Broken shoulder blades: The request could not be satisfied
Scapula Fracture – Broken Shoulder Blade Bone
A scapula fracture is an uncommon injury. The scapula, or shoulder blade, is a wide, flat bone that sits behind the rib cage. The scapula connects to the clavicle (collar bone) in the front of the body, and to the humerus (arm bone) at the side. Part of the scapula is lined with cartilage (the glenoid) and forms the socket of the ball-and-socket shoulder joint.
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Scapular fractures are rare injuries that generally occur with significant, high-energy traumatic injuries such as motor vehicle collisions or falls from a height. When a scapular fracture does occur, doctors need to look carefully for the occurrence of other chest injuries. Because of the energy necessary to cause a scapular fracture, it is common for there to be other types of chest injuries including pulmonary contusions, rib fractures, and pneumothorax.
Types of Scapular Fractures
- Scapular Body Fractures: Scapular body fractures are the most common type of scapula fracture. These injuries seldom require any specific treatment more than a simple arm sling. The important fact is that scapular body fractures are commonly (80-90%) associated with other injuries such as lung and chest injuries.
- Scapular Neck Fractures: Scapular neck fractures occur just adjacent to the glenoid–part of the shoulder joint. Again, most of these fractures can be treated without surgery unless there is significant angulation of the broken bones. In these cases, the shoulder joint can be affected if surgery is not done to realign the bones.
- Glenoid Fractures: Glenoid fractures involve the cartilage surfaces of the shoulder joint. These fractures require surgery when the should joint becomes unstable or if the fragments are far out of alignment. Patients with glenoid fractures are at risk of developing shoulder arthritis.
Common signs of a scapular fracture may include tenderness over the back of the shoulder and upper back, difficulty lifting the arm moving the shoulder, and pain when taking a deep breath. There may be swelling in the area of the shoulder blade, and over time bruising be also developed in this area.
Many scapular fractures can be evaluated with regular x-rays. X-rays may show signs of damage to the bone of the scapula, and may also show evidence of damage to the lungs. In many situations, additional imaging tests may be necessary to further evaluate both the scapula and lungs. The most commonly performed test to further evaluate is called a CT scan.
Treatment of Scapular Fractures
There is great variability in the treatment of scapular fractures. Surgery is often recommended for glenoid fractures because of the effects on the shoulder joint. However, there is significant variability in the treatment of scapular body fractures. While there are many published guidelines, these don’t always agree, and most authors agree that individual patient characteristics often play a role in determining the best treatment.
If you have sustained a scapular fracture, you will need to be evaluated by an orthopedic surgeon. Often orthopedic surgeons that specialized in either shoulder surgery or trauma surgery will help to manage complex scapular injuries. Your surgeon will review imaging studies and examining her shoulder to determine if surgical treatment is needed.
A Word From Verywell
Scapular fractures or uncommon injuries that are often associated with high energy trauma. Because of the location of the shoulder blade, injuries to the lung should always be evaluated when the patient has sustained a scapular fracture. The ideal treatment of a scapular fracture depends on a number of characteristics. While no scapular fractures can be managed without surgical treatment, there are reasons why a scapular fracture may require surgery and the scapular fracture should be evaluated by an orthopedic surgeon to determine the optimal treatment plan.
Fractures of the Shoulder and Collarbone
The shoulder joint is composed of three bones, which can break independently or in combination:
- The clavicle (collarbone)
- The scapula (shoulder blade)
- The top of the humerus (upper arm bone), known as the humeral head
A broken collarbone (clavicular fracture) is a common injury that is often caused by a fall from a bicycle or injury during a contact sport like football. Symptoms include:
- Pain and tenderness
- A bump over the midpoint of the bone
- A lowered or sagging shoulder
In children, the injury may occur at the growth plate, closer to the end of the bone. Any child who experiences a growth plate injury should receive specialized care by a pediatric orthopedic surgeon to avoid future problems with bone growth and function.
A doctor’s exam of the shoulder will usually show a visible deformity or bump at the site of the fracture. There may also be grinding between the broken segments (this is called “crepitus”). If the skin is being pushed outward by a sharp bony spike, this is a surgical emergency that requires immediate evaluation by an orthopedic trauma surgeon. An X-ray will reveal the type of fracture and guide the appropriate treatment.
Usually, a broken collarbone will heal without surgery by immobilizing it in a sling and treating the patient with ice (to reduce swelling) and pain medication. In some cases where this nonsurgical treatment is used, an excess of new bone growth will occur and create a bony prominence or bump at the healing site. This bump will gradually get smaller over time.
However, if the break results in an overlapping of the bone ends, or if the bone is broken into multiple pieces, surgery may be necessary to prevent a nonunion of the break or shortening of the bone, either of which can reduce shoulder function.
Explore collarbone fractures
Shoulder blade fractures
The scapula (shoulder blade) is a strong, triangular-shaped bone that is well-protected by muscle. Breaks in this bone are usually caused by a high-impact trauma such as a vehicle collision, rather than by a fall or sports injury. Most breaks occur along the scapular body – the large flat section toward the bottom that makes up most of the scapula. Less often, breaks occur in the knobby, upper portions of the scapula. The main symptoms are intense pain while moving the arm and swelling at the back of the shoulder. A simple X-ray will usually reveal the type of fracture and guide the appropriate treatment, however, a CT scan can be useful to assess more severe or complex breaks.
Most breaks in the scapular body heal without surgery by immobilizing it in a sling. Breaks in the knobby upper portions of the bone (the glenoid, scapular neck or acromion) may require surgical realignment. In some cases, this may include fixation by metal plates and/or screws.
Explore scapular fractures
humeral head fractures
The humeral head is located at the upper tip (proximal region) of the humerus (upper arm bone). It forms the “ball” of the ball-and-socket shoulder joint. Breaks in this area are quite common, especially in older patients who have low bone density due to osteoporosis. Most breaks in humeral head are nondisplaced, meaning the bone is broken but still properly aligned. These types of breaks usually heal without surgery by immobilizing the humerus in a sling for two to three weeks. This will be followed by physical therapy to regain range of motion and strengthen the muscles not used during the immobilization. In displaced breaks (where the pieces of broken bone are out of alignment), surgical realignment is necessary and may require fixation by metal plates and/or screws. Severe cases may require a partial or total shoulder replacement.
Explore humeral head fractures
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How to Know If You Have a Fractured Shoulder
You suffered a fall, a blow, or a car accident and your shoulder hurts. It really hurts. How do you know how serious your injury actually is? You may wonder if it’s damage to the soft tissue or if you have a fracture that needs immediate care.
The following symptoms can help you determine if you have a fracture in one of the three bones of the shoulder: the scapula (shoulder blade), clavicle (collar bone), or humerus (arm bone). If you have pain, weakness, and dysfunction — even if you don’t think you have a broken bone — contact us at Austin Shoulder Institute for an evaluation.
1. You suffered injury
It’s not just any injury that causes a broken shoulder. But falling from a height, as when cycling or when rock climbing, that causes shoulder discomfort or dysfunction may indicate a broken shoulder. Contact sports like football and rugby include tackles and collisions that can lead to a fractured shoulder. Car accidents, especially at a high speed, also commonly cause serious shoulder injuries.
2. Inability to move the shoulder
If your shoulder feels weak or if any movement up and down, to and from your torso, or rotating around the joint hurts or seems impossible, you may very well have a fracture. A grinding sensation when you do move the shoulder is further confirmation of a fracture.
3. Swelling and bruising
A severely swollen shoulder may indicate a proximal humerus fracture. This fracture describes a break when the ball of your ball-and-socket joint is broken at the top of the arm bone. If the swelling is more near the middle of the collarbone, you may have a clavicular fracture. Swelling at the back of the shoulder indicates a potential fracture of the scapula.
If your shoulder looks “off” or just not right, you may have a fracture in one of the three bones. Deformity can sometimes indicate a dislocation too. If you have a bump under your skin around the joint, you may have a fracture and the ends of the broken bones are protruding just under the skin.
This should go without saying, but if you have pain in your shoulder that just doesn’t feel right, you see us at Austin Shoulder Institute so we can examine your shoulder. You may have a fracture that didn’t displace the bones, meaning they’re cracked but not moved out of their normal position. Only an X-ray or MRI can confirm your injury
6. Weakness and tingling in the extremities
Your extremities, meaning your hands and arms, may feel weak and experience some tingling, especially if your break affects nearby nerves. You might experience these symptoms while still or when trying to move your shoulder.
The most common shoulder breaks involve the clavicle. Older adults are more likely to break the humerus at the joint due to falls or osteoporosis. Scapular breaks are quite rare, comprising less than 1% of all broken bones reported.
If you think you have a fractured shoulder, the specialists at Austin Shoulder Institute can help. In some cases, you may need surgery to repair a fracture, but immobilization of the joint that allows the bones to heal is often enough. Contact our office as soon as possible to get a diagnosis and proper treatment.
Healing From a Broken Shoulder: What to Expect : Tadje Orthopaedics: Sports Medicine
You can break your shoulder for several reasons, including falls, car accidents, and contact sports. But, no matter what caused your fracture, Dr. Jared Tadje at Tadje Orthopaedics can ensure you have an optimal recovery.
As an orthopedic trauma surgeon in Meridian, Idaho, Dr. Tadje provides nonsurgical and surgical solutions for shoulder fractures. He offered these insights into broken shoulders and what you can expect as you heal.
Shoulder break basics
Your shoulder contains three bones:
- Collarbone (clavicle)
- Arm bone (humerus)
- Shoulder blade (scapula)
You can break any of these bones, but collarbone fractures are most common in young people. In those over 65, fractures in the humerus fractures are more prevalent. Shoulder breaks involving the scapula are less common and typically occur because of high-energy traumas, like car accidents.
There are two classifications for shoulder fractures: nondisplaced and displaced. Approximately 80% of fractures fall into the nondisplaced category, meaning your shoulder bones stay in the proper position despite the fracture. In most cases, Dr. Tadje can treat these types of injuries with nonsurgical methods.
If you have a displaced shoulder fracture, broken pieces and fragments of your bones move out of position. These types of shoulder breaks often require surgery to realign your broken bones.
Treating broken shoulders
In order to heal correctly from a broken shoulder, you need proper treatment.
Nonsurgical fracture treatments
Based on your shoulder break, Dr. Tadje could recommend conservative treatments like immobilizing your arm with a wrap or sling while your bones heal. This approach could also involve medications to help manage pain and physical therapy to strengthen muscles in the area and safely restore range of motion to your shoulder.
Surgical fracture treatments
These treatments can vary depending on the severity of your break and its location. In some cases, Dr. Tadje could realign and stabilize the broken bones with hardware, like screws, pins, or plates, or he could also repair soft tissue damage or bone grafting.
For severe cases, Dr. Tadje could recommend a partial or total shoulder replacement surgery. These procedures focus on removing and replacing damaged parts of a joint with new prosthetic pieces. Shoulder replacements can ease pain, improve function, and restore range of motion in a severely damaged shoulder.
Recovering from a broken shoulder
Healing from a shoulder fracture takes time and can take anywhere from three months to a year, depending on your injury and treatment.
Whether you undergo nonsurgical or surgical treatment options, it’s key to follow Dr. Tadje’s instructions. If you move your shoulder too early while recovering, you can delay the healing process. At the same time, you have to maintain some movement while resting your shoulder or you can experience too much stiffness.
It’s also important to follow your physical therapy program to maximize your recovery and improve your results. You can rest easy knowing that Dr. Tadje monitors your progress every step of the way to ensure your healing stays on track.
If you have a broken shoulder, don’t wait to find expert care in the Boise area. Contact our office at 208-231-7851 or request an appointment online today.
Watauga Orthopaedics Blog | Scapular Fracture (Shoulder Blade) Re
The shoulder blade is a triangular-shaped bone that connects your upper arm bone to your collarbone and chest wall. You have two shoulder blades, one located on either side of your upper back. An intricate web of muscles, which work to give the shoulder strength and allow it to move smoothly, protects it.
The scapula, or shoulder blade, is a bony structure found on the upper back that connects the upper arm to the chest wall (thorax). It also forms the socket part of the shoulder joint, connecting the upper arm (humerus) to the socket (glenoid). The acromion and coracoid processes are bony bumps found on the upper part of the scapula, and they function to connect the scapula to the collarbone. Thick layers of muscles, tendons, and ligaments surround the scapula, and are responsible for the smooth movement of the shoulder joint.
Shoulder blade fractures are not as common as some other joint injuries. According to the American Association of the Orthopaedic Surgeons, they make up less than 1 percent of all broken bones in the United States each year. Because it’s so hard to break a shoulder blade, fractures are usually caused by major traumas, such as car or motorcycle crashes, sports accidents, or extreme falls.
Scapular fractures are caused by direct trauma involving a large amount of force or violence. Associated injuries to the chest wall, lungs, and shoulder occur in a majority of people with broken shoulder blades. Consequently, if a scapula is fractured, other areas of the body should be diligently examined for additional problems. Common causes of broken shoulder blades include the following:
· Motor vehicle accidents
· Long trips or falls
· Direct trauma to the shoulder
· Falls onto an outstretched arm
Fractures to the different parts of the shoulder blade may cause slightly different symptoms. But generally, symptoms include:
· Severe pain when you try to move your arm
· Inability to lift your arm over your head
· Swelling, bruising, and skin abrasion at the back of your shoulder blade
Other injuries, especially those caused by trauma, may present the same symptoms as a fractured shoulder blade. All fractures are serious, so it’s important to see a doctor right away if you experience any of the above symptoms. Those whose shoulder blade fractures are treated successfully can expect to return to an active, healthy life within six months to a year.
To learn more about how to recover from a scapula fracture, call Watauga Orthopaedics today at (423) 282-9011 to request an appointment. You can also schedule an appointment online with one of our board-certified orthopedic surgeons.
Fractures in the shoulder commonly involve the clavicle (collar bone), proximal humerus (top of the upper arm bone), and scapula (shoulder blade).
Clavicle (collarbone) fractures
The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. The clavicle is a long bone and most breaks occur in the middle of it. Occasionally, the bone will break where it attaches at the ribcage or shoulder blade.
