肱骨干骨折（Fracture of humeral shaft）.doc

肱骨干骨折（Fracture of humeral shaft） Anatomical Outline: the fracture of the 2 cm segment of the humerus under the surgical neck of the humerus from 1 to 2 cm is called a fracture of the humeral shaft. There is a radial nerve groove behind the 1 / 3 posterior segment of the humeral shaft, and the radial nerve released by the posterior bundle of the brachial plexus goes straight through the bone surface into the forearm, where the fracture of the radial nerve is easy to occur. The cause of injury may be the direct impact on the fracture site or the compression of the lateral intermuscular septum. Etiology and classification: fracture of the shaft of the humerus can be caused by direct or indirect violence. No matter where the fracture occurs, in the frail patient, fracture or displacement or rotation of the fracture end can be caused by the gravity of the limb or the weight of the wrong external fixator. The displacement direction of the 1 / 3 fracture of the humeral shaft is related to the direction of violence, the position of the forearm and elbow joint, and most of them have angulation, shortening and rotation deformity. The clinical manifestations and diagnosis: after the injury, arm pain, swelling, deformity, ecchymosis, upper limb movement disorder. The examination revealed that the motion of the joint, the sensation of bone friction, and the attenuation or disappearance of the bone conduction sound. X-ray can determine the type of fracture and the direction of displacement. If combined with radial nerve injury, the wrist may appear, the metacarpophalangeal joints of each finger can not be extended, the thumb can not extend, the forearm is supination, and the skin of the radial side of the dorsum of the hand feels diminished or disappeared. Treatment: most humeral shaft transverse or short oblique fracture can be treated by non-surgical method. (1) manual reduction and external fixation; 1. anesthesia: local anesthesia or brachial plexus block anesthesia. 2. posit