Clavicle fracture is a phenomenon common in all age categories of people. In newborns, such an injury is caused by rapid labor or the wrong actions of obstetricians. In adolescents and adults, it can be caused by a fall on the shoulder or a strong blow to the clavicle.
If it so happened that the patient has a collarbone fracture, then he urgently needs to provide first aid and refer to a traumatologist. The basis of the treatment method is to restore the integrity of bone fragments. The patient can undergo plaster immobilization in case of collarbone fracture or apply a tight bandage. The choice of treatment depends on the complexity of the fracture, so it is important to correctly classify it.
How to determine a collarbone fracture?
The clinical manifestations of a clavicle fracture can be determined visually if a deviation from the natural state of the bone is noticeable. The main symptom that worries the patient is pain in the shoulder. Any movement causes severe pain in a person. In addition, in the patient's forearm, there is severe swelling or swelling, which accurately indicates the presence of a problem.
If such signs appeared, then an urgent need to contact a traumatologist, he will be able to accurately diagnose and take all the necessary measures of immobilization in case of a collarbone fracture or bruise.
Classification
Depending on the area in which the fault occurred, the collarbone fracture is divided into several types:
- trauma to the inner third of the bone or sternal end;
- trauma to the middle third or diaphyseal fracture;
- fracture of the acromial end or trauma to the outer third.
The most typical is the second type.
By the nature of the fracture, there are such types of collarbone fracture:
- transverse, when the bone breaks across, splitting into two blunt limbs;
- longitudinal, when the fault goes along the bone;
- oblique - the fracture passes at an angle, and as a result, the bone is divided into two parts with sharp ends;
- spiral fault;
- comminuted when the bone is crushed into several pieces.
Fractures are also closed when the skin is not damaged. Or open - with impaired skin integrity.
There are many types of collarbone fractures, but 80 percent of patients have a diaphyseal view, which is located in the middle third of the tubular bone. What immobilization is performed for a collarbone fracture?
First aid for clavicle fracture
Clavicle fracture is a serious problem that cannot be dealt with at home. But correctly provided first aid will reduce the likelihood of complications and reduce the recovery time.
If the first signs of a collarbone fracture appear, then it is better to keep your hand pressed to the body. If the patient in this position feels pain, it is better to leave in that position in which the discomfort is minimal.
The patient needs to be given an anesthetic. It can be a non-steroidal anti-inflammatory drug, such as Analgin, Ketanov, Ibufen and others.
Also, with a fracture of the clavicle, immobilization is carried out, which is the key to a speedy recovery.
Primary immobilization is called temporary and is done in order to reduce pain and avoid serious complications. There are many ways, but it is important to know: the longer the dressing is on the patient, the weaker its supporting function becomes. That is why during prolonged transportation, you should rewind the bandage from time to time to improve the degree of fixation.
Simple and effective dressings
There are several ways to immobilize with a collarbone fracture:
- Delbe rings. You can make such a latch using improvised means, such as towels or shirts. Around the forearms, two rings must be formed. They should fit snugly to the skin, but not squeeze. A bandage is inserted through the rings in the back, which will help to properly tighten the bandage until the patient himself says that the pain syndrome has decreased to a minimum. This method will allow you to dissolve the debris and relieve pain. But this method has its own minus - it does not allow to raise the forearm.
- Bandage in the form of a figure eight. This method, like the first, helps to separate the shoulders, but it also requires an additional supporting dressing. You need to start knitting it with the imposition of three rounds for fixation, which are located at the level of the chest. During the passage of gauze through the back at the level of the shoulder blades, soft pillows are placed in the armpits. After they are fixed, you can proceed to the bandage itself. When the bandage goes to the front of the torso, it should not cross the chest, but pass into the armpit, again heading for the back. As a result, it turns out that a vest was put on the patient. Bandage should be tight so that the shoulders are as good as possible, so that the patient is comfortable.
- Headscarf. This method is the simplest and most affordable, but only it will not allow immobilization during fracture of the clavicle in an unbent form and will not allow for reliable fixation. This type of dressing helps raise your hand and prevent it from sagging. In this case, the muscles in the clavicle do not stretch and do not provoke discrepancies in bone fragments.
- Bandage Deso. It can be done with a simple or elastic bandage. In the chest area, it is necessary to fix a pair of pillows, wrapping them with a bandage, and after from the armpit of a healthy hand the bandage goes to the patient’s shoulder and throws over him, and then goes down from the back to the elbow, goes around it and follows to the armpit of the healthy hand. Passes to the back along the oblique and again bypasses the sore forearm, but only from the back and forth. Further, the bandage passes again to the elbow, but already from the front of the body, again goes under the elbow and to the armpit of a healthy hand. In the end, you need to make another round around the body and the pressed shoulder and return to the original. If you repeat this sequence again, you can better immobilize the upper limbs with a fracture of the clavicle. You can purchase such a bandage already in finished form.
- Velpo's dressing. You need to arm yourself with a bandage, put your sick hand on your shoulder healthy at an angle of 45 degrees. To begin to apply a bandage should be from the middle of the shoulder of a sore arm. On the front side of the body, the bandage passes to the opposite side and goes on the back. So do a couple of revolutions, after from the back, throw the bandage on the front side over the shoulder of the sore arm, throw it over the elbow, then onto the side healthy. Following it passes along the back and again on the forearm of an injured limb. Thus, it is possible to more reliably fix the loop on the shoulder and prevent it from moving. Carry out two or three such cycles, and effective immobilization for a collarbone fracture has been carried out.
All these methods of fixation will not only relieve pain, but also prevent the fracture from shifting and damage nearby tissues.
