct Fructus fragrantosae and 续断 to remove the dregs, then add the remaining two ingredients to cook porridge for eating. Take once a day, 7 days as a course of treatment. The interval between each course of treatment is 3-5 days, and 3-4 courses can be used.