Clavicle fractures are often caused by a direct blow to the shoulder. This can happen during a fall onto the shoulder or a car collision. A fall onto an outstretched arm can also cause a clavicle fracture. In babies, these fractures can occur during the passage through the birth canal.
- Clavicle fractures can be very painful and may make it hard to move your arm.
- Sagging shoulder (down and forward)
- Inability to lift the arm because of pain
- A grinding sensation if an attempt is made to raise the arm
- A deformity or “bump” over the break
- Bruising, swelling, and/or tenderness over the collarbone
There is usually an obvious deformity, or “bump,” at the fracture site. Gentle pressure over the break will bring about pain. Although a fragment of bone rarely breaks through the skin, it may push the skin into a “tent” formation.
In order to pinpoint the location and severity of the break, your doctor will order an x-ray. X-rays of the entire shoulder will often be done to check for additional injuries.
If the broken ends of the bones have not shifted out of place and line up correctly, you may not need surgery. Broken collarbones can heal without surgery.
Whether your treatment involves surgery or not, it can take several months for your collarbone fracture to heal. It may take longer in diabetics or people who smoke or chew tobacco.
Most people return to regular activities within 3 months of their injury. Your doctor will tell you when your injury is stable enough to do so. Returning to regular activities or lifting with your arm before your doctor advises may cause your fracture fragments to move or your hardware to break. This may require you to start your treatment from the beginning. Once your fracture has completely healed, you can safely return to sports activities.
Humerus (upper arm bone) fractures
Fractures of the proximal humerus can be caused by a direct blow to the area from a fall, collision, or motor vehicle accident.
- A severely swollen shoulder
- Very limited movement of the shoulder
- Severe pain
Most fractures of the proximal humerus can be treated without surgery if the bone fragments are not shifted out of position (displaced). If the fragments are shifted out of position, surgery is usually required. Surgery usually involves fixation of the fracture fragments with plates, screws, or pins or it involves shoulder replacement.
Recovery from an upper arm fracture can take several weeks or even months. Most fractures whether treated surgically or nonsurgically require a period of immobilization followed by rehabilitation. If the fracture was not severe and didn’t require surgery, improvement and return of function is typically seen after the first 4 to 6 weeks.
Scapula (shoulder blade) fractures
Because the scapula is protected by the chest and surrounding muscles, it is not easily fractured. Therefore, fractures of the scapula are usually caused by high-energy trauma, such as a high speed motor vehicle accident. Scapula fractures are often associated with injuries to the chest.
- Severe bruising about the shoulder blade
Most fractures of the scapula can be treated without surgery. Treatment involves immobilization with a sling or shoulder immobilizer, icing, and pain medications. About 10% to 20% of scapula fractures need surgery. Fractures that need surgery usually have fracture fragments involving the shoulder joint or there is an additional fracture of the clavicle. Surgery involves fixation of the fracture fragments with plates and screws.
It can take several weeks or even months to recover from a scapular fracture in the shoulder. Most fractures whether treated surgically or nonsurgically require a period of immobilization followed by rehabilitation. If the injury was not severe, there is fairly rapid improvement and return of function after the first 4 to 6 weeks. Shoulder exercises, usually as part of a supervised physical therapy program, are usually necessary. Exercises decrease stiffness, improve range of motion, and help the patient regain muscle strength.
Fracture of the Shoulder Blade (Scapula)
The scapula (shoulder blade) is a flat, triangular bone providing attachment to the muscles of the back, neck, chest and arm. The scapula has a body, neck and spine portion.
Scapular fractures are uncommon but do occur and require a large amount of force to fracture. They are usually the result of intense trauma, such as a high speed motor vehicle accident or a fall from height onto one’s back. They can also occur from a fall on an outstretched arm if the humeral head impacts on the glenoid cavity.
Symptoms of a scapular fracture include the following:
- Pain: Usually severe and immediate following injury to the scapula.
- Swelling: The scapular area quickly swells following the injury.
- Bruising: Bruising occurs soon after injury.
- Impaired Mobility: Decreased range of motion of the joint occurs, often with inability to straighten the arm.
- Numbness: Numbness, tingling, or coldness of the hand and forearm can occur if blood supply is impaired or nerves are injured.
- Popping Sound: A cracking or popping sound, also referred to as crepitus, can often be heard or felt at the time of the fracture.
Scapular fractures should be evaluated by an orthopaedic surgeon for proper diagnosis and treatment.
Your surgeon will perform the following:
- Medical History
- Physical Examination
Diagnostic Studies may include:
- X-rays: A form of electromagnetic radiation that is used to take pictures of bones.
- CT scan: This test creates images from multiple X-rays and shows your physician structures not seen on regular X-ray.
- MRI: Magnetic and radio waves are used to create a computer image of soft tissue such as nerves and ligaments.
Most scapular fractures are not significantly displaced due to the strong supporting soft tissue structures surrounding it. Therefore, a majority of scapular fractures are treated conservatively and with early motion to reduce the risk of stiffness and will usually heal without affecting shoulder movement.
Conservative treatment options include:
- Immobilization: A sling is used for comfort and to support the shoulder to allow healing to take place. This is usually worn about 3-6 weeks depending on the type of fracture and how well you heal.
- Prescription Medications: Pain medications will be prescribed for your comfort during the healing process.
- Physical Therapy: Early progressive range of motion exercises is essential in restoring full shoulder function. Your physician will most likely refer you to a Physical Therapist for instruction on proper exercises and early motion of the shoulder to prevent complications.
Fractures of the scapula involving the neck or glenoid or with severe displacement have been associated with poor outcomes when treated non-operatively. will usually require surgical intervention to realign the bones properly and restore a functional, pain free range of motion to the shoulder joint.
Scapular fracture repair surgery has historically been performed through a large, open incision. Newer, minimally invasive techniques have evolved and surgery to repair scapular fractures can now be performed through arthroscopy.
90,000 What is a clavicle fracture and how to treat it
Diagnosis and treatment of clavicle fracture
Clavicle fracture – damage to the bone that connects the sternum to the scapula. A fracture is always the result of an injury, such as a direct hit or fall. It is most often observed in athletes, but it can also be diagnosed in newborns who are injured while passing through the birth canal.
Main symptoms of clavicle fracture:
- severe pain in the area of injury;
- displacement or misalignment of the shoulder;
- crunching and increased pain when trying to raise the arm;
- inability to fully move the arm and raise it.
The injury is dangerous because it can be accompanied by damage to blood vessels and nerves, therefore, at the first suspicion of a fracture, you should immediately consult a doctor.
Which doctor should I go to with a fracture of the clavicle?
The primary diagnosis and treatment of trauma is done by a traumatologist. Once your condition has stabilized, your doctor will refer you to a surgeon who will see you for several months.
Why you should contact the traumatologists of “Scandinavia”
Patients with fractures and other traumatic injuries choose the Scandinavia clinic, rather than state trauma centers, because:
- we have traumatologists with more than 5 years of experience who can carry out a full diagnosis and select treatment in order to restore your condition as soon as possible;
- the clinic is equipped with modern X-ray machines and tomographs, which allows all the necessary examinations to be carried out in one place.
For patients who are shown osteosynthesis, we have equipped a comfortable hospital with TV, Wi-Fi in the clinic. We also accept nonresident citizens: you can find out the details by calling the clinic.
How is the first consultation with a traumatologist going
On your first visit, your doctor will create a medical record for you with your life history and symptoms. To do this, he asks you about your personal data, how you got injured, whether you visited other doctors.After collecting the anamnesis, the traumatologist will conduct an examination: he will clarify the localization of pain, sensitivity of the hand.
Diagnosis of clavicle fracture
To make a diagnosis, an examination is sufficient: bone fragments either tighten the skin tightly or break through it. To clarify the nature of the injury and the choice of treatment tactics, the doctor will refer you to an x-ray.
Methods of treating a fracture of the clavicle in “Scandinavia”
The equipment of the Scandinavia clinic allows to treat fractures both by surgical and conservative methods:
- Fracture immobilization.The doctor will fix the bones with a special bandage, which should be worn for several weeks.
- Osteosynthesis with screws and plates or a pin. During the operation, the doctor removes the displacement of the fragments and restores the integrity of the bone with the help of metal structures.
Surgical treatment is most commonly used to treat a displaced fracture.
Make an appointment with a traumatologist
You can make an appointment with a traumatologist at the Scandinavia clinic by calling our hotline: +7 (812) 600-77-77.
90,000 Clavicle fracture – symptoms, treatment and recovery
Skeletal injuries are the main reason for hospitalization. Bone damage occurs under the influence of a variety of factors. Most of the visits are due to a clavicle fracture.
This is due to the peculiarities of the structure of the bone. The danger of such a fracture is loss of motor ability and possible rupture of large vessels.
Causes of damage to the clavicular region
The cause of the fracture of the clavicle is different.Many patients injure bone when they fall unsuccessfully. The skeleton breaks when the arm is misaligned to the side or when it falls on the elbow joint.
The injury occurs due to the structure of the clavicular region. The bone has an S-shaped structure. The middle of the segment has a small diameter. This is the reason for his frequent fracture.
Any blow to the thoracic and clavicular region is reflected on the bone without shock absorption. The wave causes strong vibration. The hard shell contributes to its retention.With a strong impact, the center of the bone breaks.
Displaced clavicle fracture is not uncommon. This is also due to the peculiarity of the structure of the body. At the sagittal end, three muscle bases are attached. These muscles are responsible for all arm movements. Thanks to them, a person can take his hands back and forth, make rotational swings and spread them to the sides. On the chest part, the scapular muscles are attached to the clavicle. These muscles are responsible for bringing the thoracic region forward.
This muscle arrangement affects the dilution of debris resulting from injury.The center of gravity falls on the place of the break. The wreckage is diverging in different directions. The muscular frame of the scapula leads to an upward displacement of the fragment. The second part of the clavicle is shifted to the side. This arrangement of parts of the bone occurs in 70% of patients treated with this injury.
Types of injuries of the clavicular region
Fractures are divided into several types. The type of injury depends on the location of the wreckage. The damage is highlighted without displacement and with displacement. Also, the types depend on the presence of concomitant complications.
When the skeleton is injured, sharp ends of the bone are formed. The tip causes soft tissue damage.
With a strong displacement of the fragment, a rupture of muscle fascia and epidermis is observed. A part of the affected bone appears on the surface of the body. This form is called open.
Also, sharp edges cause rupture of large vessels. At the back of the clavicular girdle is the brachial artery. This vessel is responsible for the flow of blood to peripheral tissues. Artery rupture is accompanied by active bleeding.Blood fluid is removed from the vessel under pressure.
A cavity filled with blood is formed in the damaged area. Large blood loss is fatal. Internal bleeding is established by additional symptoms. With such a fracture, the patient needs urgent hospitalization.
Signs of injury to the clavicle
If a person has a broken collarbone, various symptoms are observed. Signs depend on the nature of the fracture. Doctors observe the following trauma symptoms:
- Shoulder girdle shortening;
- Sagging of the arm on the side of the injury;
- Loss of habitual physical activity;
- Supraclavicular fossa edema;
- Formation of hematoma.
The patient has a shortening of the shoulder girdle after injury. This is due to the displacement of debris into the lower torso. Due to the displacement of the thoracic region, the shoulder muscles are tightened. The neck area is pressed against the shoulder. This causes the shortening of the shoulder region.
Loose debris attached to the shoulder area also causes external torso deformity. The patient has a sagging of the injured limb. Muscle fasciae are heavy.They pull the piece aside. Outwardly, the sagging looks like a lengthening of the arm by several centimeters.
Due to the peculiarities of attachment to the body, a person has two supraclavicular fossae. The fossa is formed due to the sagging of the soft tissue over the bone. When the bone is damaged, soft tissues are traumatized.
The walls of small capillaries are ruptured. Blood enters the free cavity. The filling of the cavity is accompanied by edema. With severe bleeding, a hematoma forms under the upper layer of the epidermis.
There are a number of additional symptoms. They indicate internal concomitant injuries. These symptoms include the following:
- Shortness of breath;
- Loss of sensitivity in the hand;
- Absence of arterial pressure in the limb;
- Pallor of the skin;
- Loss of consciousness.
The clavicle is located above the superior cone of the human lung. With a sharp displacement of the fragment, the pleural tissue of the pulmonary sac ruptures.Air is removed from the damaged bag into the abdominal cavity. The diameter of the lung decreases sharply.
The patient is short of air. Shortness of breath occurs against the background of a lack of oxygen. With this symptom, a person needs urgent surgical intervention.
A separate group of patients complains of lack of hand sensitivity. Any painful effect does not cause unpleasant sensations in a person. The symptom is associated with internal damage to the nerve endings. A signal from the brain is transmitted along the nerve bundles to the limb.Compression of the beam or its rupture interrupts the impulse circuit.
Dangerous symptoms include the absence of blood pressure in the arm. Extremity pressure occurs when blood flows to peripheral vessels. The force of pressure increases in the artery. Blood enters the arm through the brachial artery.
The rupture of its walls is accompanied by the disappearance of blood pressure. If such a phenomenon occurs after a blow or fall, the patient is admitted to the medical center. Timely assistance will help save a person’s life.
Dangerous symptoms also include pallor of the skin and loss of consciousness. With such signs, the patient should not be moved independently. It is recommended to wait for medical help.
Signs of clavicle fracture in children are considered separately. The skeleton of a young organism does not have sufficient hardness. Any strong external effect on the shoulder complex is accompanied by damage to hard tissues. Children rarely have debris displacement. This is due to insufficient development of the muscular frame.Thanks to this feature, there is no symptomatic picture. A fracture can be identified by the following criteria:
- Complaints of a child about pain in the injured area;
- Formation of edema and bruising;
- Decreased physical activity.
If you find these symptoms, you should carefully ask the child about the reasons.
Possible cause could be a fall from a small height, a failed jump, or twisting of the body in an unnatural posture.
After clarification of the circumstances, the child must be shown to a traumatologist. He will establish the exact cause of the symptoms that have appeared.
