Causes and types of fractures

Fracture of the clavicle is a violation of the integrity of the bone. According to the mechanism of injury clavicle fractures can be divided into two groups. The first group fractures resulting from direct trauma, such as, for example, the impact on the shoulder or collarbone. Such injuries result in comminuted, transverse and kosopoperechnomu fractures. The second group includes fractures arising from the indirect mechanism of injury, for example, after the fall of the outer surface of the shoulder, elbow or on the outstretched arm. In these cases, fractures are more often oblique and kosopoperechnymi. Sometimes clavicle fractures occur due to muscle contraction caused by seizures (eg, epilepsy).

By location clavicle fractures are divided into fractures in the area of ​​the outer third, middle third and the inner third. Most often fractures occur in the middle third or between the middle and outer thirds.

How does

For fractures of the clavicle can be damaged by a variety of organs and tissues, as the nature of the displacement of bone fragments can be affected by factors such as the impact force, the severity of the extremities, muscle traction, etc. Ends displaced fragments can be damaged pleura, blood vessels, nerves, skin.

The victim is concerned about pain at the fracture site, the hand on the side of the injury moves with difficulty because of the pain. At the site of injury have swelling, change in shape of the clavicle, the shortening of the shoulder girdle, hemorrhage, shoulder lowered and shifted to front and inside, supraclavicular fossa smoothed. The victim maintains good arm forearm and elbow of the injured limb, pinning her to the trunk. When probing at the fracture site can be determined by the mobility of fragments of the clavicle and the friction (crepitus). It is not necessary to achieve a clear identification of the mobility of fragments of the clavicle when viewed, as it is very painful and can damage the surrounding soft tissues.

Examination of victim

If you suspect a fractured collarbone doctor in the first place reveals the degree of violation of the soft tissue (skin, subcutaneous tissue, blood vessels, nerves, organs of the chest), after which the victim is assigned to X-ray examination to clarify the diagnosis and adequate treatment of.

Treatment of fractures of the clavicle

At the scene, the victim must be first aid, which is suspending his hands on the headscarf. It is also possible to bandage his hand to the body (the elbow is bent at a right angle), then bring the victim to the emergency room (or in the hospital, depending on the state) to establish an accurate diagnosis and the provision of medical care.

Treatment of clavicle fracture depends on its nature. Treatment subperiosteal fracture (of the type "green branches") and fractures without displacement of fragments is carried out using a variety of fixing bandages, which are imposed for a period of two to three weeks in children and adults for a month (in children fractures grow together more quickly).

For fractures of the clavicle with displacement of bone fragments after local anesthesia produced fragments reduction. But to keep fragments in position is very difficult due to muscle strain, so special methods of fixation, e.g., rings Delbo - two soft grip ring shoulder joints and are connected with each other on the back.

In case of damage, requiring prolonged bed rest, the victim is laid on the bed with a hard mattress, arm hanging down from the bed and behind.

If fractures are complicated by a violation of the skin (open fractures) or closed fractures with soft tissue injury hosts a variety of surgical procedures, restore the function of the clavicle.

Fractures of the clavicle are common, so you need to know their main features, and CPR and first aid.

  Galina Romanenko

What is a dislocation and its species

Dislocation - a persistent shift of articular ends of bones articulated beyond their physiological mobility, causing dysfunction of the joint. Dislocation can be full with widespread loss of contact of the articular surfaces of bones that form the joint, and incomplete (subluxations), when retained their partial contact, but in inappropriate places. Sprained considered peripheral bone, the title of which is denoted by a dislocation. For example, with dislocation of the elbow dislocation say forearm Dislocation of the forearm: only reduce a traumatologist .

Due to the occurrence of dislocations are divided into traumatic, habitual and pathological (caused against the background of a disease).

Traumatic dislocation

Traumatic dislocations occur most frequently, while their frequency varies in different joints, it depends on the functionality of the joint and its structure. The most common dislocation of the shoulder joint, which has a sharp discrepancy articular surfaces. Rare dislocation of the hip, as it has a good correspondence of the articular surfaces of bones, a strong joint capsule and ligaments strong.

Traumatic dislocation usually occurs as a result of indirect trauma of violent and rapid motion in the joint. As a result of traumatic dislocation usually occurs rupture of the joint capsule over a large area, stretching or torn ligaments. As a result, damage to the soft tissue ruptures small blood vessels and nerves, blood enters into the joint cavity. All of this in the future may serve as a basis for the formation of osteoarthritis (swelling inside the joint connective tissue in violation of its mobility).

Depending on the time elapsed since the injury, dislocations are divided into fresh (up to 3 days), stale (3-4 weeks) and chronic (over a month). Traumatic dislocations can also be opened (in violation of the skin) and closed (without breaking the skin).

Perelomovyvihi cases also when a dislocation occurs simultaneously with a fractured articular or periarticular bone sections (usually it happens in the elbow, hip and ankle).

Permanent sign of dislocation is a sharp pain in the affected joint and the violation of its functions at the moment of injury. Characteristic change in shape of the joint - often allows a diagnosis after examination of the victim: the joint loses its normal shape, its contours are smoothed out, there is a retraction on the site of one of the joint ends of the bone, the limb is in a forced position and can look lengthened or shortened. When probing the joint revealed no bone heads in the usual place. Active movement in the joint is almost entirely absent, passive movement (if someone, for example, raise the injured limb) are painful, their volume is sharply limited, the injured limb has a spring resistance.

Traumatic dislocation may be complicated by osteoarthritis Osteoarthritis - when the joint loses its function   with joint dysfunction, habitual dislocation Habitual dislocation - that kind of attack you pursue?   and varying degrees of damage to the soft tissue.

If you suspect a dislocation held X-ray study of the damaged limb, which reveals how the dislocation and fracture.

First aid at the dislocation must ensure that only complete rest the injured limb (in the position in which it is located) by imposing transport tires or retention bandages, with an open fracture of the wound is necessary to apply a sterile bandage, and on top to make the cold (in any case not be alone reduce a dislocation). After that, the victim must be delivered to the emergency room or the hospital, where, after the anesthesia he will vpravlen dislocation followed by the imposition of fixing cast.

Familiar, congenital and pathological dislocation

Habitual dislocation often occurs in the shoulder joint and is the result of improper treatment - reposition or subsequent fixation (usually insufficient maturity). Habitual dislocation occurs without visible external violence, even during normal movements, due to the presence of weaknesses in the joint capsule at the site of the former divide. Treatment only operative habitual dislocation - closure of the joint capsule, plastic bones and tendons.

Congenital dislocation of the result of improper fetal development with the formation of defective articular ends of bones. The most common congenital unilateral hip dislocation Hip dislocation - the result of indirect injury   (boys it occurs less frequently than in girls). The success of the treatment of congenital dislocation depends on how early it will reveal. When detected early (in infants) may conservative treatment with the imposition of tires, if the dislocation diagnosed late, it will only operation.

Pathological dislocation occur due to the development in the joint cavity or articular ends of the bones of various kinds of pathological (disease) processes leading to the disfigurement of the articular ends of the bones (bone-joint tuberculosis, osteomyelitis, etc.). Such dislocations in their characteristics are similar to the trauma. Treatment of pathological dislocations depends on their causes and is reduced to restoration of joint function of conservative and surgical methods.

Galina Romanenko