Fracture of clavicle with displacement: operation, recovery period

Fracture of clavicle with displacement: plate surgery and recovery period

The clavicle is called the tubular bone, which connects the thorax with the shoulder blades.

On the side of the acromion of the scapula, the acromial process of the clavicle is localized, and on the chest side is the thoracic end.

Between them is the most delicate and fragile part of the bones - the diaphysis. It is in this area that the integrity of the clavicle is often violated.

Fracture of the clavicle with displacement is a frequent trauma in medical practice, and especially in children and people of advanced age. If the clavicle is damaged, the upper limbs lose their ordinary motor function, since it is their support.

Due to the fact that in the upper shoulder zone there are powerful and large muscles, and they are transferred to the state of trauma increased tone and are in a similar position for a long time, there is a shift in the fragments and often damage them soft tissues.

Classification

Injuries are classified according to the affected area:

• fracture of the acromial end of the clavicle;
• damage to the pectoral process;
• trauma of diaphysis (middle of bone).

Fractures are:

1. open;
2. closed;
3. without bias and with it;
4. cloven and multi-lobed.

Trauma with a displacement of fragments is divided into:

• displacement of incomplete type - in case of bone fragments retained by periosteum;
• complete displacement - the periosteum does not retain bone and soft tissue damage occurs;
• open trauma - broken bones come out, tearing the victim's skin;
• closed damage - bones do not damage the condition of soft tissues.

Causes

Fracture of the clavicle occurs due to increased traumatic effects on this area of ​​the bone.

Most often such men are injured up to 40 and people suffering from such a disease as osteoporosis, in In the case of this disease, bone strength is significantly impaired, and injuries occur even with a weak effect on the bone.

Also, damage can occur as a result of:

1. direct or indirect impact to the key area;
2. falls on the hand;
3. industrial injury;
4. non-compliance with safety rules;
5. employment in extreme sports;
6. increased pressure to the place of damage;
7. road accident;
8. increased axial load;

First signs

The most common signs of fracture of the clavicle with displacement:

• severe pain in the injured area;
• the appearance of swelling of the injury site;
• the appearance of internal hemorrhage;
• visual change of the bruised place;
• shortening of the upper limb;
• deterioration of the motor function of the hand;
• at a palpation and a load on a bone the painful syndrome amplifies;
• In the case of an open fracture, there is bleeding, and the fragments protrude outwards;
• The shoulder of the injured side stands forward.

Emergency medical care

First of all, you need to call an ambulance, but if you need to transport yourself, first aid will play a big role in the effectiveness of subsequent treatment.

If the victim has a pronounced pain syndrome, then it is necessary to give him any available anesthetic non-narcotic remedy.

In case of an open fracture, a tourniquet should be applied to stop the hemorrhage.If after applying the skin becomes darker - loosen the tearing bandage.

Next, treat the wound and fix the bone in one position.

Immobilization of the limb occurs by imposing a bandage on the arm and attaching it to the trunk. Before the fixation procedure, it is recommended to put something in the armpit of the victim.

Methods of diagnosis

First of all, if the clavicle is broken with a shift, the doctor conducts a survey of how the injury was received and what symptoms the victim is concerned about.

Next, a palpation procedure is performed, which helps to understand how far the fragments of bones were displaced. A more accurate diagnostic method is radiography.

After receiving its results, the attending physician makes an accurate diagnosis and, based on the nature of the injury and the degree of its severity, prescribes the most appropriate treatment.

Methods of therapy

Treatment of fractures of the clavicle with displacement can be carried out in two ways:

1. surgical treatment;
2. conservative therapy.

Conservative treatment

Conservative type of treatment is applied if the degree of damage is light and the bone is displaced insignificant, and also in the event that the victim has contraindications to the surgical intervention. They can be this:

• severe stage of diabetes mellitus;
• cardiovascular diseases;
• advanced age of the patient;
• a serious condition of the patient's general health;
• neurological diseases.

Treatment of fracture of the clavicle with displacement is a strong comparison of bone fragments and the subsequent immobilization of the injured limb. The trauma doctor gives the patient an anesthetic, and then performs the reposition procedure.

After the displaced clavic fragments are firmly juxtaposed - the hand is fixed with a special bandage that fastens the limb on the chest and shoulder.

The doctor appoints the period of immobilization individually for each case. On average, immobilization takes place within 4-8 weeks. During the fixation, the doctor carefully monitors the state of bone splicing and the formation of bone callus.