Danger of injury
This injury should not be treated with disdain. If the collarbone is broken, the following possible complications are identified:
- Loss of limb sensation;
- Muscular myopia;
- Development of arthrosis of the damaged joint;
- Inflammation of the joint;
- Suppuration of damaged tissues;
- Decreased motor ability of the hand;
- Significant loss of blood fluid.
In case of damage to the nerve endings, loss of limb sensitivity occurs. During treatment, the activity of the nervous system is not always restored. The defeat of large beams causes a lifelong loss of the ability to feel by a person. In this case, the patient is assigned additional surgical intervention.
Physicians often find muscle myopia associated with injury. Several muscle fascia are attached to the ends of the clavicle.With improper splicing, the muscle changes its correct position. Prolonged stay in this position entails deformation of the muscular body. Myopia develops – muscle weakness. The problem of repeated bone fractures in a medical setting is eliminated.
The ends of the bone are part of two joints. The synovial bags are responsible for reducing bone friction. In the absence of proper treatment, the debris puts pressure on the cartilaginous part of the joint. This causes inflammation. Long-term inflammation is accompanied by the development of arthrosis of the affected joints.
Complications also occur in the open form of trauma. When soft tissue breaks through, a wound forms on the skin. The wound surface is an ideal breeding ground for pathogens. Pathogenic bacteria cause cell death. Pus accumulates in the wound. This complication slows down the course of the recovery process.
Provision of first aid
Doctors recommend knowing how first aid is provided for a clavicle fracture. It is carried out before the arrival of the doctors.Follow these steps:
- Patient pain relief;
- Applying a fixation bandage;
- Cooling of the fracture site;
- Call for an ambulance.
When injured, the patient complains of severe pain. It is eliminated with the help of analgesic drugs. Before the arrival of doctors, the patient takes an anesthetic drug. When taking, take into account the presence of allergies to drugs.
The main task is correct fixation in case of clavicle fracture.A roller made of improvised material is inserted into the armpit area. The diameter of the roller is 10-15 cm. The limb is bent at the elbow joint and pressed against the anterior wall of the peritoneum. The bent arm is fixed in this position with a bandage or any available material.
After the hand is fastened, it is necessary to stop the spread of edema. For this, a cooling object is applied to the bruised area.
A special bag or heating pad filled with cold water is used for cooling.Staying cold on the affected area is 15–20 minutes. After this time, the cooling bag is removed.
If the fracture is open, the wound should be cleaned. The patient must maintain the original position. Any independent movement causes the development of additional gaps. The surface is treated with an antiseptic liquid. A sterile napkin is applied to the wound.
After completing all the measures, an ambulance is called. Until the arrival of doctors, the patient is prohibited from moving.
After an external examination, the patient is sent for an X-ray examination. The picture is taken in two projections. Direct projection allows you to establish the location of the fracture and its characteristics. The side shot sets the exact angle of the debris displacement.
Also, during the diagnosis, an ultrasound examination of the vessels is prescribed. It is carried out when there are signs of internal damage to soft tissues and large veins.After determining the clinical picture, the patient is prescribed treatment.
Therapeutic measures for trauma
In case of damage to the skeleton, an immobilizing method is used. The broken bone is fixed with a plaster cast. The cast prevents the limb from moving. This speeds up the fusion of the fragments. Several methods are used for fixing. In modern centers, an eight-shaped immobilization is used.
With this fixation, the shoulder girdle is immobilized by twisting the joints through the shoulder blades.Pillows made of gauze and cotton wool are placed under the plaster. They prevent the skin from rubbing against the hard plaster.
Velpo dressing is used in some centers. The disadvantage of this bandage is the tight fixation of the thoracic region. The patient has difficulty breathing properly.
Medical stores also offer elastic bandages. They are made from a material that is extensible. A solid plate is installed at the place of fixation of the joint. The plate does not allow the patient to make the usual movements.
Immobilization is maintained until complete fusion of the clavicle fragments. The dressing is worn for 4-6 weeks.
The presence of complications is also taken into account during therapy. With a displaced fracture, reduction is performed. It has an open and closed shape. The closed technique consists in combining the debris without the use of additional devices. The injured area is anesthetized with topical drugs.
After loss of sensitivity, the bones are aligned manually.An additional X-ray is taken to determine the position of the wreckage.
In the open method, the patient is administered general anesthesia. Through an incision in the soft tissues, the doctor combines the fragments and holds them together with special devices. For a fracture of the clavicular bone, a small-diameter nail or plate is used.
After restoration of the integrity of the skeleton, plaster immobilization is performed.
Additional procedures help to speed up the restoration of bone integrity.Several sessions of low-frequency magnetic therapy are prescribed. The magnetic wave has a warming effect on the cell membranes. Cellular renewal is accelerated. This provokes the rapid formation of the corpus callosum.
Also, the patient is recommended to take vitamin and mineral complexes containing collagen and calcium. Medicines promote rapid fusion of the clavicle. The choice of the drug is made by the doctor.
After removal of the plaster cast, restorative therapy is prescribed.The patient needs to undergo a course of therapeutic massage. Medical gymnastics is prescribed for children. It allows you to restore the correct motor ability.
Damage to the skeletal framework is accompanied by various complications. If your collarbone is broken, you should see a doctor immediately. This will allow a person to quickly recover and maintain health.
Fracture of the clavicle
Diagnosis and treatment of clavicle fracture
Clavicle fracture – damage to the bone that connects the sternum to the scapula.A fracture is always the result of an injury, such as a direct hit or fall. It is most often observed in athletes, but it can also be diagnosed in newborns who are injured while passing through the birth canal.
Main symptoms of clavicle fracture:
- severe pain in the area of injury;
- shoulder misalignment or misalignment;
- crunching and increased pain when trying to raise the arm;
- Inability to fully move and lift the arm.
The injury is dangerous because it can be accompanied by damage to blood vessels and nerves, therefore, at the first suspicion of a fracture, you should immediately consult a doctor.
Which doctor should I go to with a fracture of the clavicle?
A traumatologist deals with the primary diagnosis and treatment of trauma. Once your condition has stabilized, your doctor will refer you to a surgeon who will see you for several months.
Why you should contact the traumatologists of “Scandinavia”
Patients with fractures and other traumatic injuries choose the clinic “Scandinavia”, rather than state trauma centers, because:
- we employ traumatologists with more than 5 years of experience, who can carry out a full diagnosis and select treatment in order to restore your condition as soon as possible;
- clinic is equipped with modern X-ray machines and tomographs, which allows all the necessary examinations to be carried out in one place.
For patients who need osteosynthesis, we have equipped a comfortable hospital with TV, Wi-Fi in the clinic. We also accept nonresident citizens: you can find out the details by calling the clinic.
How is the first consultation with a traumatologist going
On your first visit, your doctor will create a medical record for you, which includes your life history and symptoms. To do this, he asks you about your personal data, how you got injured, whether you visited other doctors.After collecting the anamnesis, the traumatologist will conduct an examination: he will clarify the localization of pain, sensitivity of the hand.
Diagnosis of clavicle fracture
An examination is sufficient to make a diagnosis: bone fragments either stretch the skin tightly or break through it. To clarify the nature of the injury and the choice of treatment tactics, the doctor will refer you to an x-ray.
Methods of treating a fracture of the clavicle in “Scandinavia”
The equipment of the Scandinavia clinic allows to treat fractures both by surgical and conservative methods:
- Immobilization of the fracture.The doctor will fix the bones with a special bandage, which should be worn for several weeks.
- Osteosynthesis with screws and plates or posts. During the operation, the doctor removes the displacement of the fragments and restores the integrity of the bone with the help of metal structures.
Surgical treatment is most commonly used to treat a displaced fracture.
Make an appointment with a traumatologist
You can make an appointment with a traumatologist at the Scandinavia clinic by calling our hotline: +7 (812) 600-77-77.
Clavicle fracture – causes, types, treatment, what to do
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Among all fractures, collarbone injuries occupy almost a tenth, which indicates a high prevalence of this injury.Despite such a high frequency, it is one of the most favorable in terms of prognosis. The likelihood of complications against the background of timely and correct treatment does not exceed 1%.
Currently, many algorithms have been developed to help with this fracture, taking into account any option and severity of damage. Since the medical literacy of the population is increasing, people almost always turn to medical institutions for help. The symptoms of trauma are quite specific, so even a common man in the street can easily suspect it before being examined by a doctor.
Getting a basic knowledge of the manifestations of a clavicle fracture is not enough – a person who is next to the victim must also have first aid skills. Its implementation immediately reduces the risk of possible complications, and also speeds up the implementation of further stages of care in a hospital setting. Therefore, it is necessary to consider this trauma from all possible facets that fully reveal its course.
First of all, the integrity of the skin is determined – open and closed fractures have different treatment tactics.Then it is necessary to assess the localization of the damage, which will affect the choice of the method of reposition (reduction) of the fragments, as well as their fixation. Therefore, the following three types of injury are distinguished:
- The typical location of the fracture line is the middle third of the clavicle – in the area of its bend. In this part, the bone has the smallest thickness, which immediately determines the weak point in the event of a traumatic effect. This option takes from 80 to 90% of the total. Typical trauma can be easily repaired, so it rarely complicates or complicates assistance.
- Less common damage to the acromial end of the clavicle, which attaches it to the process of the scapula of the same name. Moreover, the fracture line is almost always determined in the area of transition of its expanded part into a narrow bone body. In terms of prognosis, the injury is not very favorable, since it does not respond well to standard reduction.
- The most rare variant is the lesion of the sternal end of the clavicle, as it is well strengthened by the adjacent bones and ligaments. Instead, a rupture or dislocation of the sternoclavicular junction usually occurs.
The maximum complication rate is observed in fractures with displacement and formation of fragments, which easily injure adjacent nerve and vascular bundles.
Mechanism of trauma
Subsequent reduction of the fragments will occur in the reverse order of the development of the fracture. To understand the first aid technique in an accessible way, it is necessary to understand the pathological processes that occur when the collarbone is damaged. Typical mechanisms of trauma include the following changes:
- In case of a sudden mechanical impact, going perpendicular to the direction of the bone, its strength is tested.
- Normally, the elasticity of the bone tissue and the surrounding ligaments creates a springy resistance that prevents collapse. If flexibility is not enough, then a crack appears in the collarbone.
- A lot of pain impulses are immediately sent from the injury, which cause a sharp contraction of the surrounding muscles (cervical and pectoral).
- The peculiarity of the attachment of the muscles also determines the implementation of the injury – they pull different ends of the bone in completely opposite directions.
- Therefore, a small defect under the influence of sudden traction begins to increase in size, eventually leading to a broken collarbone.
- Since pain signals are only amplified, this also determines the further dilution of the fragments.
- Considering the role of this bone in support and mobility of the upper limb, there is a sharp dysfunction of the latter on the affected side.
Reposition of the fracture occurs in a similar order – first, the pathological traction of the muscles is eliminated, and then the destroyed ends are compared by changing the position of the injured arm.
Given the relatively unprotected position of the bone (from the outside it is practically not covered by soft tissues), it is often subjected to direct or indirect impacts. Therefore, the formation of a fracture can occur for two main reasons:
- Most often, a person is injured due to the transmission of a shock impulse from the upper limb. Such a mechanism fully corresponds to an awkward fall, which is accompanied by a landing on an outstretched and outstretched arm.In this case, the head of the humerus practically transfers the entire force of the impact to the clavicle and scapula.
- A similar situation can be observed when falling on the elbow or shoulder, when the arm itself is pressed to the body. This creates a sharp compression of the bone at an angle, which can lead to its damage.
- Less commonly, a fracture occurs as a result of direct impact on the clavicle through the skin – with a directed impact or falling on an object. Then the effect on the bone tissue is carried out perpendicular to the axis of its strength.
Injuries resulting from a direct impact on the bone are much more severe, since they are often accompanied by significant displacement of fragments from each other, as well as the formation of fragments.
The fracture is an acute condition, therefore, immediately after its occurrence, it leads to a complete loss of motor function of the upper limb. It is this criterion that is taken into account in the first place, allowing you to immediately sweep away bruises or sprains. When determining the following manifestations, it is also important to exclude the possibility of dislocation of the clavicle:
- At the moment of falling or hitting, the victim may hear a crunch in the clavicle, followed by a sharp pain in the shoulder.
- Independent hand movements (abduction, lifting) on the affected side are practically impossible. An attempt to help him ends with a sharp increase in pain and muscle resistance. In this case, a person can hardly bend it at the elbow, and also move the brush.
- The patient assumes a characteristic sparing posture – the affected upper limb is bent and pressed to the body, and is also supported by the healthy hand by the forearm.
- Due to the displacement of the fragments, the external deformation of the broken clavicle can be noticeable – it bends sharply, losing its usual smooth bend.
- After a while, the edema in the fracture area increases – the shoulder on the affected side visually shortens and falls down, it becomes outwardly more healthy, the supraclavicular fossa is smoothed out. A hematoma becomes noticeable under the skin – hemorrhage in the form of a dark spot.
If most of the listed signs are found, the victim needs to be given first aid, and immediately go with him to the hospital.
Confirmation of external manifestations does not require any special techniques – just a plain X-ray image is enough.It is performed in two projections – direct and lateral, in order to assess the possibility and direction of displacement of fragments, as well as the formation of fragments. It is necessary to list the main signs characteristic of damage to the clavicle:
- A fracture is diagnosed on the basis of the destruction of the outer lamina of the bone – in the image it looks like a dark crack, completely or partially penetrating the bone.
- Displacement is assessed by the location of the fragments in relation to each other – it can be complete or partial.Its degree plays a role in further repositioning.
- Also extremely important is the detection of fragments, which often serve as an obstacle to conservative treatment. If they are carelessly repositioned, they can damage the vessels or nerves passing nearby.
After X-ray exposure, the optimal method is selected that best matches the detected type of damage.
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Fracture of the clavicle – first aid. Clavicle fracture dressings, treatment, recovery and rehabilitation
The paired bone of the shoulder girdle is considered one of the most vulnerable due to its location and structure. It has an oblong, S-shaped shape, the main purpose of which is the hitch between the free upper limb and the trunk.
