How does a broken collarbone heal. What are the stages of clavicle fracture recovery. How long does it take for a collarbone to fully heal. What factors can affect clavicle fracture healing. How to promote optimal recovery from a broken collarbone.

Understanding Clavicle Fractures: Causes and Symptoms

A clavicle fracture, commonly known as a broken collarbone, is a frequent injury that occurs in people of all ages. The clavicle is the bone that connects the breastbone to the shoulder blade, and it plays a crucial role in shoulder function and stability.

Clavicle fractures typically result from:

• Direct impact to the shoulder during falls or collisions
• Sports-related injuries, especially in contact sports
• Vehicle accidents
• Falls onto an outstretched arm

Symptoms of a clavicle fracture often include:

• Severe pain in the shoulder area
• Difficulty moving the affected arm
• Swelling and bruising around the collarbone
• A visible deformity or bump over the fracture site
• Grinding or crackling sensation when attempting to raise the arm

The Three Stages of Clavicle Fracture Healing

The healing process of a clavicle fracture occurs in three distinct stages, each playing a crucial role in the bone’s recovery.

1. Inflammatory Stage

The inflammatory stage begins immediately after the fracture occurs and typically lasts for about a week. During this phase:

• The body sends special cells to the injured area, causing inflammation
• A hematoma (blood clot) forms around the broken bone, creating an initial bridge between the fractured pieces
• Pain and swelling are most prominent during this stage

2. Reparative Stage

The reparative stage starts approximately one week after the injury and can last for several weeks. Key events during this phase include:

• Formation of a soft callus, replacing the blood clot
• Gradual hardening of the callus, providing stability to the fracture site
• By 2-6 weeks, the hard callus is usually strong enough for limited use of the arm

3. Remodeling Stage

The final stage of healing, known as the remodeling stage, begins around 6 weeks post-injury and can continue for several months to a year. During this phase:

• Regular bone tissue replaces the hard callus
• The bone gradually reshapes itself to resemble its pre-injury state
• Strength and function of the clavicle continue to improve

Diagnosis and Treatment Options for Clavicle Fractures

Proper diagnosis and treatment are essential for optimal healing of clavicle fractures. Healthcare providers typically use the following methods to diagnose a broken collarbone:

• Physical examination to assess pain, swelling, and deformity
• X-rays to confirm the fracture and determine its severity
• CT scans or MRI in cases of complex fractures or suspected soft tissue damage

Treatment options for clavicle fractures depend on the severity and location of the break. Common approaches include:

Non-surgical Treatment

For simple fractures with good bone alignment, non-surgical treatment is often sufficient. This may involve:

• Wearing a sling or figure-8 brace to immobilize the arm and support the shoulder
• Pain management with over-the-counter or prescription medications
• Gradual introduction of exercises to maintain range of motion

Surgical Treatment

Surgery may be necessary for severe fractures or those that don’t heal properly with conservative treatment. Surgical options include:

• Open reduction and internal fixation (ORIF) using plates and screws
• Intramedullary fixation with specialized rods
• External fixation in cases of open fractures or severe soft tissue damage

Factors Affecting Clavicle Fracture Healing

Several factors can influence the healing process of a clavicle fracture. Understanding these factors can help patients and healthcare providers optimize recovery:

• Age: Younger individuals typically heal faster than older adults
• Overall health: Conditions like diabetes, osteoporosis, or nutritional deficiencies can slow healing
• Smoking: Tobacco use impairs bone healing and increases the risk of complications
• Severity of the fracture: Complex or displaced fractures may take longer to heal
• Blood supply: Adequate blood flow to the fracture site is crucial for optimal healing
• Compliance with treatment: Following medical advice and rehabilitation protocols is essential

Promoting Optimal Recovery from a Clavicle Fracture

To enhance healing and minimize complications, individuals with clavicle fractures should follow these guidelines:

