The skeleton is a supporting structure that can withstand heavy loads. Muscles and ligaments are attached to bones. Sometimes, due to unfavorable circumstances, they collapse, forming fractures. Treatment methods and the duration of the rehabilitation period depend on the location of the injury, the characteristics of the fracture and the patient’s health status.
Video: collarbone fracture
Healing occurs faster in children, the delay depends on age. Rehabilitation is rarely necessary. In rare cases, intervention is necessary from the very beginning. Endangered or exposed skin Some external ¼ fractures Vascular or nerve complications Significant accidents involving one end, one shoulder blade, one of the 2 clavicles or lesions upper limb at a pathological level in some athletes, including bikers. In all these cases, there is an operational risk that must be explained to the patient.
The collarbone is small tubular bone, belonging to shoulder girdle and connecting the scapula with chest. Its shape resembles an S-shaped curved ancient key, which is precisely what determines its name. This is the only bone that connects the upper limb to the skeleton of the body; it is located directly above the ribs. The collarbone is clearly visible and easily palpable.
This damage occurs due to the excess of mechanical force over the strength of the bone. This can happen during severe epileptic seizures. But common cause are injuries resulting from contact sports: hockey, football, boxing, as well as motorcycling and cycling. There are many casualties after road accidents. Even newborns passing through the mother's birth canal can receive similar trauma.
A clavicular fracture can occur in any part of the bone. But it is the median (central) injuries (in the area of the diaphysis) that occur more often, due to the fact that the middle third of the clavicle is the thinnest and most curved. Problems in the sternal and acromial region are less common. In the latter case, damage to the collarbone may be accompanied by ligament rupture, dislocations and a fracture of the scapula.
Depending on the degree of shear of bone fragments, they are distinguished:
- incomplete (subject to minimal deformation and displacement);
- complete fracture.
Symptoms and diagnosis
If the injury is incomplete, the patient feels pain in the problem area, but this practically does not prevent him from moving the limb. Movement is limited only when raising the arm above the shoulder line. After some time, a bone callus forms at the site of damage.
With complete displacement of bone fragments, a change in the outline of the upper limb occurs. This injury is accompanied by:
- sharp pain in the area of suspected damage;
- development of swelling in the problem area;
- pathological mobility in the damaged area;
- cyanosis and pallor of the skin;
- in case of open injury, bone fragments injure the skin;
- bleeding (internal and external);
- the appearance of hematomas;
- deformation of the shoulder line;
- numbness of the hand;
- inactivity of the hand and fingers.
Making a final diagnosis in a hospital setting involves an x-ray examination. It allows you to determine not only the type of injury, but also the displacement of the bone and the location of the fragments. If after this the doctor still has some doubts or the study does not allow the location of all the fragments to be determined, then additional radiography in the lateral projection and CT scan are performed ( CT scan) of this site in 3D reconstruction.
Consequences of injury
Damage to the collarbone can lead to the following unpleasant consequences:
- loss of performance of the upper limb;
- damage by bone fragments to nearby nerves, blood vessels, and skin;
- blood loss;
- plexopathy (damage to the nerve plexuses);
- loss of muscle strength;
- secondary displacements as a result muscle contractions or incorrect application of the bandage;
- formation of false joints;
- scoliosis (spinal deformity) as a result of improper fusion of bone fragments;
- nonunion;
- infection due to failure to comply with antiseptic measures in conditions of an open fracture;
- cosmetic defect due to incorrect fusion of fragments;
- osteomyelitis (a purulent-necrotic process caused by pyogenic bacteria and affecting bone tissue, periosteum and bone marrow).
First aid
Before the doctors arrive, the victim must be given first aid. This will help alleviate the patient’s condition and prevent the development of various complications. First aid is to immobilize the injured part of the body. Bend your arm at the elbow, hang it with a bandage, scarf or rope behind your neck and press it to your body. Before doing this, place a soft pad (a large piece of cotton wool or crumpled cloth) in the armpit area.
Advice: Do not, under any circumstances, try to set displaced bone fragments protruding under the skin with your own hands. To relieve pain, give the victim an analgesic. If there open wounds- treat them with a bactericidal agent. The easiest option is to sprinkle the wound with streptocide. The victim is transported strictly in a sitting position.
Treatment methods
There are two methods for treating a displaced clavicle fracture:
- conservative;
- operational.
For a fracture of the middle part of the clavicle, osteosynthesis using a plate is most often used. This operation uses S-shaped plates. If the fracture occurred in the acromial part, which is the junction of the clavicle and scapula, then hook-shaped plates or models equipped with additional screws may be needed.
Postoperative complications
With a successful operation, complete fusion bone tissue observed after 3-7 weeks. However, after osteosynthesis of the clavicle, as after other operations, there is a possible risk of developing postoperative complications:
- Non-union of the bone. This may be due to the fragmented nature of the injury, incorrect selection of a metal fixator, and excessive traumatic surgical treatment.
- Infection. Here, as in the case with, it is necessary to follow the rules of asepsis and antiseptics. The victim should receive antibiotics for prevention possible complications(prescribed intravenously half an hour before surgery).
Yes, complications are possible, but do not be afraid of them, since the incidence is less than 1%.
You should not be afraid of surgery, because it is resorted to in rare cases and it ends mostly successfully. Besides surgery compared with conservative treatment has a number undeniable advantages: smooth fusion of the clavicle, absence of visual cosmetic defect, complete elimination of displacement of the fragments.
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Attention! The information on the site is presented by specialists, but is for informational purposes only and cannot be used for independent treatment. Be sure to consult your doctor!