How can a collarbone be broken
Features of the structure of the bone do not provide for the presence of a rigid protective surface, so the clavicle can be broken in several ways.One of the most common is the dislocation of the acromial end (ICD code S42.0). This can happen as a result of a shock to the shoulder joint, a fall on the elbow, or a bruised hand in a traffic accident. Fractures of a pathological nature that occur when malignant neoplasms are exposed to the bone are rare. Also, a crack in the collarbone sometimes forms with a sharp muscle contraction.
Signs of clavicle fracture
Characteristic clinical signs indicating deviations from the natural state of the bone are a direct indicator of the presence of ailment.The main symptoms of a clavicle fracture are directly related to severe pain in the affected area that the patient experiences after injury. Attempts to make any movement with the injured limb will be doomed to failure, since severe pain will not allow the victim to even raise his hand. In addition, swelling or swelling will appear on the forearm, which clearly indicates the presence of a bruise.
Clavicle fracture – treatment
Treatment for trauma will depend on the age of the patient, but should not be treated at home.As you know, in newborns and children under three years of age, the treatment of a clavicle fracture occurs very quickly with minimal intervention from doctors. For those patients whose age exceeds the indicated figure, the bone will heal 6-7 months. Before starting the procedure, an anesthetic is administered to the victim, after which a special plaster cast is applied as a rigid fixator.
The injured part of the body requires urgent hospitalization, therefore, first aid for a fracture of the collarbone should provide the safest way to move the victim to the nearest hospital.First, give the patient any available analgesic and apply cold to the bruised area to relieve pain. After that, you need to try to stop the bleeding by fixing the injured area with a bandage. Doctors use a cruciform fixation method in which the shoulder girdle remains motionless.
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Clavicle fracture surgery
Surgery is not necessary in all cases, however, if the patient does not want to have visible deformities on the body, therapeutic massage will not help here.During the operation, in case of a clavicle fracture, the bone is fastened using a special metal structure, which eliminates the displacement of the fragments. Osteosynthesis can be performed both with screws and with plates, the choice is made by the attending physician based on the nature of the fracture (open, closed).
Splint for clavicle fracture
Clavicle fracture is a complex injury, the treatment of which requires a special approach, since it is not possible to splinter the paired humerus directly.For this reason, a splint in case of a clavicle fracture is applied using an elastic bandage or dressing. The success of the event will depend on how effectively it is possible to fix the arm and immobilize the shoulder girdle. It is equally important to press the shoulder to the body as much as possible by placing a cotton wool roller under the arm.
Plaster cast for clavicle fracture
Correct therapy always includes the application of a plaster cast due to the exclusion of complications in the process of recovery. In the absence of gypsum, with a fracture of the clavicle, there is a risk of damage to the nerve trunks, muscles or a group of vessels, which will inevitably lead to improper bone fusion.A broken collarbone requires urgent immobilization, if proper measures are not taken, the patient risks permanently being disabled. Modern materials for fracture therapy have a number of advantages:
- high plastic properties;
Clavicle fracture dressing
Plaster cast and splint for treating clavicle fractures are integral parts of the therapy process. However, it is not uncommon to use other attributes of medical practice.Often, immobilization in case of a clavicle fracture includes the use of dressings during the provision of first aid, but they are also irreplaceable at the stage of patients undergoing health therapy. The most famous dressings for treatment in medical circles are:
- Delbe’s bandage;
- Kuzminsky bus;
- eight-shaped soft bandage;
- Sayra’s bandage;
- Titova’s oval.
Delbe’s rings in case of clavicle fracture
There is another equally effective method of applying a bandage that restores the length of the clavicle – these are Delba’s rings.According to the rules of desmurgy, rings for a fracture of the clavicle should be prepared as follows: two rings of cotton wrapped in gauze are formed, the holes in which are slightly larger than the diameter of the victim’s shoulder. The resulting structure is put on through the hands, stretching it up to the muscle cavities, after which the rings are tied with a special rubber tube on the patient’s back.
Eight-shaped bandage on the clavicle is one of the methods of immobilization.It is applied only after the doctor has repositioned the sharp fragments, it is contraindicated to do this when providing first aid, otherwise the injury will heal for a very long time. The main task of this dressing is to prevent the displacement and extension of bone fragments, therefore it is applied very tightly. In the case when it is not possible to eliminate the displacement in this way, a surgical intervention is performed for the purpose of reduction.
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How to sleep with a fracture of the clavicle
After receiving medical care, the patient should adhere to certain rules for a speedy recovery.Safety measures are aimed at providing the injured area with the most favorable conditions for rehabilitation, therefore, sleeping with a collarbone fracture is allowed only on the back or on a healthy side. Doctors recommend removing the bandage at night and straightening the arm where the collarbone is fractured. If necessary, you can buy special dumbbells for muscle development.
Consequences of fracture
No treatment process can give one hundred percent guarantee of healing of the injury, so the consequences of a clavicle fracture can be very different.And although in most cases this ailment passes quickly, some patients experienced complications such as slow healing during therapy. In addition, with a multi-splinter fracture, there may be:
- arthrosis of the joints;
- violation of the ratio of soft tissues;
- risk of skin rupture;
- damage to the neurovascular bundle;
- Bone infections or growths.
A bandage is rarely used for treatment, especially if the collarbone is broken.This decision is explained by the need for surgical intervention when the patient receives a fracture. The position of the injured bone affects the choice of the method of therapy, therefore, in some cases, special means are used, such as the Weinstein bandage. By the principle of overlapping, it is similar to Velpo or Desot dressings, however, it has its own nuances:
- The arm is bent at a right angle at the elbow joint.
- The shoulder is raised at a 45 degree angle and tilted back slightly.
- A roller is placed in the axillary region.
- A cotton-gauze bandage is applied to the shoulder girdle of the opposite side.
- The shoulder girdle is fixed using flattened splints.
- Longuets are fixed with plaster bandage.
Dezo dressing for clavicle fracture
With this dressing, you can immobilize a certain part of the patient’s body, it is mainly used for injuries of the humerus or collarbone. In addition, this dressing can be done during the rehabilitation period or after operations.In case of a clavicle fracture, the Dezo bandage is applied only to reposition the dislocation, if there was one. It is important to inspect the muscle cavity for skin maceration prior to the procedure. To apply a bandage, you will need a cotton swab, a pin, and wide bandages.
Complications of clavicle fracture
The risk of complications from injury is always present, for example, an incorrectly healed fracture in a child. In such a situation, you will have to break the bone again so that it can heal again.Often, complications of a clavicle fracture slow down the healing process or cause internal hemorrhage. The optimal treatment period for adult patients is 16 weeks; the child’s rehabilitation takes much less time.
Recovery from clavicle fracture
Exercise therapy after trauma includes three main stages, each of which is an important component of the recovery process for any patient, be it an adult or a child.First, the patient is immobilized with bandages, which includes simple exercises for the hand and fingers. The second stage of recovery after a fracture of the clavicle is performed using special gymnastic sticks. During this period, the patient needs to develop the shoulder joint. After removing the plaster, physiotherapy exercises are added, including additional procedures:
- amplipulse therapy;
- high-frequency magnetotherapy;
- distance shock wave therapy;
- mineral waters;
- low-frequency magnetotherapy;
- hydrogen sulfide baths;
- SUV-irradiation in erythemal doses;
- UHF therapy;
- ultrasound therapy;
- sodium chloride baths;
- electrophoresis of painkillers;
- electrophoresis of vasodilating drugs.
Fracture of the clavicle
Clavicle fractures is a violation of the integrity of the clavicle. It is characterized by pain, limitation of movement in the hand, swelling, change in the shape of the clavicle, shortening of the shoulder girdle. Diagnostics is carried out by a traumatologist based on complaints, anamnesis, the results of an external examination and X-ray data. In case of a “green branch” fracture in children, a soft fixation bandage is applied.When the fragments are displaced, reposition is necessary, followed by fixation with a plaster cast. In case of damage or threat of damage to blood vessels and nerves, surgery is required.
- Clavicle fracture symptoms
- Clavicle fracture treatment
- First Aid
- Conservative treatment
- Surgical treatment
- Treatment prices
Clavicle fractures account for up to 12% of the total number of fractures and up to 66% of fractures of the bones of the shoulder girdle.In 80% of cases, the damage is localized in the middle third of the clavicle, the acromial end suffers in 15%, the sternal end in 5% of cases. Most often occur in childhood and adolescence. In children, the collarbone usually breaks like a “green branch” (while maintaining the integrity of the periosteum). Displaced fractures are common in adults.
Most often, injuries develop as a result of an accident at home or on the street. The following mechanisms are possible:
- In direct trauma (impact to the clavicle), oblique, transverse and comminuted fractures of the clavicle usually occur.Observed during fights using sticks, bits and metal rods, falling a heavy object, colliding with a protruding part of the structure: production mechanism, playground, etc.
- In case of indirect injury (fall on an outstretched arm, elbow or shoulder), oblique and oblique fractures are formed. The reason for the fall is usually unfavorable weather conditions, less often – alcohol or drug intoxication.
- In some cases, a clavicle fracture is provoked by a sharp muscle contraction.Such injuries can be detected after a generalized epileptic seizure.
The clavicle is a small, slightly curved tubular bone located above the superior rib and connecting the sternum to the scapula. Serves to strengthen the shoulder girdle, is a support for the scapula and bones of the upper limb. Protects the nerves and large vessels of the axillary region.
The location of the fracture is largely determined by the anatomical features of the bone.Most often, the clavicle breaks in the middle third closer to the acromial end – in the thinnest and most curved section. Other factors influencing the location of the injury are the direction and point of application of the traumatic force.
The most common are comminuted and oblique fractures. Under the influence of muscle traction and the weight of the limb, the peripheral fragment of the clavicle is displaced downward, inward and anteriorly. At the same time, the sternoclavicular muscle “pulls” the central fragment down and back. As a result, the shoulder girdle is shortened.Sometimes the end of a peripheral fragment moves into the area of the neurovascular bundle, this is dangerous due to the threat of nerve damage and bleeding.
In modern traumatology and orthopedics, the classification of clavicle fractures is used taking into account several factors:
- for localization: damage to the outer, middle and inner third of the clavicle;
- by the nature of the fragments: transverse, oblique, oblique, comminuted and S-shaped;
- by type of damage: open and closed fractures.
Possible injuries of the clavicle without displacement and with displacement of fragments. Displaced fractures can cause damage to the pleura, nearby nerves, and blood vessels.
Clavicle fracture symptoms
The patient is worried about pain at the fracture site. Hand movements on the side of injury are sharply limited. The shoulder girdle is swollen, shortened. The shape of the clavicle is changed. The shoulder is lowered, its displacement is observed inward and forward. With a healthy hand, the patient holds the injured limb by the elbow or forearm and presses it to the body.
On examination, hemorrhages, pathological mobility and crepitus of fragments of the clavicle can be detected. With open fractures in the shoulder girdle, a small wound is visible, often with the end of the bone fragment protruding from it. In case of violation of the integrity of the neurovascular bundle, numbness and weakness of the limb can be detected, general weakness and dizziness are possible due to internal bleeding. Pleural rupture is accompanied by shortness of breath and lack of air due to pneumothorax.
Complications of clavicle fractures are rare. The most common negative consequence is injury to a vessel or nerve with a sharp bone fragment. In case of violation of the integrity of the nerves in the long-term period, disorders of sensitivity and movements of varying severity can be observed. The rupture of a large vessel is fraught with significant blood loss. Pneumothorax is rarely diagnosed and can be life-threatening in the absence of medical attention.
Diagnosis of a fracture of the clavicle is carried out by a traumatologist in an emergency room or outpatient appointment at a trauma center. The following techniques are used:
- Objective examination . When examining the site of injury, a characteristic deformation of the clavicle, edema, pain, and sometimes crepitus of fragments is determined. When conducting a general examination, attention is paid to the safety of sensitivity and movements in the upper limb, the absence or presence of signs of blood loss, difficulty breathing.
- Clavicle X-ray . The images usually show the fracture zone and the direction of displacement of the fragments. In children, angular deformity is revealed, due to the displacement of the fragments while maintaining the integrity of the periosteum.
If there is a suspicion of nerve injury, a neurologist’s consultation is required; if there are signs of a violation of the integrity of the vessels, an examination of the vascular surgeon is indicated.
Clavicle fracture treatment
Therapeutic tactics are determined by the presence and nature of the displacement.Children and adults with uncomplicated, well-reparable clavicle fractures without the threat of damage to the nerve trunks or blood vessels do not require inpatient treatment. If there is a threat of complications, hospitalization in the trauma department is indicated. In most cases, there is a good efficacy of conservative treatment, operations are rarely performed.
First aid consists in hanging the limb on a kerchief bandage, bending it at the elbow joint and bandaging it to the body.You should not try to eliminate the displacement on your own by sudden jerks or movements of the affected limb – this can cause secondary displacement of fragments, increase the risk of complications.
The main method of treatment is immobilization. The fixation period for children is 2-3 weeks, for adults – 1 month. In childhood, Delbe’s rings are usually sufficient to hold the fragments. In adults, the Chizhin frame and other special bandages are used.
- For green-line fractures and injuries without displacement, a fixation bandage is applied.
- In case of a clavicle fracture with displacement of fragments, local anesthesia is performed, followed by reduction and fixation with a soft or plaster cast.
After reduction, a control picture is taken, UHF is prescribed. With severe pain in the first days after injury, it is recommended to take analgesics. After the termination of immobilization, the patient is sent for massage and exercise therapy.
Indications for urgent surgical treatment are all open fractures of the clavicle and closed injuries with the development of complications or the threat of damage to the nerves, pleura and blood vessels by unstable bone fragments. Planned operations are carried out with irreparable displacement of fragments and significant external deformation of the shoulder girdle. The following options for clavicle osteosynthesis are possible:
- Intraosseous . It is indicated for comminuted fractures, a special pin or Bogdanov’s nail is used.
- Surface . Recommended for multi-splinter injuries, it is carried out using a curved plate.
- Spoke . Fixation is performed with needles, which are passed through the fragments of the clavicle. The ends of the needles are brought out of the bone and fastened.
In the postoperative period, antibiotics, analgesics, physiotherapy are prescribed. The discharge is carried out after the removal of the stitches (for 8-10 days).