Clavicle Fracture Treatment
The choice of treatment for clavicle fracture depends on the age of the patient, but in no case do you need to carry out therapy at home. In newborns and children under the age of three, the treatment of clavicle injury is quick and easy with minimal intervention from a traumatologist.
In those children who are already more than three years old, the bones will grow together for at least six months. That is why it is recommended to apply a gypsum dressing, but painkillers are administered before the victim.
A much more complicated case is possible when an operation cannot be dispensed with. Its essence is to impose a special metal structure, which will allow for reliable transport immobilization in case of collarbone fracture with displacement. With its help, you can completely eliminate the displacement of fragments.
Osteosynthesis is carried out with screws or plates. The decision about what to use in a particular case is made by the doctor based on the nature of the fracture, because it can be closed or open.
In some cases, immobilization is carried out with the Cramer splint in case of a collarbone fracture. It is an aluminum ladder that bends perfectly, so it perfectly follows the contours of the body and helps to more reliably fix a fracture not only of the forearm, but also of other bones of the body.
How to treat a fracture with an offset?
What to do if the collarbone is broken with an offset? The first step is to properly immobilize. With a fracture of the clavicle with an offset, the arm is completely immobilized and the main symptoms are determined.
After confirming the diagnosis, the traumatologist applies a bandage that is securely fixed with plaster. But this can only be done when the doctor puts in place all the pieces, having made the adjustment by taking the shoulder back. But only an experienced doctor should carry out this procedure, self-medication in this case can only do harm. Only after this a bandage is applied.
If the bone is broken in several places and there are a lot of pieces, then in this case, transport immobilization during a collarbone fracture involves the application of a special tire so that as a result all the bones grow together correctly. This procedure should be performed if the usual tight bandage did not help and the vessels and nerve endings were damaged. Proper therapy involves recovery for seven weeks, after which all symptoms will go away.
Rehabilitation period
Rehabilitation after a fracture of the clavicle is simply necessary, because due to prolonged immobilization of the arm during a fracture of the clavicle, the muscles partially atrophy. Exercises begin to be done immediately after it becomes possible. The load and type of exercise are selected by the doctor individually for each patient. Most often, the rehabilitation course lasts from three to seven weeks.
The rehabilitation period is divided into three stages:
- during immobilization during fractures of the clavicle, it is allowed to perform passive gymnastics;
- after the callus builds up and the fixing bandage is removed, gymnastic sticks are used, due to which the range of exercises expands;
- power loads are added.
In order to recover faster and regain mobility of the arm, they continue to conduct physiotherapeutic procedures, including water therapy and massage. Thanks to an integrated approach, rehabilitation gives good chances for a full recovery. Thanks to magnetotherapy, ultrasound and UHF, blood quickly enters the affected area, and sufficient blood circulation contributes to the speedy restoration of damaged tissues. Massage improves metabolic processes, improves mobility in an injured limb.
Exercises for developing clavicle after fracture
The complex of exercises after conservative therapy and surgical intervention is different, but in both cases, the load increases gradually.
A set of exercises after surgery:
- breathing and tonic exercises;
- light swaying of the shoulder joint, arm at this time in a bandage-scarf;
- alternately strain, and then relax the muscles of the shoulder girdle and shoulder;
- active movements of the elbow joint and wrist, fingers and hand of the injured hand;
- rotation of the forearm;
- shrugs;
- strengthening complex for all muscles of the body;
- tonic walking and running;
- strength and speed exercises for the hands;
- gymnastics to restore coordination;
- active sports.
The first exercises are best done with an assistant and only a few minutes, and then constantly increase the time. From smooth and measured movements move to more intense. To develop the collarbone after the fracture, you will have to make a lot of effort and patience.
Physical therapy for clavicle injury
A special treatment complex helps not only strengthen weak muscles, but also improves joint mobility, enhances blood flow in an injured arm. Only a constant active flow of blood to a sore spot helps to recover faster. An important rule of exercise therapy is to strictly observe the sequence of loads and perform exercises regularly.
In fact, the exercises begin to be performed already on the first day after transport immobilization in case of fracture of both clavicles or only one. Exercise well copes with the syndrome of "frozen shoulder". As mentioned above, exercises become more complicated gradually. Initially, the development of the muscles of the hand is underway:
- it is necessary to compress and unclench the fist, alternately hold the thumb in your hands or leave it outside;
- alternately connect the fingertips with a large one;
- knock a speck with each of the fingers;
- twist with each of the fingers, and afterwards with the whole brush clockwise;
- raise and lower the brush;
- wave the brush to the sides.
After you need to start developing the elbow and shoulder.
After removing the bandage, you can perform this complex:
- put the brush on the shoulders and lift each of the elbows alternately;
- rotate the elbows clockwise and against it;
- raise and lower the upper limbs;
- raising your hands, take them back;
- do the exercise "scissors" with straightened arms.
The collarbone is a support for the hand; a powerful apparatus for ligament is fixed on it. That is why her fracture can disable her hands. Only competent treatment will help to avoid complications and irreversible consequences.
The consequences of a collarbone fracture
If you do not seek timely qualified assistance and do not carry out transport immobilization with a collarbone fracture, then in the end the patient may experience the following consequences:
- bleeding from a wound if the fracture is open;
- damage to soft tissues and nerve endings with bone fragments;
- damage to the nerve plexus;
- decreased or complete loss of sensitivity in the hand;
- paralysis of the upper limbs;
- the formation of false joints;
- violation of posture;
- the development of arthrosis;
- suppuration of the wound after surgery;
- wound infection with an open fracture;
- shortening of the hand.
Only correctly and timely immobilization will allow a patient who has broken his collarbone to recover quickly and return to his previous lifestyle. First aid is necessary in order to subsequently avoid serious complications.