Depending on all these factors, the wearing time of the dressing is determined.

Operation

An operative method of treatment is applied if:

1. there is an infringement of blood vessels and nerve endings between bone fragments;
2. a greater likelihood of improper splicing when using a conservative method of treatment;
3. trauma of internal organs;
4. Ineffective or ineffective effect of external therapy.

Methods of surgical treatment are many and they are selected individually for each case. Types of surgical intervention:

• bonding pin internal osteosynthesis (there may be two types: 1 - According to Klyuchevsky, 2 - Spijan-Kuncher method);
• the use of screws;
• fixing bones with a plate;
• treatment with pins;
• application of external fixation apparatus.

Depending on the nature of the damage, any of the above operations is performed. Conduct it using local anesthesia.

After the operation, the cut area is stitched, and the hand is also fixed with a bandage.

Move limb is allowed after the removal of stitches, and intensive work capacity is also allowed on the advice of a doctor. After a few months, the metal structures are removed.

Operation with a plate with a fractured clavicle with displacement can determine the use of various devices.

So, for example, there is an S-shaped, hook-shaped and special plate with locking screws.

The last 3 devices are used in case of a fracture of the acromial end, and in case of a fracture of the middle part of the bone an S-shaped plate is used.

In the video below you can see how the clavicle bone is made with such a plate.

The pin can be further locked with screws, for this purpose, holes are provided therein.

Also there is an unlockable pin, the surface of which can be flat or threaded. The latter is more firmly in the bone.

Recovery period

After the injured person is removed from the bandage, the doctor prescribes the beginning of the rehabilitation period.

It is necessary, because after prolonged immobilization of the limb, the performance of the injured bone is significantly deteriorates and in order to fully resume its ordinary motor function, special developmental procedures.

What will be the recovery period after the fracture of the clavicle with an offset, determines the attending physician. The length of rehabilitation depends on the nature of the damage and on the time that was spent for bone fusion.

There are such rehabilitation procedures:

• special massage courses;
• special development exercises;
• physiotherapy;
• physiotherapy;

Equally important in the recovery period is proper nutrition. It should be balanced, high-calorie and rich in vitamins.

The doctor appoints a visit to massage and physiotherapy procedures that help improve blood circulation and develop muscles. The period and frequency of visits are determined depending on the severity of the injury.

Also, a qualified specialist prescribes a number of recommended exercises, which also help to bring the injured bone into shape.

Adhering to all the recommendations in the treatment and subsequent rehabilitation, the motor functions are renewed after a couple of months, and the patient will never again remember the previous trauma.

Effects

Fracture of the clavicle with displacement may be accompanied by such complications:

1. shortening of the injured limb;
2. constant pain;
3. visual deformation of the hand;
4. improper fusion of fragments;
5. introduction of infection (in case of open trauma);
6. worsened performance of the limb.

A source: https://PerelomaNet.ru/perelomy/klyuchitsy-perelom-so-smeshheniem-period-vosstanovleniya.html

Fracture of clavicle with displacement

Fracture of the clavicle with displacement is one of the most common injuries in childhood and the elderly. The baby has elastic bones, but does not have the necessary strength.

In elderly people, a large amount of mineral substances accumulate in the bone tissue, resulting in the clavicle becoming fragile and easily deformed under the influence of traumatic factors.

Fracture of the clavicle is often accompanied by a displacement of the bone fragments as a result of reflex spasm of the surrounding muscles.

This, in turn, contributes to the trauma of the neurovascular bundle, which passes in the region of the upper humeral girdle.

What is a clavicle fracture?

The clavicle is a small tubular bone that connects the scapular and sternum between each other. It is located at the level of the first rib, has an S-shape and several anatomical parts.

On the side of the acromial process of the scapula, the acromial end of the clavicle is localized, on the side of the sternum is the sternal end, and between them is the diaphysis, the thinnest and fragile part.

Fractures of the clavicle in most clinical cases occur in the diaphysis region and are much less frequent in the area of ​​its ends.

The clavicle is the support for the upper limb. If it is damaged, the motor function of the hand suffers.

In the region of the upper humeral girdle there are large muscles, which, for a fracture, reflexively contract and are in a state of increased tonus for a long time. This causes the displacement of bone fragments and damage to surrounding soft tissues.

Following the location of the clavicle, large vessels and neural bundles follow, which can be damaged by acute bone fragments, which causes the development of complications.