The prognosis for uncomplicated clavicle fractures is favorable.Fragments usually heal well even in the presence of residual displacement, the function of the upper limb is fully restored. The outcome in case of concomitant injuries of the pleura and neurovascular bundle is determined by the severity of the injury, the timeliness of medical care.
Prevention includes measures to reduce the level of injuries. During the icy period, it is necessary to choose stable shoes with non-slip soles to prevent falls. Since clavicle fractures are common in children, adequate control when the child is on the street and the equipment of safe playgrounds for children are important preventive measures.
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Cells and the roads they choose
Bone grows together due to the division of living and active stem cells that have not “determined their fate” completely since the time of embryonic development. How does a bone cell make its way to this state? Its development is similar to how we choose a profession: first, a humanitarian or mathematical class, then a faculty, then a department or department, obtaining a specialty, and so on.
Initially, during the first few cycles of division after fertilization, not a single cell of our future body “knows” which path it will take, and “all roads are open to it”.
As the embryo develops, a more complex structure is formed from simple and identical cells – three germ layers, endoderm, ectoderm and mesoderm, which in the future will give rise to organ systems. The mesenchyme is formed from the mesoderm. The cells of the mesenchyme are already different from the rest, but they are very similar to each other, and it is not yet known which of them will choose the “profession” of blood cells, who will become a muscle cell, and who will become bones.A group of cells stands out from the mesenchyme that do not yet want to make a decision, limiting their future choices. Further, the body goes through many more stages of development, at each of which the cells are determined more and more, until they finally choose their “profession”.
Stem cells, as well as this group of “indecisive” mesenchyme cells, remain in a frozen state of “eternal childhood”, so that in case of death in the body of differentiated cells, finally make their choice and take their place.
At first, these cells are called osteogenic (literally – producing bone). They can produce growth factors by stimulating bone marrow formation. Then they differentiate again, becoming osteoblasts, cells on the inner surface of the periosteum. Angular and actively dividing osteoblasts produce collagen proteins and components of loose intercellular substance. Then the osteoblasts lose their ability to divide, “retire”, harden and become osteocytes.It is these mesenchymal osteogenic cells that play the main role in fracture healing.
ByRobert M. Hunt Formation of bone tissue by osteoblasts
“Fracture, lost consciousness, woke up – plaster cast”
In Russia, more than 13 million people a year are injured, the consequences of which are the most common cause of disability among citizens of working age. An additional risk factor is congenital diseases of the musculoskeletal system. In Russia, for every 10 thous.newborns account for 219 people with such disorders.
For the treatment of fractures and post-traumatic complications, special implants are used – inserts made of metals that help to connect broken bones, fix and maintain them in this state until they heal. The material of the implants itself can affect healing (consolidation) in different ways, but none of the metals known to modern doctors can accelerate it.
Therefore, over the past 100 years, with all the development of medicine, the timing of fracture healing has not changed.
Kurgan scientists have proposed to combine the metal base of the implant with a coating of hydroxyapatite – a substance based on calcium and phosphorus present in the bone in the form of nanoscale crystals. Hydroxyapatite promotes osteogenesis and stimulates osteogenic cells, but in itself it is too fragile material for implantation (flexibility of bones is given by organic components, which are replaced with calcium compounds more and more, which makes bones more fragile in old age).
Therefore, it was decided to combine a biotolerant (that is, not harming ostenosynthesis, but not improving it) titanium alloy and a rough bioactive (stimulating bone to regenerate) nanohydroxyapatite coating.
The developed technology of mathematical 3D modeling makes it possible to form an implant individually for each patient, taking into account the total bone density, the number of channels, pores and vessels, and to implant it into the internal cavity of the bone (intramedullary). Controlled arrangement of hydroxyapatite nanocrystals allows “mimicking” individual bone roughness.Materials are made after tomography using selective laser sintering technology, and then a layer of hydroxyapatite is applied to them.
“The use of stimulation methods based on intramedullary implants with ceramic nanohydroxyapatite coating guarantees a positive treatment result and a real reduction in the time of osteosynthesis in bone fractures by 2–4 times,” says the author of the monograph, Dr. med. Arnold Popkov.
– Simplicity, availability and economic feasibility of use at the earliest stages of medical evacuation (district hospital) are especially important during the transition of the Russian Federation to the compulsory medical insurance system.New technologies easily fit into the scope of basic trauma care and care, carried out according to urgent indications and in a planned manner in the rehabilitation treatment of the consequences and complications of trauma, financed from the compulsory medical insurance funds ”.
The author adds that his work can become a contribution to import substitution and makes it possible to produce implants in Russia that are not only comparable to Western counterparts, but even surpassing them in terms of healing rate characteristics.
90,000 Dmitry Kvartalnov – about Voronkov’s broken jaw, the game of Kazan legionnaires and defeat by Avangard
Ak Bars head coach Dmitry Kvartalnov commented on the defeat in the seventh match of the Vostok finals against Avangard (3: 4 OT).
– Haven’t won four home games. It happened. I would like to congratulate the guys on the end of the season. Vanguard was stronger. We lost. Of course, we wanted a different result, but it turned out that way.
– What was the key in today’s defeat?
– The opponent has scored one more goal. This is the key.
– Ak Bars lost two starting matches of the series. The bad start could have been caused by the fact that you had not played for a week and a half before?
– No.We had to react, not lose at home. We scored three goals today, which means we could have done it then. Few goals were scored at home.
– Have you ever lost four home games in the playoffs in your career?
– No, it wasn’t.
– In the third period, the team retreated to the defense, gave more control of the puck to Avangard. Do you think this is your mistake?
– I say it again – the team lost. You know, they say that the coach has five aces in the deck, you can’t put it on his shoulder blades.Of course there are mistakes, there are many mistakes. We wanted to win someone, we didn’t put someone there, we replaced someone. The coach is to blame. I will not tell anyone any fairy tales. We have lost, which means we have missed something. There are many moments, but this is our team business. It means that somewhere we have not finalized.
– Do you agree that Avangard has a much stronger link of foreigners?
– I won’t say anything about the guys. The guys tried, did, could. Now you can talk a lot of moments.Somewhere someone was not prepared, someone played wrong – this is our business.
– Do you think that the youth of “Ak Bars” have grown great this season? Especially Dmitry Voronkov in this series has reached a new level.
– Yes, he grew up. Moreover, he is a fighter, a guy’s character. Remember the moment in the last game – he lay face down under the puck, the jaw breaks. He played with a broken jaw today. We did everything we could. Everything was broken there, and he goes to the next shift: “I’m ready.”Great respect for such players. Plus he is generally a young boy. Today he came out, played as it should, set an example for many. I think the guy has a good future.
– Leaving aside the result, in general, do you think that the series has become one of the greatest in the history of the KHL?
– I agree, the series is unusual. We also wanted it differently. Avangard offered us a different game, we adjusted to this game, but not enough. It seems a little bit, but in hockey, any other sport, a little bit doesn’t count.
– Two days ago you played an almost perfect match, why did mistakes affect the result today?
– Somewhere fatigue, somewhere, maybe the seventh match affected. I say again: the guys tried. Hockey is made up of mistakes. We made a little more mistakes, – the official website of Kazan residents reports Kvartalnov’s words.
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90,000 causes of injury, examination methods and treatment features, recovery period
Fractures of the scapula are not as common as, for example, fractures of the upper or lower limb.But this injury also has its own subtleties and peculiarities, which are taken into account during the diagnosis and treatment prescription.
Clinical picture of fracture
Immediately after the injury, the patient is worried about pain at the site of injury, it can be localized in the shoulder girdle, shoulder and becomes stronger when trying to move the arm.
In the area of the shoulder girdle, along its back surface, edema develops as a result of an impact, which is the cause of the fracture, the skin is often damaged.
Damage localized in this area can be in the form of abrasions or wounds.
Some time after the injury and the fracture of the scapula, a bruise appears, which is the result of tissue soaking with blood. Later, the hemorrhage can go down the shoulder, it happens after a few days, and sometimes weeks.
Vane breaks from direct impact, fall or road traffic damage. As a result, other bones or organs may also be broken; doctors call this condition polytrauma.
According to research data, from 35 to 98% of cases are accompanied by other injuries. The clavicle most often breaks, from 15 to 40% of cases, followed by the ribs, from 25 to 40%, the lungs and pleura are damaged from 15 to 55%.
More rarely, the humerus breaks in any of its parts (about 12%), the brachial plexus is damaged (from 5 to 10%), fractures of the skull bones are observed in about 25%, the hip and lower leg are broken in 11%, large vessels are damaged in 11% , rupture of the spleen is observed in 8%.
Dezo bandage and Cramer’s splint – two options for fixing the scapula fracture
In case of a clavicle fracture, the most important thing is to prevent the displacement of the fragments and, as a result, traumatic shock. This can be done by immobilization, the simplest way is a kerchief bandage on the hand. A Dezo bandage or Cramer’s splint can help fix the limb.
Cramer’s stair rail must be bent and modeled before being applied.This can be done on a healthy limb without causing any special problems. Then she is put on the injured hand and wrapped with a bandage.
Cold is applied to the injury site directly through the clothing to reduce swelling and bleeding in the tissue. If there are injuries to other parts of the body, then it is necessary to immobilize them, stop bleeding, apply bandages. The person must be taken to a medical facility for a comprehensive examination.
Scapula fracture treatment
Fixation of scapula fracture using plates
The tactics at this stage depend on the nature of the fracture.There are two main directions here:
If the fracture is without displacement, then it can heal conservatively, for this it is enough to simply immobilize it with a bandage. During the operation, it is important to eliminate the displacement of the fragments, if any, and then fix them with plates or screws.
Indications for surgery may be:
- Intra-articular fracture, with a displacement (step) of more than 5 millimeters, if more than a quarter of the circumference of the glenoid cavity on the scapula is affected.
- Presence of subluxation of the shoulder head. This can happen when the angle of inclination of the depression, where the head of the humerus is located, changes.
- The upper complex that supports the scapula is damaged.
Treatment of intra-articular fractures
If the surface entering the cavity of the shoulder joint is affected, then if there is a displacement, it is eliminated, and then it is fixed with the help of metal structures. An operation of this kind is called osteosynthesis and in these types of fractures, screws are used for fixation.
After the surgery, the arm is fixed with an abduction bandage for 3 to 4 weeks. The fragments grow together and the threat of displacement completely disappears, then they proceed to the restoration of movements in the joint.
With a fracture of the scapula neck, displacement is almost always present.
If it exceeds 10 millimeters, and the slope of the cavity is changed by more than 40 degrees, then the operation will not only restore the anatomical integrity of the bone, but also fix the fracture using metal structures. If the displacement is not eliminated, then the shoulder joint becomes unstable, and this leads to frequent dislocations, impairment of its function.
In order to fix the fracture in the scapula neck region, doctors prefer plates and screws. The length of the plate can vary, from a long one, which is applied along the entire outer edge, to a short one, which is used elsewhere.
If the fracture is combined with a fracture of the clavicle and rupture of the ligamentous apparatus, this condition is the cause of a floating or dangling scapula.The operation in this version is inevitable, only not only the neck of the scapula is operated on, but also the clavicle and the ligamentous apparatus.
After surgery, everything is fixed with a bandage with abduction for a period of 3 to 4 weeks. This time is quite enough for the beginning of the fusion of the fragments, after the danger of secondary displacement passes. Then you can restore the function of the joint.
Fracture of the body of the scapula
A fracture of the bodies of the scapula can heal on its own, especially if it is without displacement.
Surgical treatment for a fracture of this area is required relatively infrequently, but it is carried out and indicated with a significant displacement of the fragments, which interferes with the normal breathing process.
Scientific literature and research do not give a clear answer to the question of the degree of displacement at which the operation is indicated.
An indication for surgery in case of a fracture of the body of the scapula and the placement of metal structures is a fracture of another localization, for example, a thigh or lower leg.
Many may ask: “What have the scapula and legs got to do with it?” the normal position of the crutch. If the scapula is operated on, it will be much easier for a person to walk with support on crutches.
If there is a fracture with displacement, and if it is treated conservatively, deformation of the scapula occurs, this can also happen later due to the traction of the muscles.The result will be painful sliding of the bone over the surface of the chest.
The operation can also be performed after the fracture has been healed. The main indication for it is pain due to deformity; during surgical treatment, deformities are eliminated.
After the operation, fixation will be required for a period of 3 to 4 weeks using an abduction structure. If the fixation is stable, the fragments are firmly fused, and there is no risk of displacement. After the aforementioned period, the development of the joints, in particular of the shoulder, is started.
Variants of plates used for scapula fracture surgery
The plate is made of a special high quality medical alloy. It must necessarily have a significant margin of safety, and the screws must be blocked after tightening them.
Blocking occurs due to the fact that there is a thread not only on the screw itself, but also on its head and the inner surface of the hole. When screwing in the screw, the thread on the head enters the thread on the inner surface of the hole, and thus the screw is locked.
High quality plates are produced using the cold pressing method. The threads in them appear under the influence of a cold press, due to this, the risk of metal fatigue is reduced, and the strength is increased. Due to this, the cost of the metal is high and can reach several thousand dollars.
Fractures of processes
The scapula has two processes, one of them is called the coracoid, and the other is called the acromial. It is difficult to meet this type of fracture, even traumatologists themselves do not have a consensus on how to treat such injuries.
With a significant degree of displacement, of course, one cannot do without surgical intervention, but to what extent? Naturally, the operation is necessary if the work of the victim is connected with physical activity.
The fracture is fixed with plates, screws, but you can use a special wire, cerclage, and knitting needles.
There is a category of people in whom the acromial process has its own characteristics, that is, it consists of two parts: the process itself and the accessory bone, which are interconnected by cartilage.This is a variant of the norm, but it is often mistaken for a fracture. In this case, the acromial process on the opposite side is checked, it turns out to be identical to the first.
With a conservative treatment option, instability of the shoulder joint may develop, which manifests itself as habitual dislocations.
There are frequent cases of development of post-traumatic arthrosis, limitation of movements. Due to damage to the suprascapular nerve, neuropathy develops. There may be atrophy of the muscles that support the scapula or it can freely leave its place (float).
