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Abstract: Ms. Zhang, 45 years old, presented to our hospital with pain in her left wrist with impaired mobility due to a fall while walking. Combined with specialist as well as X-ray examination, it was determined that the patient had bone rubbing sensation, pressure pain, swelling, and displacement of the left radius, which was finally diagnosed as a left radial trunk fracture. The patient was given surgical treatment and medication. The patient recovered well after surgery with no special discomfort and the fracture end healed.
Basic information】Female, 45 years old
Type of disease】Radial trunk fracture
Hospital】The First Affiliated Hospital of Zhengzhou University
Date of consultation】March 2021
Treatment plan】Surgical treatment (incisional plate and screw internal fixation) + medication (Mizarin tablets, ibuprofen extended-release capsules)
Treatment period】7 days in hospital, regular review
Treatment effect] The condition was basically stable, no special discomfort, and the fracture end was healed.
I. Initial consultation
Patient Ms. Zhang, 45 years old, suffered from pain in her left wrist due to an accidental fall. She reported that when she was walking on the road five hours ago, she fell because the road surface was uneven and she did not step firmly at that time. When she fell, the patient landed on her left wrist and immediately felt pain and immobility in her left wrist. When asked about the patient’s other symptoms, no headache, dizziness, nausea or vomiting were observed. When asked about the patient’s past medical history, the patient replied that he was relatively healthy and had no past medical history. The patient was given a specialist examination, which showed pressure pain, swelling and bone rubbing sensation in the left forearm, immobility and good peripheral blood flow, and the preliminary diagnosis was fracture. The patient was given an X-ray examination, which showed a significant displacement of the left radius. The patient was informed that surgery was needed in this case, and the patient agreed and was admitted to the hospital.
II. Treatment history
Preoperatively, the patient was given skin preparation and immobilization of the left forearm to avoid more obvious fracture displacement, as well as anti-swelling and pain-relieving medications, including Mizarin tablets and ibuprofen extended-release capsules, to relieve the swelling and pain of the left arm. The patient was given preoperative tests such as routine blood tests and drug sensitivity tests, which met the criteria for preoperative examination and were not contraindicated for surgery.
The patient was returned to the ward after the operation and was fixed with a plaster cast to keep the left forearm in a functional position. The patient was discharged from the hospital 7 days after the operation, and the stitches were removed 2 weeks after the operation, and the patient was fixed with a tubular cast for 3-4 weeks.
III. Treatment effect
One day after surgery, the patient’s left arm pain was reduced, and he was in good spirits, and his diet was fine. Seven days after surgery, the patient’s left arm pain symptoms basically disappeared, and the patient’s spirit, diet and urine and stool were okay, so the patient was discharged from the hospital. Two weeks after the operation, the X-ray examination was repeated in the hospital, which showed that the displacement of the left radial trunk was restored, and the surgical incision was free of bleeding, oozing, redness and swelling, without signs of infection, and the incision healed well. After the removal of the stitches, the patient was replaced with a tubular cast and fixed again for 3-4 weeks, and the wound exudation and temperature changes were observed. One month after the operation, the patient came to the hospital for follow-up and showed that the fracture site was healed, and the cast was removed.
IV. Notes
I am sincerely happy for the patient when I saw that the operation went well and the postoperative recovery was good. However, since the fracture is not completely healed overnight, the patient needs to pay attention to the following points in daily life.
1. the patient needs to pay attention to moving the fingers during the period of cast fixation after discharge from the hospital to promote peripheral blood circulation and also to prevent joint stiffness.
2. Patients need to pay attention to more nutrition in their daily diet, and eat more eggs, milk, lean meat, nuts and other foods, which can supplement nutrients for the body to promote fracture healing.
3, after the patient is discharged from the hospital to remove the stitches, it is necessary to pay attention to observe whether there is blood oozing, abnormal body temperature and other changes in the wound. In case of abnormalities, patients need to go to the hospital actively to give appropriate treatment.
V. Personal insight
Radial trunk fracture is a more common type of fracture in trauma, which is caused by fall, pressure and other factors like the patient in this case, and often results in pain and immobility of the affected limb. If the fracture is not corrected in time, it may cause poor healing of the fractured end and affect the normal activities of the arm, which is not good for health. Take care to prevent falls, avoid injuries, and avoid external blows or forceful rotation of the forearm.