Structure of clavicle

Fracture of the clavicle with displacement is divided into several types:

• incomplete displacement - bone fragments are retained by the periosteum;
• complete displacement - bone fragments are not retained by the periosteum, their displacement injures soft tissues;
• open fracture - bone fragments go out through the wound surface of the skin;
• closed fracture - bone fragments do not injure the skin.

Fracture of the clavicle, which is accompanied by a complete displacement of bone fragments, requires long-term treatment and recovery, especially with concomitant dislocation and lesion of the vascular nerve trunks. The most severe form of injury is an open fracture due to a significant displacement of fragments and a threat of infection of bone or soft tissue.

Causes

In infants, fracture of the clavicle occurs as a result of birth trauma

Fracture of the clavicle occurs with a direct stroke in the area of ​​the shoulder, falling on the arm or a high axial load on the bone.

In any case, the mechanism of injury consists in exceeding the strength of the traumatic agent over the strength of bone tissue. In people at young and adulthood the clavicle possesses sufficient strength and is rarely subjected to deformation.

Its fracture can occur with an intense impact, for example during traffic accidents.

In most clinical cases, collar trauma occurs in a newborn child due to birth trauma or in children at an older age during games, ice skating or biking.

During the growth of the skeleton (up to 18-20 years) in the bones, organic compounds prevail over mineral ones, which makes them elastic, but not strong. In elderly people, after 50 years, a fracture of the clavicle occurs quite often.

It occurs when exposed to traumatic factors of low intensity. This is due to the increased fragility of bones in connection with age mineralization.

Clinical picture

The clinical manifestations of a collarbone fracture depend on the nature and severity of the injury, but usually have a vivid symptomatology. A comminuted fracture proceeds with damage to the surrounding soft tissues, which aggravates the course of the disease. After a fracture, there are such clinical manifestations:

• a sharp pain in the area of ​​the injury, which is amplified when the hand moves on the side of the lesion;
• swelling of soft tissues in the clavicle;
• the formation of a hematoma when a bone fracture of a blood vessel ruptures;
• The shoulder is below the physiological position and projects forward;
• hand hangs down in the form of a "whip motor activity is difficult and painful, numbness of the hand;
• the scapula on the side of the lesion is stronger than on the healthy half of the body;
• when touching the forelegs, they find crepitation - a crunch of bone fragments and their mobility relative to each other;
• bleeding and wound surface, from which fragments of the clavicle may protrude;
• damage to the dome of the pleura, accompanied by increased pain and respiratory failure.

X-ray of a clavic fracture of the clavicle

To eliminate pain, the victim holds a healthy arm with the elbow of the hand on the side of the injury and presses it against the body. Confirmation of the diagnosis is performed with the radiography of the clavicle in a straight and lateral projection, where displacement of bone fragments and bone fragments in soft tissues are revealed.

First aid

Also you can read:Plexitis of the cervical plexus

After fracture or suspicion of a trauma patient must urgently be delivered to trauma.

For transportation it is better to call an ambulance. If it is not possible to deliver a patient to a hospital on a specialized machine, it is necessary to use an improvised transport.

At the same time, it is necessary to know the rules of transportation of the patient to the trauma center, from the precise performance of which the duration of treatment and recovery after trauma depends.

Improper transportation contributes to damage to the bone fragments of the neurovascular bundle, which complicates the severity of the injury and causes complications.

To fix bone fragments, the bent arm in the elbow joint on the side of the lesion is bandaged to the trunk. To immobilize the upper limb in this position, you can use a kerchief or clothing items.

The task is to prevent the trauma of soft tissues during transportation and to reduce pain. Immobilization should be tough and reliable.

Before fixing the arm into the armpit, it is better to put a roller of soft material.

When rendering assistance to the victim, do not take such actions:

• to insert bone fragments into the wound with an open fracture or to compare them with closed trauma;
• pull for the injured limb;
• Straighten the arm on the side of the fracture;
• tilt the torso forward;
• to transport the patient in a standing or lying position.

Harness for transporting the patient to the emergency room

Deliver the victim to the hospital in a semi-sitting position and only after fixing the injured upper limb.

Therapeutic tactics

Treatment of fracture of the clavicle with displacement is carried out conservatively and surgically. The method of therapy is determined by the doctor, according to the severity of the injury and the age of the patient.

Conservative treatment consists in repositioning - comparison of bone fragments. The repositioning is carried out after radiography and analgesia of the place of trauma with anesthetics.