With surgical treatment, the risk of consequences decreases, but the same conditions may develop as after conservative treatment.
As you can see, the fracture of the scapula is accompanied by its own individual characteristics, and in principle it is not difficult to diagnose it.
But in case of polytrauma, it is not possible to notice it, and sometimes they simply do not pay attention to it, because there are more significant injuries. In the meantime, the bone is gradually growing together and it is good, if without displacement.
It is better to discuss the question of the expediency of surgical treatment with your attending physician, and he will already decide how to achieve the result with maximum benefit.
Fracture of the scapula: first aid, treatment, rehabilitation
Classification of scapular fractures implies the following types of damage:
- Fracture of the scapula neck – almost always accompanied by displacement and injury of the joint, it is treated mainly by surgery.In case of incorrect or incomplete fusion in case of damage to the neck, repeated dislocations and cracks are not excluded,
- Fracture of the coracoid process of the scapula – often accompanied by dislocation of the clavicle. A relatively harmless injury that recovers without complications.
If we talk about a fracture of the glenoid fossa, the following injuries are clinically distinguished: multiple fragmentation of the joint and fractures of the edge of the scapula with displacement forward or backward.
ICD trauma code 10
Fractures at the level of the shoulder girdle are included in one group according to the international classification.If there is a fracture of the scapula, the code S42.1 is assigned. In case of damage to other sections of the shoulder and shoulder girdle, assign codes S42.2 to S42.9.
The reasons for the fracture may be:
- fall on the side with extended arm,
- direct blow to the scapular region,
- fall on the back.
A comminuted fracture of the scapula is an exceptional phenomenon. Muscles protect bone tissue and prevent fragments from moving.If injury occurs during a fall, then there may be a simultaneous violation of the integrity of the bone of the wrist joint. In cases where a person leans on his hand when falling, cracks and dislocations are not excluded.
If the victim has a fracture due to a blow to the back or falling backwards, the collarbone is often displaced. This condition is accompanied by a change in the geometry of the shoulder. Even a layman can easily recognize a fracture.
Joint hemorrhage is one of the characteristic signs of a fracture.Hemarthrosis is accompanied by severe swelling and enlargement of the joint in size. The pain increases and becomes constant.
First aid for a fracture of the scapula involves anesthesia and immobilization. In the case of severe edema, cold is indicated. It prevents tissue swelling and prevents hemorrhage. In time, the cold is left for 15 minutes. Limit movement of the upper limb. For this purpose, a tight bandage is used.
The scapula enters the shoulder girdle and protects the bones of the spine, if injuries occur with displacement, then the patient has pain in the vertebral region.
What kind of immobilization is needed for a fracture of the scapula? An ordinary kerchief sling will help out. In this case, the shoulder is pulled back, a cotton roll is placed under the armpit, the arm is fixed in a bent position.
First aid for a fracture of the scapula involves taking analgesics. They alleviate the condition of the victim and prevent the development of pain shock. Do not give pain relievers more than once. A standard dosage is sufficient to relieve severe pain. Further manipulations should be carried out by a traumatologist.
There is a deformation on the side of the damage, so there are no problems with the diagnosis. Clarifying studies can determine the nature of the injury. An x-ray is taken in two projections.
The traumatologist recommends everything that is needed to identify concomitant disorders: computed tomography, MRI. In the area of damage, other injuries to internal organs and soft tissues can also occur.
Magnetic resonance imaging allows you to identify them at an early stage.
Manipulations in traumatology are not limited solely to diagnostic measures. Based on the clinical picture, the doctor selects the optimal treatment tactics.
Conservative treatment involves the use of fixation bandages. Therapeutic fixation is performed after reposition of bone fragments. Used for immobilization:
- diverting splints – installed for 6 weeks. A splint for a period of 4 weeks is recommended for minor cervical injuries,
- Dezo plaster casts – recommended for injuries to the scapula, clavicle and other bones of the shoulder girdle.They fix the shoulder muscles and reliably immobilize them. It is not very comfortable to sleep with a cast during treatment, but the shoulder girdle is protected from deformation,
- Thoracobrachial dressings – displaced fractures of the scapula are best immobilized in this way. They are applied for a period of 1 month. If the application of the bandage was preceded by skeletal traction on the splint, then the thoracobrachial bandage in case of a fracture is left for 3 weeks.
A brace for the shoulder joint is required during the recovery period.This method of treatment is effective for injuries associated with weakening of the skeleton and osteoporosis. The doctor conducts palpation, and if the bone tissue is not displaced, then a conventional orthosis will replace a plaster cast.
Surgical treatment is prescribed for a complicated fracture.
If the fragments are displaced by a fracture of the neck of the scapula, then a screw connection is advisable. The victim is placed on his stomach, arms spread out to the sides, an incision is made. Surgery for a fracture of the scapula involves open reposition of the fragments.
Then the fabrics are connected and fastened with catgut sutures. After a scapula fracture, you will have to spend half a month in an immobilizing bandage. Fully functions of the hand after a fracture with displacement of fragments are restored after 3 months.
Rehabilitation procedures are recommended to shorten recovery time.
It is not possible to restore the fracture of the scapula immediately. A single injury is rare, so you have to work out the arm and shoulder girdle at the same time.If the ribs are injured, then the recovery period takes longer.
Toes can be flexed as early as 2 days after injury. After a week, you should start working on the wrist joint. The main restoration measures are carried out after removing the plaster.
Physiotherapy with thermal and medicinal action helps to speed up recovery. Proven Benefit:
- electrophoresis with calcium – improves fusion, strengthens bone tissue, stimulates regeneration,
- phonophoresis with arthrosenex – has a general strengthening effect, improves tissue recovery and blood supply,
- diadynamic currents – increase muscle tone, counteract stiffness.
Massage, swimming and underwater traction will improve the condition of the skeletal system, but all these procedures must be agreed with the doctor.
Complications and consequences
Progressive arthritis is among the negative consequences of trauma to the joint capsule. Instability of the shoulder joint provokes frequent injuries, mainly dislocations. Frequent complications of a fracture are stiffness and loss of movement accuracy. This is due to a decrease in muscle functionality, damage to nerve fibers and blood vessels.
Complications after an injury to the scapula are rare and can be easily eliminated through physiotherapy and balneotherapy. Physiotherapy exercises will be useful not only during the rehabilitation period, but also in the future. Moderate exertion will help to properly develop the joint and strengthen the muscle corset.
With increased fragility of bones, the damaged organ remains a vulnerable area. Avoid excessive pressure on the spine and shoulder girdle, increase the load gradually and take calcium supplements with vitamin D3.Early diagnosis of trauma and adequate therapy completely exclude the development of complications.
Source: https: //xn--h2aeegmc7b.xn--p1ai/pervaya-pomoshh/perelomyi/perelom-lopatki
Scapular fracture: common causes, classification, symptoms and treatment
In humans, the scapula is represented by a flat paired triangular bone. They are localized on the back of the chest, on the side of the spine. Fracture of the scapula is rare and the proportion of such damage does not exceed 1.5% of all fractures.But any person will not be prevented from knowing the symptoms of such damage, as well as the skills of providing first aid in this case.
How often does a fracture occur
The relative rarity of such an injury is that the bone is located in the thickness of the muscles and has significant mobility. In addition, the shape of the bone also plays a role.
The most common causes of this fracture are:
- drop on hand;
- falls on the back;
- direct blow to the shoulder blade;
- work-related injuries.
Sometimes these fractures are due to a strain in the muscles of the shoulder joint. As a result, stress is transmitted to the neck of the scapula, as a result of which it breaks under the weight of the bones of the limb. This is often a problem for athletes throwing a sword or discus. A fracture of the scapula neck often occurs when the arm is deeply pulled back.
Classification of scapula fractures involves their division into open or closed (without damaging the integrity of the skin).Also, scapula fractures are classified by the number of fragments (with one or more) and by the location of the damage.
In the latter case, allocate:
- axis area;
- cervical fractures;
- glenoid trauma;
- damage to the coracoid process;
- damage to the acromial process;
- injuries in the area of the upper and lower corners;
- transverse, longitudinal and multi-splintered;
- separately distinguish perforated (they happen when struck with a sharp object or a bullet wound).
As a rule, the most common injuries are the acromion and glenoid cavity. Such fractures of the scapula require special treatment, and even after the completion of rehabilitation, pain may bother for some time. Damage to the scapula neck often causes severe complications and serious consequences.
Clinical picture of fracture
There are certain signs and symptoms of a scapular fracture that can help in a tentative diagnosis.As a rule, after an injury, a person complains of pain in the shoulder, shoulder girdle and scapula, the intensity of which increases when trying to move. Swelling of the back surface of the shoulder girdle is noted, and an abrasion or wound appears in the affected area.
The surrounding tissues become engorged and this leads to the formation of a bruise that clearly appears under the skin. Further, it will go down the shoulder. When feeling the affected area, pathological mobility may be noted, however, if the patient has only a crack, and not a closed fracture of the scapula, then this symptom is absent.
It should be emphasized separately that the previously described edema will completely repeat the shape of the bone. That is why this phenomenon is called the “Comolli triangle”. An attempt to feel the damaged area will provoke an increase in pain, and in the event of a fracture of the scapula with a displacement, crepitus of the fragments will be clearly heard.
“Comolli’s Triangle” – a distinct bruise repeating the shape of the bone
Occasionally, after a fracture, the upper limb rises with the scapula, indicating an injury near the joint.In addition, blood accumulates in the articulation cavity, which increases its size. With a fracture of the neck of the scapula, the shoulder on the affected side will hang down, the acromion will protrude forward, and the coracoid process will be aggravated.
In the case of an open fracture of the scapula, attention is drawn to the wound, from which fragments of bone are visible. If the fracture is accompanied by nerve damage, then hand sensitivity may be impaired. Also, the victim will be disturbed by the pain syndrome with a deep breath.
Immediately after the accident, the victim must be provided with competent first aid, which will help reduce the intensity of pain and edema.
First, the person is given 1 tablet of analgesic, and until the ambulance arrives, a support roller is placed in the axillary region. Also, a scarf needs to be made from scrap materials that will support the damaged limb.
Correct immobilization of the hand can significantly reduce pain syndrome, and also helps to avoid possible damage to blood vessels, nerves, muscles and skin during transportation of the victim.If a person has skin lesions, then sterile dressings are applied to them.
In addition, first aid for a fractured scapula is to apply a cooling compress. For such purposes, you can use packages of frozen vegetables or berries, previously wrapped in a towel.
The duration of such a compress should not exceed 20 minutes, after which a 10-minute pause is made. The procedure is repeated at least 3 times.
Transportation of the victim to the hospital is carried out in a purely sitting position.
X-ray is a mandatory diagnostic procedure for scapula damage, as with any other fracture.
Radiography is performed in two projections, but in certain cases another, oblique, projection is shown. Such a picture is required in case of damage to the clavicle or the acromion process of the scapula.
An even more informative procedure is CT with spatial reconstruction.
It is worth noting that during the diagnosis of scapular damage, specialists may encounter a very serious problem – an untimely detected fracture.
This is possible when a patient has polytrauma and more serious damage to bones or internal organs comes to the fore.
That is why MRI is gaining in popularity.
The value of the method lies in the ability to display not only bones, but also soft tissues in the image. This helps specialists detect rotator cuff, nerve or vascular injuries in time and provide the necessary assistance.
The tactics in the treatment of any fracture of the scapula directly depends on the nature of the damage.As a rule, preference is given to methods of conservative treatment, followed by immobilization (in case of a fracture of the scapula, plaster is now rarely used, mainly a special fixing bandage is applied).
As for the surgical intervention, it is often performed in case of a fracture with displacement, when there is a need to fix the fragments with screws, pins, plates or more complex metal structures. The fracture is fixed for 1-1.5 months, after which the recovery phase begins with the use of physiotherapy exercises.
As already mentioned, plaster is now very rarely used for a broken scapula. Basically, preference is given to the Dezo bandage. It allows the skin to breathe, which prevents the occurrence of diaper rash.
In addition, applying and wearing it gives the patient less discomfort and pain. As a rule, wearing a Dezo bandage lasts 3-4 weeks.
However, in the case of a fracture of the scapula neck, a slightly different method of immobilization is used.
In this case, an abduction splint is used, and when the neck is displaced, skeletal stretching is first carried out. These are very exhausting procedures that take 5-6 weeks in total. In addition to immobilization, conservative therapy is supplemented by taking medications. Often, analgesics, antibiotics, calcium preparations, vitamin complexes and restorative agents are prescribed.
Surgical intervention is carried out with the following indications:
- Damage to the upper support blade complex;
- fracture inside the joint when there is a step greater than 5 mm;
- due to subluxation of the head of the humerus or due to a change in the angle of inclination of the joint.
In addition, surgery can be performed if the injury has affected more than ¼ of the circumference of the joint surface. In the course of the operation, the displacement is eliminated, after which the metal structure is introduced.
This intervention is called metal osteosynthesis. After it is carried out, the hand is fixed with a sling bandage with its obligatory abduction. In this position, the patient walks for 3-4 weeks until the debris heals.
Only after removing the bandage, you can start in exercise therapy.
A scapular fracture is not at all harmless. Because of such an injury, the cartilage of the shoulder joint is often damaged, against the background of which arthrosis may subsequently develop in this place. Fracture of the scapula with displacement in the future is dangerous by the deformation of this triangular bone. In addition, she may begin to move freely along the ribs, which is usually accompanied by an unpleasant crunch and pain.
As for the operation, it can provoke:
- muscle atrophy;
- chronic dislocations;
- intercostal neuralgia;
- limited hand movements.
However, if the operation is not performed on time, a person can completely lose their ability to work and turn into a disabled person. It is extremely important to diagnose this fracture in time, then the negative consequences will be minimal.
From the very first days of immobilization, doctors recommend doing therapeutic exercises, since it reduces the risk of complications. But exercise therapy should be carried out by a specialist, because independent exercises in the early stages of recovery can cause irreparable harm.However, after the patient has mastered all the skills in relation to exercise therapy, he can continue to study at home.
Begin gymnastics with the development of fingers and hands (flexion, extension, circular rotation). The duration of the exercises should not exceed 15 minutes, but it is important to do about 4-5 approaches per day.
