The collarbone is a rather fragile bone that does not have good protection. For its displacement does not need much effort. Dislocation of the acromial end of the clavicle can be obtained during training in the gym or careless movements. At risk are people with poorly developed muscles.
Causes of occurrence
Impact on the clavicle can be direct and indirect. The main cause of injury can be a strong blow to the chest. Ligaments may not be able to withstand heavy loads, as a result of which damage occurs. Dislocations of the acromial end of the clavicle (ICD-10 - S43) may be associated with a fall. The bone at such a moment moves back and rests against the rib. Often, such injuries are accompanied by damage to nerve endings and blood vessels. The affected person may experience various complications.
Common signs of dislocation
Upon receipt of a dislocation of the acromial end of the clavicle, a person may complain of several symptoms:
- severe pain in the area of injury;
- inability to move an injured hand.
Some patients confuse this phenomenon with injuries of the shoulder joint. Their difference lies in the fact that with trauma to the shoulder, severe swelling develops. The upper limb begins to swell, and a protrusion of the outer end of the clavicle is observed. The occurrence of swelling with dislocation of the clavicle is quite rare. Attempts to move the injured limb during fractures are accompanied by severe pain. Pain in dislocation is characterized by the most moderate in nature. A patient may experience a complete dislocation of the shoulder or a subluxation.
How to recognize a dislocation?
The patient complains of pain in the area of damage. Attempts to take a deep breath lead to increased pain. After trauma, bone deformation occurs. In this case, soft tissues begin to swell strongly, a hematoma is formed.
The main distinguishing feature of a dislocation of the acromial end of the clavicle is a visual shortening of the length of the shoulder girdle.
Varieties of clavicle dislocations
Distinguished above the sternum, prothoracic and posterior sternal traumatic injuries. The most common injury is prone suprasternal dislocation of the clavicle. In this case, its inner end protrudes forward. For suprasternal dislocations, a similar protrusion of the bone up is characteristic. An extremely dangerous injury is a sternal dislocation of the clavicle. In this case, the victim risks serious damage to nerve endings, muscles and blood vessels.
A dislocation of the sternal end of the clavicle is fairly easy to fix. To do this, you need to press your finger on the protruding end of the bone, but as soon as such pressure stops, the clavicle begins to shift back. This symptom allows you to distinguish a fracture from a dislocation.
Old clavicle dislocation
If more than three to four weeks have passed since the dislocation of the acromial end of the clavicle, such a dislocation of the clavicle is considered to be inveterate. An incomplete chronic dislocation of the acromial site can be almost asymptomatic. The only complaint of patients is the deformation of the acromioclavicular joints.
Sometimes, with a complete chronic dislocation of the acromial end of the clavicle, patients are disturbed by pain in the damaged area and a decrease in limb strength. It is eliminated only with the help of surgical intervention.
Help for the victim who got a dislocation of the collarbone
The first thing in this situation is to fix the injured limb. Bandages can be used for this. In this case, a roller made of soft materials should be placed under the arm of a damaged limb.
In order to reduce swelling after an injury, an ice compress should be applied to the sore spot for 15-20 minutes. Before arriving at a medical institution, one should not give a person medications that have a pronounced analgesic effect, since this can complicate the procedure for making the correct diagnosis. It is strictly forbidden to self-dislocate the dislocation of the acromial end of the clavicle with a rupture of the ligaments and try to fix it on your own, since there are other important structures next to the clavicular bone that can be damaged if misplaced.
Diagnostic techniques
To determine the degree of damage caused after dislocation, a specialist performs a thorough examination of the patient. An x-ray is also taken, which helps to eliminate the likelihood of errors in the diagnosis. A doctor can easily determine where the external process of the scapula is based on an x-ray. If additional questions arise, the patient is referred for computed tomography, during which the study of shoulder dislocation is performed in layers.
Principles of Conservative Therapy
The procedures for repositioning the clavicle are carried out under local anesthesia. When determining the dislocation of her sternal end, the patient is laid on her back. A roller should be placed under the blades. You can use a rolled towel for this. After the reduction procedure, it is necessary to fix the clavicle in the correct position. Several methods are used to fix a damaged joint:
- imposition of exhaust tires;
- adhesive bandages with orthoplastic gaskets;
- thoracobrachial dressings.
The timing of the application of such dressings depends mainly on the severity of the injury and the individual characteristics of the patient. In most patients, ligament fusion is observed for approximately 3-6 weeks. The choice of the optimal treatment methodology depends on the particular case. The nature of the damage received by the patient must also be considered. The main disadvantage of thoracobrachial dressings is the restriction of chest movements during breathing. At the same time, prolonged stiffness can lead to the formation of pressure sores.
What operation is prescribed for a dislocation of the acromial end of the clavicle?
Surgical Treatment Techniques
Surgery is used to treat chronic dislocations. With the help of surgery, you can achieve the most durable fixation of the damaged joint. Specialists use the following surgical techniques:
- To fix the damaged bone, you can use knitting needles. The disadvantage of this method is that during the treatment process, doctors cannot restore ligaments. After the surgical procedure, a second dislocation may occur.
- Screws can be used to immobilize the injured clavicle. This technique allows you to achieve the most stable result. Nevertheless, its use leads to a restriction of the mobility of the clavicle and affects the activity of the entire limb.
- Ligament repair is the most effective method of getting rid of injuries. It consists in the establishment of artificial ligaments.
- Fix a damaged bone and joint with buttons. The healing process at the same time proceeds rather quickly, since surgical intervention of this nature practically does not damage soft tissues. However, such a technique is not without drawbacks. After implantation of the buttons there are traces in the form of scars on the skin.
After surgery, the plaster cast must be worn for two months. If this rule is ignored, it can adversely affect the functioning of the clavicle.
After surgical treatment of dislocation of the acromial end of the clavicle, rehabilitation is very important.
Recovery period
In order to accelerate the recovery of damaged clavicle and adjacent joints, the patient must undergo physiotherapeutic procedures. After the surgical procedure, the injured limb remains in an immobilized state for a long time. The joint allows gymnastics to develop a joint, so you can quickly return it to work. With UHF, the affected area is affected by electric fields of various frequencies. The influence of such fields normalizes the body's metabolism and the process of repairing damaged ligaments. Against the background of this procedure, the damaged zones are heated. At the same time, swelling begins to subside and the healing of injured areas accelerates.
Carrying out massages also significantly improves the patient's condition, normalizes the outflow of lymph from injured tissues. Swelling gradually decreases, blood circulation is restored. When conducting massages, techniques such as stroking and rubbing are used. Such a massage has no contraindications and is prescribed to patients with a wide variety of injuries. This procedure facilitates the process of recovering muscles that have been atrophied after being inactive.
Effects
The clavicle in the body plays the role of muscle attachment sites, so even a slight damage to it leads to very serious consequences. They may be:
- impaired functioning of the nervous system;
- muscle stretching;
- violation of the vascular system;
- loss of motor activity of the forearm and upper limb;
- in more complex cases, complete paralysis of the arm may develop;
- damage to the structures of the tendons and lymphatic system.
Conclusion
It is possible to exclude the development of complications only with a timely visit to a traumatologist who will conduct a proper examination and prescribe treatment for a dislocation of the acromial end of the clavicle. This phenomenon must be treated immediately, since it is possible to avoid surgical intervention, which can also cause some adverse effects.