绿枝性骨折与GOLF
(2009-06-17 16:44:59)
标签:
golf技术体育 |
分类: 技术 |
The name for a greenstick fracture comes from the analogy of breaking a young, fresh tree branch. The broken branch snaps on one side (the outer side of the bend), while the inner side is bent, and still in continuity. Most often the greenstick fracture must be bent back into the proper position (called a "reduction") and then casted for about six weeks. Greenstick fractures can take a long time to heal because they tend to occur in the middle, slower growing parts of bone.
Practically, greenstick fractures are treated by correcting the
rotational and angular malalignment
simultaneously by reversing the mechanism of injury. Recurrence of
deformity can occur without
proper immobilization technique and the refracture rate after
greenstick fracture is higher than with
completely displace fractures. Complete shaft fractures can be
managed with cast immobilization
(Jones). Rotation of the distal fragment is matched to the
proximal; most will be in neutral position
or some supination. The radial bow should be restored. The cast
should be molded to widen the
interosseous space, and the ulnar border straight. Subsidence of
initial swelling often necessitates a
cast change. Casting in extension can sometimes maintain position
better than elbow flexion
(Shaer). Ten degrees (10() of angulation is acceptable at any age,
in children < 15-20 degrees is
acceptable. Proximal fractures seem to remodel less than distal
shaft fractures. A loss of 20-30
degrees of rotation does not impair function; loss of supination is
more problematic than loss of
pronation. Residual angulation of < 10 degrees does
not result in functional loss of motion at any
age. Children < 9 years of age can remodel up to 15
degrees of angulation, and 45 degrees of
angulation. (Noonan) However, factors other than angulation can
result in restriction of motion.