Already on the 10th day after the fracture, exercises for the shoulder muscles (slow raising of the limb) are introduced.
Sometimes, after 14 days of wearing the Dezo bandage, it will be replaced with a kerchief type of fixation, which significantly expands the range of exercises.
In addition to exercise therapy, the patient can be prescribed physiotherapy. As a rule, UHF and magnetotherapy are prescribed.
These procedures help to eliminate pain and relieve inflammation, which significantly speeds up the process of bone fusion. Already at the final stages of recovery, you can connect classes in the pool.
Nevertheless, it is important not to overload the body, ensuring the gradual restoration of the damaged joint and the work of all groups of adjacent muscles.
Diagnosis and treatment of scapula fracture
Among all fractures of the chest and upper limb bones, damage to the scapula is relatively rare . This is due to the fact that it is protected by a fairly large muscle mass that prevents injury.
But at the same time, this injury is difficult to treat : the structure of this bone and its location suggests a rather problematic surgical repair of its fractures.
Photo 1. Fracture of the scapula is a rare and complex injury. Source: Flickr (Matt Maness).
The structure of the blade
The shoulder bone belongs to the girdle of the upper limbs. It is located in the upper third of the back, adjoins its front surface to the ribs and is fixed by a powerful muscle frame.
It consists of flat body , the highest protruding acromial process , located under it coracoid process , extending from the body of the neck and located on it glenoid cavity .
Through the scapula, the humerus and the clavicle are connected. The body of the scapula has an anterior and posterior surface, an upper, vertebral and lateral (outer) edge and an upper, lower and lateral angle.
- From the body spine of the scapula departs, separating large muscle groups, it has a coracoid and acromial processes.
- The humerus is also in contact with the articular surface of the scapula, delimited from the body by the neck.
- In addition, the supra- and infraspinatus, subscapularis, trapezius, latissimus and longitudinal vertebral muscles are located around it.
- Tendons of the biceps, pectoralis major, and many smaller muscles attach to the scapula.
This is interesting! The body of the scapula itself is extremely fragile. The thickness of the bone tissue in some areas does not exceed 1 mm, and when viewed through the rays of light, it shines through. The strength of this bone is provided due to the fact that it does not bear an axial load and is tightly fixed on all sides by rather large muscles.
Causes depending on the type of scapula fracture
Damage to the body of the bone and acromial process occurs with direct impact due to impacts, falls or crushing .Other types of fractures are associated with the indirect impact of a traumatic factor through other bone structures, as a rule, through the humerus.
Fracture of the spine
This injury occurs as a result of strong blows to the back, falls on the back. A spine fracture can be either isolated or combined with damage to the body of the scapular bone. Due to the firm fixation of the supra- and infraspinatus muscles, displacements occur extremely rarely . Because of the muscular frame, a fracture is rarely diagnosed, often mistaken for a bruise.
Fracture of the acromial process
A similar injury develops due to direct blows to the shoulder girdle. Due to the traction of the muscles of the shoulder girdle, the bone fragment is displaced, violation or loss of function of the shoulder joint .
Fracture of the glenoid cavity
A similar injury occurs as a result of a fall with an emphasis on outstretched arms. A sharp blow to the head of the humerus on the glenoid cavity leads to injury to the latter.
The articular cavity is often damaged with the formation of one or more loose bone fragments, which greatly complicates subsequent treatment.
This fracture refers to intra-articular and is always accompanied by damage to the articular surface .
Fracture of the neck of the scapula
A cervical fracture occurs under similar circumstances as a fracture of the glenoid cavity, however, the line of damage passes outside without affecting the shoulder joint. Displacement is observed quite often , visually, the deformation may resemble a dislocated shoulder.
Fracture of the coracoid process
The coracoid process is covered from above by the acromial process, and therefore its fractures from the direct impact of the traumatic factor are impossible.
The injury develops due to the excessive force of the head of the humerus on the process during a fall on outstretched arms.
The coracoid process is quite firmly fixed by the ligamentous apparatus, the deltoid muscle and, together with the glenoid cavity, forms the shoulder joint, due to which its displacement is extremely rare .
Top and bottom corners
Occurs due to the direct impact of a traumatic factor on the body of the scapula.The fracture line delimits the angle from the body of the scapula. Displacement is extremely rare due to strong fixation by the muscular frame.
Multi-split, longitudinal and transverse
These types of fractures of the body of the scapula are the most difficult due to the fact that they contribute to the formation of two or more large fragments of bone. And if longitudinal or transverse fractures can proceed without displacement, then multi-splintered fractures are always accompanied by displacement of bone fragments, which can contribute to damage to the circumflex arteries.
Signs of scapula fracture
The clinic of a fracture can be quite varied depending on the passage of the line of its passage and the circumstances of the injury. Permanent signs of any type of fracture include:
- Swelling of soft tissues;
- Soreness when moving the arm from the side of the injury, inability to raise a straight arm above the shoulder or at all;
- Deformation of the injured area due to displacement of bone fragments or the presence of a hematoma in case of damage to the vessels.
An important point in determining the presence of injury is to clarify the circumstances of its receipt. For a fracture of the scapula, 90,094 direct blows to the back, shoulder girdle, falls on the back or with an emphasis on outstretched arms are characteristic.
If the damage was facilitated by a direct blow to the back or shoulder girdle, then abrasions, subcutaneous hemorrhages will be observed in its place. With fractures of the body of the scapula, concomitant damage to the ribs is often observed.
Fracture of the glenoid cavity occurs as a result of falling on outstretched arms and is always accompanied by severe pain when moving in the shoulder joint, a significant decrease in its mobility, hemorrhage into the articular cavity.
Pay attention! Even significant intra-articular hematomas may be invisible due to the powerful deltoid muscle that fixes the joint, but its slight tension will cause severe pain.
Without the use of additional diagnostic methods in the form of radiography , it can be rather difficult to reliably determine the presence or absence of a fracture of the scapula, especially when it is localized in the area of the body, spine or coracoid process.
Damage to the glenoid cavity and acromial process is easier to determine due to the ability to visually assess the state of these structures and the function of the upper limb. In connection with these features, at the pre-hospital stage follows:
- Apply a bandage Dezo
or gusset plate on the arm from the side of the injury, immobilizing it as much as possible;
- In case of pain syndrome provide the victim with analgesics ;
- If you suspect hemorrhage in the shoulder joint, damage to the arteries around the scapula, apply cold at the site of injury.
Applying a Dezo bandage requires not only a sufficient amount of bandage, but also certain first aid skills. The use of a kerchief bandage seems to be more realistic. Firstly, the technique of its application is extremely simple, and secondly, it requires a square piece of fabric, tablecloth or other rather dense material, with a side of about 1 m.
The main method for diagnosing a fracture of the scapula is X-ray examination .For this, a snapshot is taken in lateral and direct projection.
In this case, for the latter, it is necessary to abduct the arm at a right angle. Some types of damage require additional projections.
In the presence of multiple fractures of the body or glenoid cavity, CT is possible to determine the localization of all bone fragments.
Treatment of fracture of the bones of the scapula
As with any fracture, there are three ways to treat scapular injuries:
- conservative (immobilization),
- semi-conservative (skeletal traction),
- operational .
This is interesting! Surgical treatment of injuries of this localization, in contrast to all other types of injuries, showed a rather meager result, having little effect on the speed of recovery. Most likely, this is due to the absence of a significant load on the scapula, which acts as a lever for the upper limb.
Conservative therapy (immobilization)
Shown for body injuries (including corners and spine) processes
and processes of scapula .Fixation is performed thanks to a special thoracobrachial bandage applied simultaneously to the chest and shoulder.
In this case, the upper limb is immobilized at a right angle to the chest with slight flexion in the elbow joint. This position of the upper limb allows you to maximally relax the muscles of the shoulder girdle and reduce pain. If necessary, an infiltration injection of an anesthetic drug is carried out into the area of injury.
Reduction of bone fragments, if necessary, is performed manually under short-term anesthesia .Fractures of the acromial and coracoid processes can be fixed with a kerchief bandage, which is much more convenient in everyday life.
Semi-conservative treatment is performed on for articular cavity fractures with a displacement of . The thrust is directed so that the arm is in the abducted position from the body, as in immobilization.
In the first days of treatment, manual reduction of bone fragments is performed. Skeletal traction requires a fairly long (about 3-4 weeks) stay in bed, which may be unacceptable for critically ill or elderly patients.
The operation is performed on in the presence of many bone fragments of any localization . At the same time, it is quite problematic due to the powerful muscle mass on the back and the inaccessibility of the shoulder joint. Surgical intervention should be used only when conservative or semi-conservative treatment is completely futile.
The operation consists in placing staples or plates on the body of the scapula, acromial and coracoid processes.
A description of the shoulder joint replacement (replacement of a crushed one with an artificial implant) in the form of installation of one glenoid cavity or glenoid cavity together with the head of the humerus is described.
This technique excludes any significant load on the operated arm in the future, which is why it should be carried out only in extreme cases.
Possible complications and consequences
Significant complications can develop with intra-articular fractures of the scapula.Violation of the integrity of the articular cartilage and hemorrhage into the joint cavity form circumstances in which the risk of developing deforming arthrosis with progressive loss of joint function is high .
Recovery from scapula injuries begins from the first days, regardless of the choice of treatment method. The main activity is aimed at prevention of muscle atrophy of the upper limb .
How long does recovery take
The rehabilitation period, regardless of the type of treatment, takes from 4 to 6 weeks .During this time, the bone tissue has time to completely grow together and mineralize. Moreover, both immobilization and skeletal traction do not take more than 3 – 4 weeks.
Photo 2. To restore limb mobility, you need to perform a set of exercises. Source: Flickr (kenga86).
Exercise therapy for recovery
Already from the first days of treatment , you should begin exercises for the gymnastics of the muscles of the hand and forearm. At the same time, all kinds of small movements of the fingers, rotation, flexion and extension in the wrist joint are performed.If the situation permits, then the elbow joint is also involved.
After the end of skeletal traction or immobilization, it is necessary to carry out daily standard set of warm-up exercises for the shoulder girdle and upper limbs.
This is important! Any strength exercises (lifting weights, bench press, squats with a barbell, pulling the upper or lower block, pull-ups, etc.) should be abandoned for a period of 2 to 3 months from the date of injury.
Medication and nutrition as ancillary methods
The main diet during rehabilitation should be fresh fruits and vegetables, red meat, beef liver, dairy products.
From medicines it is recommended to take preparations calcium and vitamin D (Osteogenon, Calcium-D3, Bivalos).
Exercise therapy for scapula fracture
Fractures of the scapula are relatively rare, in general, they account for about 1.2% of all closed fractures.As a rule, a fracture of the scapula occurs as a result of direct violence – bruising or from a gunshot wound. There may be a fracture of the body of the scapula, as well as a fracture of the processes of the scapula.
When the integrity of the scapula is compromised, the function of the shoulder joint is very negatively affected. Especially this effect increases with fractures of the glenoid cavity and the surgical neck.
In general, there are several types of fractures of the scapula, namely:
- fractures of the humeral process of the scapular spine and coracoid process
- fractures of the base of the glenoid cavity
- fractures of anatomical and surgical necks
- spine fractures
- glenoid fractures
- fractures of the upper inner and lower corners
- body fractures (most often transverse, sometimes longitudinal and multi-splintered).
These fractures can be without displacement of fragments, and can be with a slight or significant displacement. It often happens that fractures of the shoulder blades are accompanied by fractures of the ribs.
So, a fracture of the scapula can occur in the following cases: when falling on the back, hitting the scapula, severe contusion of the scapula, contusion of the outer surface of the upper part of the shoulder, which is in the adduction position, as well as under the influence of a force acting along the axis of the shoulder (to for example, a fall on the elbow with the shoulder abducted).
An important role in rehabilitation after a fracture is played by physiotherapy exercises and remedial gymnastics in case of a fracture of the scapula. But before you start exercising in exercise therapy with a fracture of the scapula, you must perform the following steps:
- When treating a fracture of the scapula, first of all, it is necessary to get rid of the pressure of the hand on the scapula. To do this, the hand must be fixed on the discharge splint.
- First, the arm is fixed with a Dezo bandage – this is when the shoulder and forearm, which are bent at the elbow at an angle of 45 degrees, are bandaged to the body, and after 7-10 days they are replaced with a plaster cast applied from the base of the fingers to the spine, while the arm should be bent into elbow joint at right angles.
- On the second day, it is already possible to perform exercise therapy exercises with a fracture of the scapula of the first period – for the fingers, wrist joint and shoulder muscles.
Sometimes (in some cases) after the Dezo bandage, about 10 days after the injury, the arm bent at the elbow at a right angle is placed on the scarf instead of a plaster cast. In this case, the patient can perform all kinds of exercises for the fingers, wrist and elbow joints, and these exercises also include turning the forearm with the palm up and down.
In addition, the patient can make movements for the shoulder joint, for this it is necessary to raise the arm forward and take it to the side until a right angle is formed. 10-14 days after the injury, swinging movements of the hand are included in the complex of exercise therapy and LH in case of a fracture of the scapula .
In case of a fracture of the scapula neck, the limb must be placed on the abduction splint for a month. And on the second day after the injury, the patient can begin to perform exercises for the fingers, wrist and elbow joints.
On days 15-20, exercise therapy for a fracture of the scapula recommends exercises for the shoulder joint: you need to raise your arm above the splint and move it back and forth until the elbow is bent at an angle of 80-90 degrees.
After the abduction splint is removed, the time comes for the second period of exercise therapy and PH with a fracture of the scapula. During this period, various exercises are performed that help restore movement in the shoulder joint in all directions. These exercises can be performed with a stick, rubber and volleyball balls.
Also, it should be noted that these exercises are performed not only by the patient, but also by the healthy, synchronously. The duration of the second period is 3-4 weeks.
Exercises included in the complex of physiotherapy exercises for a fracture of the scapula are similar to those prescribed for a fracture of the clavicle, but the patient can also move the arm forward.
In the event that the injured person should lie down as a result of the severity of the injury, in the event of a fracture of the body and the neck of the scapula, the arm is retracted to the side at shoulder level.