After comparing the deformed ends of the clavicle, a plaster bandage is applied, which is fixed on the shoulder and chest.

The cast is not shown to children due to the anatomical features of the bone tissue in the child. Also, plaster is not imposed on patients over the age of 50 due to the high risk of developing arthrosis of the shoulder joint.

In such cases, apply hard bandages Dezo or Delbe rings. Conservative therapy is usually prescribed with incomplete displacement of bone fragments or contraindications to surgery.

With a fracture with a complete displacement of bone fragments, surgical intervention is used, which prevents the development of complications.

Osteosynthesis of clavicle with plate

Operations in the fracture of the clavicle, accompanied by the displacement of fragments, are divided into several types:

1. Intraosseous osteosynthesis - fixing fragments in the physiological position with the help of metal rods: the Klyuchevsky method - It is applied in case of formation of a short central fragment; The method according to the Spirazharyu-Küpcher is used in the formation of a peripheral breaking.
2. Osteosynthesis using metal plates - S-shaped, hook-shaped, reconstructive in case of fractures of the clavicle in the diaphysis area.
3. Osteosynthesis using pins or an external fixation device: locking pins - have additional screws for fixing; Non-locking pins - do not have additional screws.

The technique of surgical intervention is determined by the doctor, according to the severity of the trauma and the general condition of the patient.

Rehabilitation after clavicle fracture

In the rehabilitation period after the removal of gypsum or fracture fusion as a result of the application of special fixing devices recommend comprehensive measures to restore motor ability extremities. Assign fizioprotsedury, massage and exercises in therapeutic gymnastics.

Physiotherapeutic methods of treatment use electrophoresis with lidase, magnetotherapy, UHF, phonophoresis with hydrocartisone.

Thanks to physioprocedures, the blood flow in the affected arm is normalized and the reparative processes in the bone tissue are improved. Massage develops muscles, which at the time of immobilization are atrophied and lose their tone.

Physiotherapy is prescribed at the stage of immobilization of the upper limb or in the early postoperative period.

Begin with passive movements of fingers and hands, and after removing the gypsum they pass to active exercises, strictly proportioning the amplitude of movements and load during classes.

Training is carried out in groups of exercise therapy under the supervision of a specialist, which significantly improves the effectiveness of the recovery period. Correctly organized rehabilitation facilitates the return of the lost functions of the damaged arm in full.

Timely seeking medical help, correct immobilization of the hand during transportation and adequate treatment prevents the development of complications and impaired motor activity of the upper extremities.

A source: http://MoyaSpina.ru/bolezni/perelom-klyuchicy-so-smeshcheniem

Fracture of the clavicle with displacement: the period of recovery and treatment, how to develop a hand

The clavicle is a tubular S-shaped bone that forms a rigid junction of the upper limb with the trunk. The age of patients with fracture varies from 14 to 40-45 years.

Among older people, the trauma is less common. Treatment is carried out on an outpatient basis. Hospitalization of the victim in a hospital is required only if surgery is necessary.

Causes and mechanism of fracture

Fracture of the clavicle with displacement is usually a consequence of a strong mechanical effect. Such injuries are considered normal, physiological.

They arise when the force of the impact exceeds the level of elasticity of bone tissue. A striking factor can be a strong blow (a fight, a fall from a height) or squeezing the upper body between two solid objects (road accidents).

Physiological fractures of the clavicle can be:

• Straight (the blow is applied directly to the collarbone), in which the bone is destroyed directly at the site of the impact. Usually found in combat zones or after a fight;
• Indirect (it is necessary to strike on the withdrawn hand). The force of the impact of the damaging factor is transmitted to the collar bone indirectly. The bone is damaged at the point of greatest bending.

Pathological fractures occur in the presence of a number of diseases, accompanied by a decrease in the elasticity and strength of bone tissue (rheumatoid arthritis, cancer, osteoporosis, improper development of the skeleton). The impact force can be minimal. In some cases, the bone breaks down completely without external influence: a sufficiently strong contraction of muscles.

Types and symptoms of clavicle fracture

As a rule, fractures of the clavicle lead to displacement of the fragments. This does not happen only with incomplete fractures - bone cracks. Frequent displacements are caused by a high lateral load on the bone.

