What to do with fractures of a clavicle of different types? Treatment of a clamp fracture with a tire, corset, gypsum and knitting needles

Why are a collar fracture. On what signs to recognize it. Conservative and surgical treatment of collar fractures.

Each bone in the human body fulfills its important function. For example, a collarbone, a tubular pair of S-shaped, connects a person’s hand and his body, provides maximum mobility of the limb, acts as a shield for nerves, blood and lymph vessels of the neck and arm.

Violation of its integrity (fracture) is not only pain, but also loss (temporary or constant) functionality of the upper limb. In order for the opportunity to live a full life and move freely, after a clavicle fracture, it is necessary to strictly fulfill the requirements of a surgeon or orthopedist regarding treatment and rehabilitation.

The most common causes of injury

The collarbone is a hollow inside and a fairly fragile bone, which consists of three parts:

• sternum (it is the most dense)
• diaphysis (it is also called the middle part or body of the bone)
• the acromial end (this end, together with the acromial -resistant, forms an acromically - clavicle joint)

Important: most often the collarbone breaks in diaphysis. The second place is occupied by a fracture of the acromial end of the bone, the third - a fracture of the sternum end

The most common reasons for the clavicle fracture are:

• the birth injury (the collarbone breaks in the newborn in the process of passing the birth canal of the mother)
• direct blow
• fall on the hand
• Accident

Important: children and youth are more susceptible to this injury, since the clavicle becomes as strong as possible only by 20 years of life

Signs of collapse of the clavicle

Needless to say, the most obvious complaint that allows you to suspect a person’s fracture is a severe pain that appears directly at the time of the injury or the cut after it.

This pain does not pass when the body position changes and does not allow the patient to move his hand. Also characteristic of the injury are the following signs:

• swelling and swelling in the bone area some time after the fracture
• crunching with your hand
• visible lengthening of the hand from the broken collarbone, if the bone fragments are shifted
• the victim from the fracture instinctively holds a hand from the damaged bone
• violations of the mobility of the forearm, hands and fingers, if nerves and blood vessels are injured during the fracture

Important: signs of a clasp fracture, if there was no displacement, young children are greased: only a slight pain and barely visible swelling. Only diagnostic measures help to recognize injury

The diagnosis is confirmed only after conducting an X -ray examination. Most often this is a regular picture of the bones of the limb. But if there is a suspicion of injury to nerves and blood vessels, they make an X -ray with contrast (angiography).

Types of collar fractures

Classification of the clavicle fracture is carried out on the basis of various criteria.
In the place where the turning point happened, as mentioned above, they distinguish:

• fracture in the body
• fracture of the acromial end
• fracture of the sternum

By the presence or absence of bone fragments, the collarbone breaks:

• without displacement
• with a displacement (this species is more common, since during the injury there is a reduction in strong muscles attached to the collarbone, they move bone fragments)

In the direction of the clavicle fractures there are:

• transverse
• oblique
• longitudinal

By the presence of skin damage and subcutaneous layer:

• open
• closed

The correct classification of a violation of the integrity of the clavicle during the diagnosis is reflected in the success of the treatment of injury.

Video: collar fracture

Keyhole fracture in a newborn during childbirth, consequences

One of the most common birth injuries in children who were born is a collar fracture. The injury occurs due to the fact that the bone does not withstand pressure while the child passes through the pelvic bones of the mother. The reasons for this are:

• the mismatch of the pelvis of the mother of the child’s size (narrow pelvis or large fruit)
• swift birth
• childbirth with the wrong position of the child
• parental obstetrication or using special tools
• medical errors

As a rule, injury is detected in the Rodzal, if there is a displacement. The clavicle fractures at birth in children, if bone fragments have not shifted, are found on the second or third day according to the following signs:

• a swelling, hematoma or swelling appears on the child's shoulder
• his handle moves is limited
• the newborn is worried, eats badly, loses weight
• when trying to swaddling, the newborn can cry

In case of suspicion of an innate fracture, the newborn is immediately made an X -ray of the belt of the upper extremities.
As a rule, a collar fracture as a birth injury is treated quickly and without any problems - the bones of the newborn quickly grow together. On average, this happens in 10 days.
A therapeutic measure is a tight swaddling with a fixation of a handle and shoulders with cotton and gauze rollers.

