Fracture of collarbone: types, treatment and consequences of fracture
Fractures of the clavicle are common in traumatologic practice quite often, according to various data they are about 2.5-15% of all fractures of the skeleton.Such an injury occurs when a direct hit in the collarbone or indirect impact as a result of a fall on the shoulder, a straightened arm.Table of contents: Types of clavicle fractures Fracture symptoms First aid Treatment of clavicle fracture
Types of clavicle fractures
Clavicle is a tubular bent bone that is attached to the sternum with one end and the other to the scapula. In the collarbone, three parts are distinguished:
- Body - middle part;
- The acromial end is the portion of the clavicle that attaches to the scapula;
- The sterile end is the portion of the clavicle that attaches to the sternum.
Where it is thin, there it breaks. .. This statement is true for the clavicle.The bone looks like an inverted horizontal letter S. At the point of bending, the bone is thinner and brittle.That's why in almost 80% of cases the clavicle breaks in the middle part, just at the point of bending.In 15% of cases, the fracture is localized in the region of the scapular end, and in 5% in the region of the sternal end.
Collar fractures happen to be closed and open .Open fractures are accompanied by rupture of soft tissues( muscles, skin) with the formation of a wound through which bone fragments can be seen.With closed fractures, soft tissues remain intact.
Collar fractures can be offset and without .When the bone fragments are displaced, they can damage nearby vessels, the nerves of the brachial plexus and even the pleura of the lungs.In young children, fracture of the clavicle often happens as a "young twig".Remember, when you try to break a young branch, it breaks, but the fragments do not separate completely from each other, but remain connected due to a thin skin.So the child's collarbone breaks, but the fragments do not diverge, but are held by the periosteum.
Given the nature of the debris formed, clavicle fractures are cloven, transverse and oblique .Knowing these characteristics is extremely important for determining further treatment tactics.
Symptoms of fracture
The first symptom of a fracture is the appearance of severe pain in the area of the clavicle after a fall or stroke.The pain is aggravated even in the timid attempts of a man to move his hand. Movement is difficult, raising the arm becomes impossible.To ease the pain, a man with a fractured clavicle often instinctively hugs the injured arm by the elbow and presses it against the body.
Visible deformation of the clavicle, smoothness of the supraclavicular fossa, puffiness of the skin in the clavicle region, and occasional subcutaneous hemorrhage are attracted during examination.If you gently feel the bone, you can hear the crunch of debris.
With a fracture of the clavicle, the arm seems to be lengthened, while the shoulder is shifted down and forward. If the fragment has damaged the subclavian artery - the wrist will not be able to feel the pulse, the hand pales and becomes cold.With the defeat of nerves, there is a decrease in skin sensitivity of the hand, as well as the inability to move with your fingers.
Important! As the fragments remain attached to the periosteum in children, the symptoms will be less pronounced.To determine there was a bruise, a dislocation or fracture of the clavicle to a person without medical education will be difficult.Therefore, when getting a collarbone injury in a child, it is necessary to take the baby to a traumatologist to determine the correct diagnosis.
And although on examination the doctor can easily determine the presence of a fracture of the collarbone, the injured person still needs to undergo radiography.In the picture you can see the displacement, the presence of fragments and their character.All this is extremely important for determining further treatment.
First aid for fracture of the clavicle
If a person suspects a fracture of the clavicle, the shoulder joint must be immobilized.For this, a folded tissue is laid in the armpit, the arm is bent at the elbow and leads to the trunk. In this position, the hand is fixed with a bandage bandage, which is tied around the neck.So the hand is immobilized, the muscles relax and the pain decreases.
If a person is worried about severe pain, you can give any painkiller( Nimesulide, Ketanov, Analgin, etc.). Do not try to fix bone fragments, this should be done by a doctor.The victim must be taken to the emergency department.
During transport, the victim must be seated.
Treatment of a collar bone fracture
Treatment tactics depend on many factors: the age of the victim, the nature of the fracture, the presence of complications.The fractured clavicle is treated with conservative and surgical methods.
In fractures of the clavicle without bias, in particular in children, they are limited to imposing a tight bandage. This can be an eight-part dressing or a Delbo dressing( two cotton-gauze rings).Locking of the clavicle and shoulder in the necessary position helps to compare bone debris.Pass with the bandage will have about three to six weeks, during this time the clavicle will grow together.
When the bone fragments are displaced, first of all, the physician performs their repositioning. This is nothing more than matching bone fragments to ensure their best adhesion.Reposition is carried out with the help of certain methods with preliminary anesthesia.After comparing the bone fragments to the clavicle and shoulder, a plaster bandage is applied through the chest.
Operation for fracture of collar bone
There are certain indications that surgical treatment is necessary.These are such circumstances as an open, multi-lobed fracture, a significant displacement of bone fragments, traumatization with bone fragments of the nerves, vessels or pleura of the lungs.
Operative treatment( osteosynthesis) is performed under anesthesia.The doctor cuts soft tissues in the area of the clavicle and in an open way compares the bone fragments.In order to stably fix bone fragments in this position - use metal spokes or plates.After doing these manipulations, soft tissues are sewn, then a plaster bandage is applied. It will take about a month and a half to pass with gypsum.Spokes from the clavicle extend after two to three months after the operation of .
Recovery after a clavicle fracture
The outcome of a clavicle fracture treatment will depend, among other things, on how effectively rehabilitation is performed.When and how it is necessary to begin rehabilitation, the doctor will tell.
The rehabilitation period can be divided into three stages:
- During the immobilization of the hand, you can do passive exercise - squeezing, unclenching the fingers of the hand, lowering and lifting the brush;
- After removing the fixative( gypsum) bandage, the range of exercises is significantly expanded - putting the wrists on the collarbones to raise and lower the elbows, rotate them, then fully raise and lower hands;
- Introduction of power physical exercises with the use of expanders, dumbbells, special simulators.
In addition, for speedy recovery shows exercise, physical therapy and massage after removing the fixing bandage.
In general, with adequate treatment and full rehabilitation, it is possible to completely restore the anatomical integrity of the clavicle, which means that the working capacity will not be lost.
Grigorova Valeria, medical reviewer