By the level of displacement fractures are divided into:

1. Incomplete. There is a fracture of the bone itself, but the periosteum remains intact and limits the mobility of the fragments. With such injuries, nearby tissues and organs do not appear to be affected;
2. Complete. Not only the bone but also the periosteum is damaged. The edges of the fragments can damage the blood vessels and nerves, cut through the skin and go beyond the body (open fractures).

Open fractures of the clavicle are rare.

In terms of the number of fragments, the damage is:

• Bezoskolchatymi;
• Two-lobed;
• Multi-lobed.

Diagnosis of fractures is simple enough. Immediately after the injury, the victim experiences severe pain in the place of injury. Sensations increase when you try to raise or lower your arm. The patient presses the limb to himself to limit her mobility.

The function of the upper shoulder girdle is disrupted, the patient's shoulder is shifted down and forward. At the moment of feeling of the affected area, a crunch of shifting bone fragments can be heard.

After several hours in the area of ​​the clavicle there is redness, swelling, local increase in body temperature.

To the touch, the lesion is hot, hard, and the edges of the bone fragments can be visually discernible. The function of the hand is broken even more.

When X-ray examination clearly shows the fracture line and the presence / absence of fragments.

Methods of treatment

Treatment of fracture of the clavicle with displacement can be both conservative and surgical.

Conservative therapy is subject to flawless subperiosteal fractures with a slight bias, as well as traumas without displacement.

Indication for surgical intervention is the presence of fragments, significant displacement, an open type of fracture.

Surgery

Surgical treatment consists in comparing bone fragments (reposition) and their strong fixation in a given position (osteosynthesis). An intraosseous pin or an outer plate can be used to bond the bone.

The apparatus of Ilizarov, successfully used in the treatment of other types of fracture, with damage to the clavicle is practically not is used because of an extremely uncomfortable position for the patient, and also because of the high risk of infectious complications.

Operation with the use of pins makes it possible to achieve the most durable connection with a comminuted fracture of the clavicle with displacement. However, it is technically complex and is accompanied by a high risk of complications.

In the tissues of the bones, a channel is laid. It introduces a metal pin, passing through the fracture line and firmly fixed in the second fragment.

When it is performed on top of the combined fragments on the fracture line and surrounding tissue, a flat metal plate with holes is placed, which is fixed with special bone screws.

This method is accompanied by the least amount of complications, but it does not allow to create an equally strong bond, as in the case of the pin.

Osteosynthesis

Osteosynthesis of fragments is carried out in the shortest possible time, before the onset of natural processes of healing and formation of a false joint. The operation is performed under general anesthesia.

The surgeon makes a cut, manually combines and fastens the debris, fixes them and installs drains. After that, the wound is sutured. The limb is immobilized with a soft bandage.

Discharges from the drains are monitored for 2 days.

If the discharge from the wound is not purulent or bloody, drains are removed, and then a permanent plaster bandage of the sternum-brachial type is applied.

If pus leaves the pus, the wound is opened, cleaned and treated with solutions of antibiotics, then re-suture and change the patient's prescribed antibacterial therapy.

The patient is allowed to perform limited limb movements for at least 3-4 weeks.

The inserted pins and bone plates are removed after complete bone fusion. As a rule, this happens six months after the operation.

It is fully feasible to use the hand and carry out heavy physical work in 8-12 months.

The complication of osteosynthesis may be the development of osteomyelitis, the failure of the fixing apparatus and its early destruction.

In addition, in the early postoperative period problems can arise that are characteristic of any species surgical intervention: infectious complications, bleeding, severe pain syndrome, insolvency seams, etc.

Medication support of treatment

In the postoperative period, the patient should receive medication. Patients who have undergone operative osteosynthesis are prescribed drugs that accelerate bone splicing (chondroitin, teraflex, agents containing calcium salts).

In the composition of such medicines there are substances that are the building material for bone and cartilaginous tissue.

In the first week after the operation, patients are prescribed antibacterial therapy with drugs, capable of penetrating into the bone (lincomycin, tetracycline, vibramycin), analgesics (ketorol, analgin), vitamin therapy, drugs that prevent the development of thromboses (aspirin-cardio, cardiomagnet).

The last group of drugs should be used only in the absence of data indicating a high risk of bleeding.

Now you know what to do with a fracture of the clavicle with a bias and how to conduct treatment without surgery, consider the types of bandages for trauma.

Types of dressings and their use

As in the postoperative period, and with the conservative treatment of clavicle fractures, several types of dressings are used.

