What to do in case of clavicle fractures of different kinds? Treatment of a fracture of the clavicle with the help of a tire, corset, gypsum and knitting needle

Why there is a fracture of the collarbone. On what grounds it is recognized. Conservative and surgical treatment of clavicle fractures.

Each bone in the human body performs its important function. For example, the clavicle, the tubular twin bone S-shaped, connects the human hand and its trunk, provides maximum mobility of the limb, serves as a shield for the nerves, blood and lymph vessels of the neck and arm.

Violation of its integrity( fracture) is not only a pain, but also a loss( temporary or permanent) of the functionality of the upper limb. To be able to live a full life and move freely, after a fracture of the clavicle, the surgeon or orthopedist's requirements for treatment and rehabilitation must be strictly observed.

The most common causes of injury

The clavicle is a hollow inside and rather fragile bone, which consists of three parts:

• of the sternum( the most dense)
• of the diaphysis( also called the middle part or body of the bone)
• of the acromial end( this end together with the acromionscapula forms an acromioclavicular joint)

IMPORTANT: Most often, the clavicle breaks down in the diaphysis. The second place is the fracture of the acromial end of the bone, the third is the fracture of the sternal end

Human clavicle: anatomy.

The most common causes of a fracture of the clavicle are:

• birth injury( clavicle breaks down in the newborn during passage of the mother's birth canal)
• direct impact
• fall on the arm
• ACCIDENT

IMPORTANT: Children and young people are more likely to suffer this trauma, as the clavicle bone becomesthe maximum lasting only to 20 years of life

Signs of fracture of the collar bone

Is it worth saying that the most obvious complaint that allows a person to suspect a fracture of the collarbone is a severe pain,those reflected directly at the moment of injury or after the shear.

In case of a fracture of the collarbone, the victim feels a sharp pain.

This pain does not go away when you change the position of the body and does not allow the patient to move his hand. Also characteristic of the trauma are the following signs:

• swelling and swelling in the bone area after a fracture
• crunch when walking along the hand
• visible elongation of the hand from the broken collarbone, if the bone fragments are displaced
• the fractured person instinctively holds the arm from the damaged bone
• infringements of mobility of a forearm, a brush of a hand and fingers if at fracture nerves and blood vessels are injured

IMPORTANT: Signs of a fracture of a clavicle if there was no dislocationof, young children are blurred: only a small pain and barely visible swelling. Only diagnostic measures help diagnose the trauma.

Fracture of the clavicle on the x-ray.

Diagnosis is confirmed only after X-ray examination. Most often this is an ordinary snapshot of the limb bones. But if there is a suspicion of a trauma to the nerves and blood vessels, X-rays are made with contrast( angiography).

Types of clavicle fractures

Classification of fracture of the clavicle is carried out on the basis of various criteria.
In the place where there was a fracture, as mentioned above, distinguish:

• fracture in the body of the bone
• fracture of the acromial end
• fracture of the sternal end

By the presence or absence of displacement of bone fragments, the clavicle breaks down:

• without displacement
• with displacement( this type occurs more often, as during the trauma a contraction of strong muscles attached to the collarbone,they move bone fragments)

In the direction of fractures of the clavicle there are:

• transverse
• oblique
• longitudinal

According to the presence of skin and subcutaneous injury:

• open
• closetier

A correct classification of the breach of the collar bone during the diagnosis is reflected in the success of the treatment of the injury.

Classification of clavicle fractures.

VIDEO: Fracture of clavicle

Fracture of collarbone in newborn during childbirth, consequences

One of the most common birth injuries in children who have been born is a fracture of the clavicle. Trauma is due to the fact that the bone does not withstand pressure while the baby passes through the mother's pelvic bones. The reasons for this are:

• miscarriage of the mother's pelvis to the size of the child( narrow pelvis or large fetus)
• rapid delivery
• childbirth with an abnormal child
• maternity by hand or with special tools
• medical errors

Fracture of the clavicle is a common birth injury.

As a rule, the trauma is detected even in the rod, if there is an offset. Fractures of the collarbone at birth in children, if the bone fragments are not displaced, are found on the second or third day by such signs:

• on the shoulders of the child appear swelling, bruising or edema
• movement of the handle is limited to it
• newborn worried, poorly eats, loses weight
• when trying to swaddle a newborn can cry

If you suspect a congenital fracture, the newborn is immediately given an X-ray of the upper extremity belt.
As a rule, fracture of the clavicle as a birth trauma is treated quickly and without problems - the bones of a newborn quickly coalesce. On average, this happens in 10 days.
The therapeutic measure is a tight swaddling with fixation of the handle and shoulders with the help of cotton wool and gauze.

IMPORTANT: In case of serious fractures of the clavicle with the displacement that occurred in the child during childbirth, he needs a surgical procedure

. Negative consequences of this trauma in newborns, as a rule, do not occur. Danger is not so much the fracture itself, as the behavior of the baby in the first days after the injury. Parents need to be very vigilant and cherish the baby, because the whims, refusal to eat, weight loss have a bad effect on his immunity.

