Fracture of the clavicle - Causes, symptoms and treatment. MF.

Fracture of the clavicle is a very common trauma and most often occurs in young people. Trauma occurs when you fall on an elongated arm or shoulder and from the compression of the trunk, and a fracture of the clavicle can also occur from a direct stroke on the collarbone.

Symptoms of clavicle fracture

• Pain of in fracture site. The nature and intensity of pain depends on the type of fracture, from barely expressed to unbearable.
• The movements of the in the shoulder and shoulder joints are limited.
• The head of the patient declines to the side of damage, and the shoulder is shortened by .
• crunch of fragments is also observed while probing and visible deformation of clavicle .
• Swelling of in the fracture region( supraclavicular fossa smoothed).
• If there is damage to the subclavian artery, there is no pulse on the radial artery( above the wrist joint), there is a cooling and necrosis of the upper limb.
• With an open clavicle fracture, there is clear bleeding .

First aid for fracture of clavicle

If a clavicle fracture is suspected, the patient should be seated and the shoulder joint and shoulder area immobilized. This is achieved in two ways. The first is a kerchief bandage. The second is an 8-band dressing or a bandage of two cloth rings.

Methods of immobilization with a fracture of the clavicle

Pain syndrome is removed with an anesthetic, for this purpose, ketorol, nimesulide, aspirin, analgin is suitable.

With open fractures, it is necessary to stop bleeding by applying a pressure bandage bandage.

One should be very careful when providing care in patients with a clavicle fracture, since any excess movement can lead to damage to the subclavian artery.

Diagnosis of collar fracture

For diagnosis of a fracture, it is sufficient to perform radiography.

Treatment of a clavicle fracture

In most cases, with a clavicle fracture, an 8-band dressing or Delbe bandage( of two cotton-gauze rings) is applied, for a period of 4-6 weeks. Creating a traction back, this dressing simultaneously and corrects, and keeps the fragments in the desired position.

Bandage from cotton-gauze rings

Bandage from cotton-gauze rings is not very comfortable and can cause considerable discomfort in the area of ​​the armpits, especially in children, so it is better to immediately prefer ready-made bandages.

8-band dressing in case of fracture of the clavicle

The cast is now applied only in the case of surgical treatment.

Often a secondary displacement of fragments takes place, which requires repeated repositioning( repositioning of fragments).Therefore, recently, most specialists are supporters of operative treatment of clavicle fractures, which consists in exposure of fragments, their open reposition and internal fixation.

In cases of open and multifuncular fractures, with damage to the subclavian artery and nerves, as well as fractures with a significant displacement, the correction is always performed operatively, with fixation with knitting needles or a plate. After the operation, a plaster cast is applied for 4-6 weeks. Spokes removed from the clavicle after 2-3 months, the plate can be up to 1 year or more.

Fixation of fragments in fracture of clavicle, radiography after osteosynthesis

Rehabilitation after fracture of clavicle

Already from the first days after the trauma we proceed to active movements in the fingers and elbow joint, as well as in the joints of a healthy arm. Movements in the shoulder joint should be done with caution and with the development of pain syndrome, focusing on the shoulder back.

1-2 weeks after the injury, physiotherapy procedures are designed to relieve inflammation, reduce pain, improve bone adhesion.
• Magnetotherapy - 10 -15 sessions;
• Ultrasound - 10-15 sessions;
• Laser therapy;
• UHF with various anti-inflammatory ointments.

Starting from the third week, we increase the amount of movements in the shoulder joint, as far as the bandage allows. To active movements during this period we connect the shoulder straps and we perform shoulder shrinkage, thus, stretching the two joints of the clavicle - with the sternum and the scapula.

At the time of removal of the bandage of movement in the joints, the hands are practically unlimited, and residual disorders are eliminated quite quickly. For a more effective recovery of the function, baths with sea salt and massage are used.

The total duration of treatment is 2-2.5 months.

Prognosis after fracture of the clavicle

Treatment can be prolonged with open fractures and fractures with damage to the subclavian artery and nerves. Sometimes a fracture does not fuse and a "false joint" is formed, which is the cause of chronic pain syndrome and physical activity disorders.

The doctor-traumatologist Voronovich NA