They are used to fix and support the injured limb, in order to immobilize and to exclude accidental displacements of the arm from a given position.

In modern clinical practice, the following types of dressings are used:

• Rings of Delbe. Around the epithelium of the patient make 2 rings from improvised means (towels, stripes of tissue). Behind the rings are connected by a rope at the level where the victim marks the reduction of pain. The dressing is suitable for primary fixation of the limb at the prehospital stage;
• Eight-piece dressing. It is imposed through the back and the shoulder straps of the patient. On the front surface of the body resembles the rings of Delbe. Behind the back is a cross-shaped view. It is also used at the prehospital stage, since it does not lift the shoulder-straps, but only raises them to the sides;
• The Dezo bandage. Performed using an elastic or simple bandage. It allows you to fix your hand in the horizontal and vertical plane, but does not spread your forearms to the sides. Complicated in performance, can only be imposed by qualified medical personnel;
• Bandage Velpo. The brush of the injured limb is fixed on the healthy shoulder-blade with the palm facing down. The hand is bent at an angle of 45 degrees. Fixation is made around the body in a vertical and horizontal plane. The bandage allows you to achieve complete immobilization of the hand, however, like the Dezo bandage, does not dilute the forearm;
• Harness dressing. It is formed from a square piece of cloth. The fabric should be folded in the shape of a triangle and lay your hand on its wide part. Long ends tie around the patient's neck. The bandage dressing is extremely simple to perform, but it is not capable of fixing the injured limb;
• Gypsum bandage. It is imposed by medical personnel as a permanent means of fixation. Provides a rigid fixation of the limb in the desired position, can be used for a long time. Today, gypsum bandages are replaced by bandages made of composite materials. They retain all the benefits of gypsum, but they have less weight and size, which makes them easier to wear.

The type of fixation of the limb is chosen by the doctor. As a rule, prolonged immobilization is carried out exclusively by gypsum or composite materials. Tissue dressings are more often used at a prehospital stage.

Rehabilitation after fracture of clavicle with displacement

Rehabilitation after a fracture of the collarbone begins in the early stages. As a rule, during the wearing of the fixing bandage, the patient is prescribed physiotherapy. The recovery period (healing) of the clavicle fracture with displacement can reach up to 8 weeks.

After removal of gypsum, it is recommended to immediately begin to develop a damaged arm, gradually increasing the load on it. A therapeutic massage is prescribed, which improves blood circulation in the damaged area and accelerates healing. The procedure is carried out 2 times a day for 10 minutes.

After healing of the injury, the doctor will prescribe exercise therapy, exercises and tell you how to develop a hand after a fracture of the clavicle with a bias.

Physiotherapy specialists recommend starting to develop a hand using special gymnastics sticks. The patient restores the ability to withdraw and bring his hand to the body, bend and unbend the shoulder joint.

After this, they pass to exercises with weights, which allows to restore the muscular strength of the limb and the volume of movements in it. The work must be done under the supervision of the trainer. The recovery period after the fracture of the clavicle with displacement will be determined by the doctor.

Consequences and complications

Complications and consequences arising from fracture of the clavicle with displacement are subdivided into early and late ones.

Early complications occur immediately at the time of injury, as well as in the first days after surgery.

This group includes bleeding, infectious processes, damage to muscles, skin and nerve trunks with bone fragments.

Late complications arise due to improper treatment or complete absence. In this case, the bone fuses incorrectly, which leads to the limitation of the mobility of the hand, the inability to perform normal physiological movements, and disability.

If a large distance is maintained between bone fragments, there is a risk of forming a false joint - the area of ​​the soft joint, unable to provide the necessary stiffness of the arm connection with body.

Fractures of the collarbone in children

Due to the good elasticity of bone tissue, fractures of the clavicle with a shift in the child often occur as a green branch,similar traumas in children are treated and heal quickly enough. This occurs subperiosteal fracture, but the periosteum keeps fragments from displacement.

As a rule, the recovery period does not exceed 1-2 months. Open fractures, as well as complicated multi-lobed lesions that occur in older children, heal longer. However, even in this case, recovery is much faster than in adults.

About the fracture of the collarbone in newborns can be read in detail here.

A source: https://1travmpunkt.com/perelom/raznie/klyuchicy-so-smeshheniem.html

Fracture of collarbone with displacement recovery period

REHABILITATION - EURODOCTOR.RU - 2012

Three periods of recovery after a collarbone fracture

Fracture of the clavicle is not a rare type of injury, the mechanism of which can be indirect, that is, due to fall on the wrist, shoulder or elbow, which is much more common than the second option - a direct blow directly to the clavicle.