Important: with serious collapses of the collarbone with a child during childbirth, he needs a surgical operation

The negative consequences of this injury in newborns, as a rule, do not occur. The fracture itself is dangerous as the behavior of the baby in the first days after the injury. Parents need to be extremely vigilant and protect the baby, because whims, refusal of food, weight loss does not affect his immunity well.

VIDEO: Fracture of the collarbone of the newborn

Assistance for a collar fracture

If a person was injured, there is reason to assume that he has a collarbone, it is necessary: \u200b\u200bit is necessary:

• call an ambulance or independently transport the victim to the emergency room
• provide him on the spot for the first urgent help

Important: in the case with the help of a person with a broken clavicle, inaction will be much better than the action is wrong. If the victim hurts, he cannot move his hand, in no case should you try to check the “functionality” of his hands. Also, under no circumstances, you should not try to "straighten out" a fracture not a place

But these actions are quite appropriate before examining the victim by a doctor:

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

Fix the hand from the broken bone in this way:

• make a wool roller, foam rubber or simply folded fabric several times
• put a roller under the armpit of the victim
• the victim’s hand is bent in the elbow joint at right angles
• the dressing bandage is fixed on the opposite shoulder

Important: if it is customary to transport the victim to the doctor on his own, this must be done in a sitting position

Video: reposition of a collar fracture of the collarbone

Tire for the treatment of collar fractures

If, after the X -ray, the collar fracture is confirmed, there is a displacement, the doctor decides what treatment will be, conservative or surgical.

If the fracture is not heavy, without fragments, the doctor, under local anesthesia (novocaine), sets the bone and decides on which immobilization of the limbs will be carried out.

IMPORTANT: With this type of injury, Immobilization of the hand is carried out for 2-3 weeks, adults-for 4-7 weeks

Sometimes a scarf bandage is enough. If the fixation is not enough, the patient will be forced to wear one of the tires:

1. Beller's tire

1. Kuzminsky tire

Double tire of Kramer

Shoulder clamp

Gypsum with collar fracture

The gypsum bandage is applied if:

• the collar fracture is closed
• there is no displacement or it is insignificant
• no borrowed bone fragments

Important: if the clavicle fracture is classified correctly, it is possible to treat it with gypsum, but it fuses in 95% of cases

The gypsum bandage is considered more reliable than tires. Despite the fact that it is less hygienic, its immobilization of its hand is made much better.

Corset with a collar fracture

Promotes the formation of bone corn and does not allow a broken clavicle to shift and a semi -rigid corset.

Important: the corset not only treats a fracture or dislocation of the collarbone, it also adjusts the posture

1. The product is sold in Medical equipment stores and on the Internet
2. As a rule, it happens in two sizes - for children (up to 44 sizes) and for adults (44 - 52 dimensions)
3. A corset made of modern high -tech materials can be wetted - the patient can calmly take a shower in him
4. The product is lightweight and does not cause the patient discomfort, similar to the one that he can experience, wearing gypsum

Knitting needle

Surgical treatment of a collar fracture (osteosynthesis) is shown if:

• the fracture is open
• a fracture closed, but affected the vascular-frozen bundle
• the nervous plexus is squeezed
• there are multiple bones fragments
• soft tissues under the skin are badly damaged

There are two options for anesthesia during the surgical treatment of a clavicle fracture:

• local anesthesia
• general anesthesia

Earlier, a spoke or pin was used to fix bone fragments:

1. The skin and subcutaneous above the place where the clavicle broke was broken. Cut length-6-8 cm
2. They exposed the collarbone
3. A spoke or pin with a diameter of up to 0.5 cm: they were introduced into the bone marrow canal. The fragments tied to it with a catgut thread
4. The wound was sutured
5. 3-4 weeks, the patient was supposed to go in a gypsum or other immobilizing bandage, after 2 months the needle was removed

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

Important: the operation gives a greater guarantee of the successful fusion of the bone. But, unfortunately, in 1 operated patient out of 100 during osteosynthesis, the bone is infected and osteomyelitis begins to develop

Recovery after a clasp fracture. Exercises after a collar fracture

After the time of immobilization of the hands is over or after extracting the knitting needle, to treat the clavicle fracture, restore limb functions will be possible with physiotherapeutic methods:

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

Important: even during the immobilization of the limb, the patient is allowed to move his fingers, after two weeks - with his hand in the elbow joint, after 3 weeks - with his shoulder (in the volume that is allowed by a bandage, gypsum or tire)

Video: a set of exercises for shoulder damage