Being in this position, the patient makes movements in the elbow joint – flexion and extension, while the arms should not come off the plane of the bed, movements in the wrist joint and movements in the joints of the fingers are also included.
In case of closed fractures, physical therapy classes begin from the 4th-5th day. If the fracture is open (especially in cases where suppuration occurs), then treatment must be delayed. Closed scapular fractures usually heal in 4-5 weeks.
After the fractures of the clavicle and scapula heal, doctors recommend that patients continue therapeutic exercises for the hands in the form of conventional exercises for the joints, as well as exercises with sticks and exercises on the gymnastic wall, and the load and range of motion during these exercises should gradually increase.
The third period of exercise therapy for a fracture of the scapula includes exercises similar to those that are part of exercise therapy for a fracture of the clavicle in the same period.
Exercises included in all periods of exercise therapy and PH with a fracture of the scapula must be repeated at least 6-10 times, and the complex must be carried out 4-6 times a day. If classes are held regularly, then the recovery of movements and the patient’s ability to work occurs 2-2.5 months after the injury.
Fracture of the clavicle | EMC
The European Clinic of Sports Traumatology and Orthopedics (ECSTO) is one of the most modern and equipped private clinics in Russia, which fully complies with international and European standards of medical care.The clinic specializes in the diagnosis and treatment of injuries of the musculoskeletal system: fractures, dislocations, ruptures and sprains and other injuries. At the service of our patients is a team of highly qualified doctors who are able to provide quality medical care and quickly return you to your usual rhythm of life.
One of the most common injuries is a fracture of the clavicle, which usually occurs during a fall or after a blow. The fracture can occur anywhere in the clavicle, but is most often localized in the area of the diaphysis (central part), less often in the area of the sternal end and the acromial end of the clavicle.Note that a fracture of the acromial end of the clavicle can be combined with dislocation and rupture of the ligaments, as well as with a fracture of the scapula.
Causes of fracture
Fracture of the clavicle occurs as a result of trauma – direct impact, fall on the arm or elbow. Fractures of the clavicle are common in children, athletes, and sometimes in newborns while passing through the birth canal.
Types of fractures
As noted above, fractures of the diaphysis, sternal and acromial ends are distinguished.Also, comminuted, multi-comminuted fractures are distinguished, with an oblique or perpendicular fracture line, etc. Note that it is very important to correctly classify injuries, because the choice of the optimal treatment and its success depend on this.
Often, under the influence of muscle strength, a displaced clavicle fracture is observed, which is very dangerous: the ends of the displaced fragments can damage the pleura, blood vessels, nerves and skin.
Fracture of the clavicle. Symptoms
inability to raise a hand;
crunch when trying to raise a hand.
It is quite easy to identify a fracture of the clavicle: there is a sharp pain in the area of the fracture, often fragments of the clavicle stretch the skin in the form of a tent, less often – break it through. A crunch may occur when you try to raise your hand.
In most cases, unevenness or deformation is obvious, and the diagnosis is not in doubt, but it is necessary to undergo an X-ray examination, which will provide accurate information about the nature of the injury, after which the most optimal treatment option is selected.
This injury is hazardous because vessels and nerves can be damaged, therefore, if you have a collarbone fracture, treatment should be immediate. Currently, there are conservative and surgical treatment.
Conservative treatment of clavicle fracture
With this method of treatment, the fracture is immobilized, i.e. fix it for several weeks in a special bandage, depending on the patient’s age and the severity of the fracture.Although conservative treatment sometimes allows the bone to heal without surgery, it has several disadvantages:
the shoulder girdle can be shortened or deformed due to the unrecovered length of the clavicle;
the formation of hypertrophied callus is possible;
cosmetic “defect” of the shoulder girdle
Osteosynthesis is an operation during which the displacement of fragments is eliminated and the bone is fastened with a metal structure.
At present, osteosynthesis with screws and plates of various shapes: hook-shaped, S-shaped, curved, etc. is widely used.
In addition to plates, sometimes a flexible pin is used to treat a fracture, which is inserted into the bone.
Both techniques allow early active development of movements and do not require immobilization after surgery.
Although surgical treatment in most cases allows you to completely eliminate the displacement of the fragments and fix them reliably, in rare cases the following consequences of a clavicle fracture are possible:
non-union of the clavicle due to the multi-splintered nature of the fracture or the wrong choice of fixator;
Note that in case of a displaced clavicle fracture, treatment is usually carried out by a surgical method.
The European Clinic for Sports Traumatology and Orthopedics (ECSTO) provides round-the-clock diagnosis and treatment of clavicle fractures. A team of qualified orthopedic trauma surgeons with extensive experience make every effort to ensure that you can return to your usual lifestyle in the shortest possible time. By contacting our ECSTO clinic, you can be sure that you will be consulted by an experienced doctor dealing with the treatment of this pathology.In addition, you will be able to take a course of conservative therapy in one of the most modern departments of rehabilitation therapy in Russia.
Pain in the area of the shoulder blades
Back hurts and it is difficult to walk. It seems that someone drove a stake between the shoulder blades. You have to hunch over and move slowly and carefully.
Back pain, especially in the area of the shoulder blades, is quite common today. True, it is impossible to characterize the group of people most often prone to back pain – pain in the area of the shoulder blades can be observed in both old people and young people.
What if hurts between the shoulder blades ? What exactly hurts, how to treat it and how can it affect the functioning of the body? What leads to painful sensations and what suffers in this case? You will find answers to these and other questions in this article.
Causes of pain in the area of the shoulder blades
Back pain, and especially in the area of the shoulder blades, is not only a very common concept, but also quite multifaceted in determining the source of pain and the nature of the disease.If you have pain in the area of the shoulder blades, this does not mean at all that it is the muscles or the spine that hurt, since soreness in other organs can radiate to the upper belt of the back and thereby manifest itself in the form of pain in the area of the shoulder blades.
However, pain in the area of the shoulder blades is usually divided into such types as pain under one of the shoulder blades or under both at once, pain in the area of the shoulder blades and pain in the shoulder blades themselves, that is, in the bones.
However, at home, it is quite difficult to determine the exact disease and the cause of pain in the shoulder blades.The suspected disease can be established by a set of characteristic symptoms and the location of the pain focus.
So what can be provoked by pain in the area of the shoulder blades? The most common cause of pain in the upper girdle of the torso can be lack of physical activity, inactive or sedentary work, back injuries such as blows or falls, bruises or fractures of the scapula. Also, irregular physical activity (classes in the gym or pool) or their complete absence is displayed badly on health.However, even if you do work out in the gym, you should not overdo it, as excessive exertion can also cause back pain.
What are blades and where are they located
The shoulder blades, as written in anatomy textbooks, are the triangular bones that connect the humerus to the clavicle. There are two of them in the human body, they are located in the upper half of the torso from the side of the back. 17 muscles are attached to each shoulder blade.
Symptoms of pain in the area of the shoulder blades
If pain in the shoulder blades nevertheless arises, it is interesting to determine what kind of disease this may indicate.Pain in the area of the shoulder blades is one of the most common symptoms in the development of such diseases:
- kyphosis, scoliosis or kyphoscoliosis – types of curvature of the spine;
- osteochondrosis of the spine in the thoracic region;
- Hernia or protrusion of the intervertebral disc in the chest area;
- sciatica of the upper body;
- periarthrosis in the shoulder or shoulder blades;
- ischemic heart disease or angina pectoris;
- neuralgia in the intercostal space;
- pathology of the mediastinal organs;
- infectious diseases;
- pathology of the pleura or lungs;
- bruises and other types of spinal injury in the neck and chest area;
- connective tissue diseases in combination with the characteristics of professional activity.
Pain in the left scapula
Pain in the left shoulder blade can be caused by various factors and diseases. The most common causes of unpleasant sensations in the area of the scapula on the left are called by doctors:
- heartburn – pain in the left scapula appears during or after a meal;
- Psychological problems, resulting in pain, burning, compression of the heart, burning sensation in the chest. Pain sensations can migrate to the arm or under the scapula;
- myocardial infarction – in this case, there is a dull, aching pain in the area of the scapula.It can fight both under the shoulder blade and in the left hand, neck, back, jaw. If the pain persists after taking medications with a vasodilating effect, such as nitroglycerin or validol, then most likely you have myocardial infarction;
- osteochondrosis of the cervical vertebrae – pain from the occiput to the middle of the back, observed mainly in the morning after waking up;
- intercostal neuralgia – paroxysmal pain, observed mainly in the intercostal spaces. Occurs during physical activity, as well as with active work of the respiratory tract;
- stomach ulcer – when the ulcer opens, pain can be observed under both shoulder blades, as well as in the area of the collarbones.The cause of pain in the area of the scapula on the left may be the malfunctioning of the nerve endings of the diaphragm.
Pain in the right scapula
Just like pain in the area of the left scapula, pain in the area of the right scapula can be a symptom of various diseases. At least 4 diseases are distinguished, which are displayed by pain in the area of the right scapula:
- Spasm of the gallbladder or ducts – occurs due to blockage of them with a stone. It causes very strong painful sensations, stitching, cutting, tearing, which come from the right hypochondrium.Soreness may radiate to the right eye, jaw, neck, shoulder or shoulder blade. Often there is nausea or vomiting. The patient tries to constantly change position in order to reduce pain, constantly screams;
- subphrenic abscess – the symptom is acute, very severe pain in the area of the right scapula or shoulder. There may also be a rapid rise in temperature or leukocytosis;
- nephritis or pyelonephritis – give pain not only in the lumbar girdle, but also in the area of the scapula on the right, hypochondrium, iliac region.Frequent, painful or difficult urination is also a characteristic symptom;
- gallstone disease – severe pain in the area of the scapula on the right, as a symptom, is less common here. However, pain can be cutting, stabbing, sharp, spreading from the right side of the back to the jaw.
Pain in the shoulder blades – pain in the bones
Sometimes pain in the shoulder blades can be caused by problems in the bones themselves. Pain in the shoulder blades most often occurs due to back or neck injuries.Such injuries can be caused by falls, accidents and other troubles. The scapula can be broken as a result of a fall on the elbow or a straight arm, and sometimes parts of the broken scapula can also touch the muscles. Pain in this case can be sharp, sharp, appearing when moving, active work of the hands. If the scapula has been fractured, the fracture site will be swollen, slightly swollen.
Changing the shape of the scapula in medicine is called the pterygoid scapula. It occurs as a result of muscle paralysis – rhomboid, trapezoidal or anterior dentate.Muscle paralysis occurs due to myopathy, neuroinfections, or other nerve damage. The pterygoid scapula can also appear as a result of persistent forearm bruises, slaughter, and other damage to the long thoracic nerve. Such problems are most often seen in circus performers and athletes.
Sometimes pain in the area of the shoulder blades can be felt in conjunction with the crunching of the shoulder joints. Such a reaction of the body is observed with a disease called scapular crunch.
Also, acute pain in the area of the shoulder blades is observed with open damage to the bone.For example – with a bullet wound. It is accompanied by general intoxication of the body.
What to do if the area of the shoulder blades hurts
Diagnosing pain in the area of the shoulder blades is not an easy task, because, as previously described, a lot of diseases can lead to pain in this area. To determine the disease, you should still consult a doctor, since many studies are required to establish an accurate diagnosis. Perhaps, as in most cases, muscle deformities (sprains or bruises) have led to pain in the shoulder blades, however, in order to avoid more serious diseases, the doctor needs to conduct a study of internal organs, diseases of which can cause discomfort in the back.
Treatment of pain in the shoulder blades
In accordance with the established disease, the treatment is, of course, different. However, it is still the pain associated with muscle work that is most often encountered, therefore it is worth considering the treatment of this particular direction.
With pain in the area of the shoulder blades caused by muscle injuries, there is a burning sensation or heaviness between the shoulder blades. Most often, to relieve such painful sensations, you just need to make several waves of your arms or several circular movements with your shoulders.If such manipulations did not give the desired result and it continues to hurt under the shoulder blades, moreover, it still gives to the region of the heart, then you may have problems with the spine or with the heart itself and you should consult a doctor for help.
Pain in the area of the shoulder blades associated with disruption of the work or position of the muscles occurs most often in people leading a sedentary lifestyle, as well as in those who, according to the specifics of their work, spend most of the day in the same position – these are office workers, banks , programmers, seamstresses and so on.As a result of daily work, the muscles of the back in these people weaken, lose elasticity, which leads to poor posture.
Curvature of the spine is fraught with the development of other, more dangerous deformities of internal organs. Therefore, the best treatment in this situation is daily exercise, as well as performing simple exercises to warm up the shoulder girdle during the day. Also, if possible, go swimming or go to the gym to strengthen your muscles and keep them in good shape.
None of the above diseases, unfortunately, can be cured at home and you still have to seek help from medical professionals who will establish an accurate diagnosis and prescribe the necessary and effective complex of physiotherapeutic and medical procedures and medications in your case.
You may be prescribed such therapeutic procedures as electrophoresis, magnetotherapy, various methods of electrotherapy, ultrasound therapy, manual or reflexology, sanitary-resort treatment.All these methods are aimed at relieving the main symptoms, pain, but do not remove the root cause of pain in the area of the shoulder blades.
If you suddenly have pain in the area of the shoulder blades, you should initially contact doctors such as a traumatologist, cardiologist, rheumatologist and neurologist. They will point out the cause of your back pain. You may need the help of a chiropractor or massage therapist when diagnosing a disease and prescribing treatment.
How to prevent pain in the area of the shoulder blades
Experts call the most effective prevention of pain in the area of the shoulder blades leading an active lifestyle, playing sports.It is also important to monitor your own emotional state, hormonal background, nutrition. Maintain your posture, do not hunch over.
It is also recommended to undergo a full medical examination once a year in order to prevent and identify various diseases of internal organs at the initial stage.
Remember that it is very important to monitor your own body, exercise, habits, and so on, in order to avoid most diseases. So that pain in the area of the shoulder blades never appears in your life, also watch your sleep – always go to bed in the right conditions, preferably on a hard surface that does not bend.
Love yourself, your body and periodically shake it up in the form of moderate physical exertion.