The main curative approach to this problem is the fixation method. For this purpose, usually use the eight-type Borchgrevinka, Ombredana or immobilizing dressing Dezo, as well as cotton-gauze rings Delbe, tire Kuzminsky.

As a rule, surgery is rarely resorted to in such situations - when bone fragments squeeze and damage nearby vessels and nerve trunks, or if in another way it is impossible to eliminate the existing displacement of the clavicle.

In such situations, fragments are first exposed, then an open reposition is made and at the end fixed using special plates, metal pins, bolt-ties or long screws.

This tactic ensures a high-quality and reliable retention of clavicle fragments in the right, correct position, eliminating the need for overlapping gypsum during the post-operation period, which allows to improve the quality of life of the patient and shorten the period of his rehabilitation.

Immobilization with bandages (including gypsum) and tires on average lasts about three weeks. Therapeutic gymnastics is appointed literally from the second to the third day after the injury.

First these are different movements of the fingers, flexion-extension in the wrist and elbow joint, pronation-supination (rotation inside-out) of the forearm, as well as small leads of the limb in the shoulder joint when tilted to the side where the injured collarbone.

Exercise at the beginning is performed with the help of an arm bent in the elbow, later the degree of diversion is increased, without exceeding the angle of 90 ° (during immobilization). Along with special exercises at this time are also engaged in respiratory and general developing gymnastics.

In the second period (at the end of immobilization), flexion-extension and retraction-reduction in the shoulder joint are performed, using gymnastic sticks, in addition continue to develop all the other joints of both hands and feet, doing exercises for housing.

In those cases when, after a fracture of the clavicle, the osteosynthesis of its fragments was performed, active movements in Shoulder joints are allowed after the removal of stitches, and hand movements exceeding 90 ° approximately a week through two.

In the process of bone splicing, physiotherapy has proved well, in particular the use of a magnet whose action is based on the influence of its field on the affected area, and electrophoresis with chloride calcium.

Massage and warm baths are also helpful, but only with the permission of the doctor.

Restoring the clavicle after a fracture

Quite often encountering a trauma is a fractured clavicle. It can happen either as a result of a fall from a height, or after a strong direct blow to the shoulder.

As you know, the skin areas near the clavicle are very thin, so a bone fracture can be seen right away.

Rehabilitation after this plays a significant role for the complete restoration of all the functions of the hand, because with trauma they are significantly violated. Often even it becomes impossible to raise your hand.

Duration of treatment is approximately four to five weeks, depending on the degree of complexity of the injury received, as well as on its nature. Rehabilitation is, on average, three weeks, after which the functions of the hands are fully restored.

Treatment can take place in two ways: with and without surgery.

Usually, the operating method is not used, because bone fragments in this part of the body can be compared manually.

But sometimes there are exceptions, for example, if the recovery is too slow and the bone either does not fuse at all, or does it incorrectly.

When a bone is broken into a damaged area of ​​the skin, a complex bandage is applied to ensure complete immobility of the bone fragments.

But it is worth noting that even despite the complete immobility, the opportunity to perform exercises remains.

In many hospitals, instead of the dressings described above, a compact oval cushion is placed in the axillary cavity and fixed with gypsum.

Physiotherapy and special procedures

Recovery includes a course of treatment, such as physiotherapy. It is prescribed, as a rule, after a week after the injury, in order to obtain a better effect.

The affected arm is affected by special magnets, electrophoresis, ultraviolet radiation and some other devices. Due to their abilities in the place of damage, blood circulation increases, which allows bone to grow much faster.

The effect of using physiotherapy will be best if you do some exercises of exercise therapy and attend a massage.

The importance of massage for breeches of the clavicle

Rehabilitation begins with the appointment of a massage course. Depending on the degree of complexity of the injury, the doctor can recommend an early course of treatment, which will begin after ten days.

In this case, there is an effect on undamaged tissues that are near the breakage.

After the removal of gypsum, more intensive measures are initiated to restore the sensitivity of the skin in the fracture site, accelerate blood flow.

Massage procedures can be performed only by an experienced doctor. It is important to know the points at which the impact is allowed, as well as correctly calculate the force.