VIDEO: Fracture of the collarbone of the newborn

Helping the fracture of the collar bone

If the person is injured, there is reason to believe that his collarbone is broken, it is necessary: ​​

• call an ambulance or transport the victim himself to the emergency center
• on the spot with the first urgenthelp

IMPORTANT: In the case of using a person with a broken clavicle bone, inaction will be much better than the action is wrong. If the victim is hurt, he can not move his hand, in any case, you can not try to check the "functional" of the hand. Also, under no circumstances should you try to "fix" the fracture not the place

But these actions before the examination of the injured physician are quite appropriate:

• he can give an analgesic medication to reduce the pain syndrome
• to fix the hand to avoid even more displacement of bone fragments
• if the fracture is open, apply a pressure bandage to stop the blood

Fix the arm on the side of the broken bone in this way:

• make a roller made of cotton wool, foam rubber or just folded several times the fabric
• put the roller under the armpit of the injured
• the injured person's arm is bent at the elbow joint at right angles.
• a bandage bandage is fixed on the opposite shoulder

. A plaited bandage with a fracture of the collarbone.

IMPORTANT: If it is customary to transport the injured person to the doctor on his own, it should be done while sitting.

VIDEO: Reconstruction of the diaphysis fracture of the clavicle

Bus for the treatment of fractures of the clavicle

If after the X-ray fracture of the clavicle is confirmed, there is an offset, the doctor decides what treatment will be conservative orsurgical.

If the fracture is not severe, without splinters, the doctor under local anesthesia( novocaine) restores the bone and decides how to immobilize the limb.

IMPORTANT: For this type of injury, immobilization of hands to children is carried out for 2-3 weeks, adults - for 4 - 7 weeks.

Sometimes, a scarf dressing is enough. If the bandage is not fixed, the patient will have to wear one of the tires:

1. Beller's tire

1. Bus of Kuzminsky

Double Cramer tire

Cramer tire.

Shoulder retainer

Gypsum in case of fracture of clavicle

Gypsum dressing is applied if:

• clavicle fracture closed
• is absent or absent
• no displaced bone fragments

IMPORTANT: If clavicle fracture is classified correctly, it can be treated with plaster, but it fuses in 95% of cases.

Gypsum brokenclavicles.

A plaster bandage is considered more reliable than tires. Despite the fact that it is less hygienic, the immobilization of its arm through it is much better.

Corset for fracture of clavicle

Promotes the formation of the bone callus and does not allow the broken clavicle bone to move and the semi-rigid corset.

IMPORTANT: The corset not only heals the fracture or dislocation of the clavicle, it also corrects the posture of the

1. . The product is sold in medical stores and on the Internet.
2. As a rule, it can be in two sizes - for children( up to 44 sizes) and for adults( 44 - 52 sizes)
3. The corset made of modern high-tech materials can be moistened - the patient can calmly take a shower in it.
4. The product is lightweight and does not give the patient any discomfort, like that which he can experience wearing a plaster cast

Corset on his shoulder.

Spine with fracture of clavicle

Surgical treatment of clavicle fracture( osteosynthesis) is indicated if:

• fracture open
• fracture closed but affected by vascular bundle
• squeezed neural plexus
• multiple bone fragments
• strongly damaged soft tissues under skin

There are probably two variants of anesthesia during the operative treatment of a clavicular bone fracture:

• local anesthesia
• general anesthesia

Stitches after an operation on the collarbone.

Previously, a pin or pin was used to fix bone fragments:

1. The skin and subcutaneous tissue above the place where the clavic bone broke was cut. The length of the incision is 6-8 cm.
2. The clavicle
3. was exposed. A pin or pin with a diameter of up to 0.5 cm: they were inserted into the medullary canal. To her fragments were tied with catgut thread
4. The wound was sutured by
5. For 3-4 weeks the patient had to walk in a plaster or other immobilizing bandage, after 2 months the needle was removed

Spike in case of fracture of the collarbone.

This method is considered retrograde today. In the process of osteosynthesis, they prefer to use plates and screws.

IMPORTANT: The operation gives a great guarantee of successful bone splicing. But, unfortunately, in 1 operated patient out of 100 during osteosynthesis the bone becomes infected and osteomyelitis

begins to develop Plate with screws on the collarbone.

Recovery after a fractured clavicle. Exercises after the fracture of the clavicle

After the end of the immobilization of the hands or after the extraction of the needle, the fracture of the collar bone, the limb fracture can be treated by physiotherapeutic methods:

• UHF
• by ultrasound
• by laser therapy
• by magnetotherapy
• by salt baths
• by massage
• by swimming
• with special exercises

Restoredafter a fracture of the collarbone, massage helps.

IMPORTANT: As soon as the limb is immobilized, the patient is allowed to move his fingers, in two weeks - by hand at the elbow joint, after 3 weeks - with the shoulder( in the volume that is allowed by the bandage, plaster or tire)

VIDEO: A set of exercises for shoulder injuries