Exercises for fracture

Without removing the shoulder from a special pillow, the injured person can perform simple exercises from the first days of the stay in the cast. You should start with the movements of the fingers and hands, but do not go higher than the elbow joint.

Light gymnastic exercises are conducted no more than a few minutes, but their frequency during the day will reach five to six times. All movements of the injured hand must be done smoothly and slowly.

At the slightest appearance of pain, exercise should be stopped immediately.

After the removal of gypsum or a special cushion, rehabilitation begins. Restoration of the functions of the injured hand begins with the procedure of massage and physiotherapy, then exercise exercises are added to them.

After a certain amount of time, the exercises can become more complicated, using dumbbells, gymnastic stick, ball.

All this will help bone fragments to fuse faster, and the restoration of the function of the damaged arm will be successful.

Exercises can be carried out including in the water.

Injury of the clavicle, requiring surgical intervention, is treated longer, so in order to avoid complications, the patient it is permitted to proceed with activities aimed at restoring the functions of the hand only after all seams. With the permission of the doctor, she can be appointed as early as the next day after surgery, but this happens only in exceptional cases.

Recovery after surgery is no different from the technique of training with a simple fracture of the bone of the upper extremity belt. Of course, it will take a little longer, but in general the activities will not be different.

In addition to an easy fracture of the clavicle, there may be more complex, for example, open forms.

This type of injury is very dangerous, as the vital vessels and organs in this area can be damaged.

When the end of the collarbone breaks, restoration with the help of exercises begins with the development of fingers, wrists, and periodic bending and extension of the arm are also performed.

LFK with a simple character of bone damage can be appointed on the second day after the injury.

The rehabilitation period in this case will be divided for a period before the removal of gypsum or a tire and after removal.

In the complex of exercises can be included not only special classes for the hands, but also general-developing and breathing exercises.

Recovery after a fracture of the clavicle

This trouble can occur due to a fall (on the arm, elbow or shoulder). Less often the cause is a direct strong blow to the area of ​​the clavicle.

There are two most common treatments for clavicle fracture. The most commonly used method of fixing a fracture.

To do this, resort to the use of an immobilizing bandage.

It can be an eight-type Borchgrevinka, Ombredana. In some cases, cotton-gauze rings Delbe or Kuzminsky tire are used.

This operation was called osteosynthesis. The displacement of bones is eliminated. As a rule, bones are fastened by means of metal parts (screws, plates, pins). Immediately after the operation, the injured hand is fixed with a bandage bandage, and pain medications are prescribed.

After the correct union of bone fragments, the function of the shoulder joint is gradually restored. As a rule, there is an insignificant limitation of movements and slight discomfort.

Rehabilitation after a fracture of the collarbone implies and therapeutic exercise.

LFK usually appointed with conservative treatment immediately after a significant or complete reduction of pain.

The rehabilitation medical complex, as a rule, includes general developing, breathing exercises, as well as various exercises for the fingers.

When the immobilization period ends and the formation of the callus begins, the exercises that facilitate the restoration and development of the shoulder joint function are prescribed. It is important that the patient perform exercises on flexion-extension of arms and withdrawal-reduction in the shoulder joint with both hands.

It is possible to use gymnastic sticks. In most cases, do not stop to develop all the joints of both hands and feet, perform exercises for the body.

Then follows the training period. At this time, the injured arm receives the main load to completely restore the movements in the shoulder joint and bring the muscles into tonus. The peculiarity of the period is not to allow the appearance of pain.

If the patient was operated on, the exercises of exercise therapy are prescribed starting the day after the operation. In parallel, for effective rehabilitation after a fracture of the clavicle, massage is recommended. You can conduct it from the second day after the injury.

In the sitting initial position, a healthy part of the chest and back of the patient are massaged 8-12 minutes twice a day using the following techniques: kneading, squeezing, stroking. After removing the fixing headscarf, the sessions of gentle massage of the injured hand are joined.

If the situation is serious and osteosynthesis was made, the active loads (movements) are possible strictly after the removal of the joints. Movement with a hand with an amplitude of more than 90 ° is allowed no earlier than two weeks.

Another positive method of rehabilitation is physiotherapy. Using a magnet helps to quickly repair damaged areas.

Its action is based on the influence of the magnetic field on the affected area and electrophoresis with calcium chloride.

In some cases, doctors prescribe warm baths and massage, but under the strictest control of a health worker.

A source: http://semejnyj-doktor.ru/chto-delat/perelom-kljuchicy-so-smeshheniem-period.html