• Adhere to the prescribed treatment plan, whether surgical or non-surgical
• Attend all follow-up appointments and physical therapy sessions
• Maintain a nutritious diet rich in calcium, vitamin D, and protein
• Avoid smoking and limit alcohol consumption
• Gradually increase activity levels as advised by healthcare providers
• Use pain management techniques as recommended
• Be patient and allow adequate time for full healing

Potential Complications and Long-term Outlook

While most clavicle fractures heal without significant issues, some potential complications may arise:

• Nonunion: Failure of the bone to heal properly
• Malunion: Healing in an incorrect position, potentially affecting shoulder function
• Shoulder stiffness or reduced range of motion
• Persistent pain or discomfort
• Nerve or blood vessel damage (rare)

The long-term outlook for clavicle fractures is generally positive. Most individuals regain full shoulder function and can return to their previous activities within 3-6 months. However, some patients may experience minor residual symptoms or limitations, particularly in cases of severe fractures or complications.

Rehabilitation and Return to Activities

Rehabilitation plays a crucial role in recovering from a clavicle fracture and regaining full shoulder function. The rehabilitation process typically involves:

Early Stage Rehabilitation

• Gentle range of motion exercises to prevent stiffness
• Isometric exercises to maintain muscle tone
• Pain management techniques and modalities

Intermediate Stage Rehabilitation

• Progressive strengthening exercises for the shoulder and arm
• Flexibility exercises to improve range of motion
• Functional exercises to restore normal movement patterns

Advanced Stage Rehabilitation

• Sport-specific or occupation-specific training
• Plyometric exercises to improve power and coordination
• Gradual return to full activities and sports participation

The timeline for returning to specific activities varies depending on the individual and the nature of the fracture. Generally, patients can expect:

• Return to desk jobs or light duty: 2-4 weeks
• Driving: 4-6 weeks (once cleared by a healthcare provider)
• Non-contact sports: 6-12 weeks
• Contact sports or heavy labor: 3-6 months

Preventing Clavicle Fractures: Safety Measures and Precautions

While not all clavicle fractures can be prevented, certain measures can reduce the risk of injury:

• Wear appropriate protective gear during sports and recreational activities
• Maintain good bone health through proper nutrition and regular exercise
• Practice proper falling techniques in sports like cycling or skiing
• Ensure a safe home environment to prevent falls, especially for older adults
• Use seatbelts and proper safety restraints in vehicles

By understanding the healing process, following proper treatment protocols, and taking preventive measures, individuals can optimize their recovery from clavicle fractures and minimize the risk of future injuries. Always consult with healthcare professionals for personalized advice and treatment plans tailored to specific cases.

How Broken Bones Heal (for Parents)

Broken bones have an amazing ability to heal, especially in children. New bone forms within a few weeks of the injury, although full healing can take longer.

What Happens as Broken Bones Heal?

There are three stages of bone healing: the inflammatory, reparative, and remodeling stages.

The Inflammatory Stage

When a bone breaks, the body sends out signals for special cells to come to the injured area. Some of these special cells cause the injured area to become inflamed (red, swollen, and painful). This tells the body to stop using the injured part so it can heal.

Other cells that come to the area during this stage form a

hematoma(blood clot) around the broken bone. This is the first bridge between the pieces of the broken bone.

The Reparative Stage

The reparative stage starts within about a week of the injury. A soft

callus(a type of soft bone) replaces the blood clot that formed in the inflammatory stage. The callus holds the bone together, but isn’t strong enough for the body part to be used.

Over the next few weeks, the soft callus becomes harder. By about 2–6 weeks, this hard callus is strong enough for the body part to be used.

The Remodeling Stage

The remodeling stage starts around 6 weeks after the injury. In this stage, regular bone replaces the hard callus. If you saw an X-ray of the healing bone, it would look uneven. But over the next few months, the bone is reshaped so that it goes back to looking the way it did before the injury.

How Do Casts and Splints Help Broken Bones Heal?

Casts and splints can hold broken bones in place while they heal. New hard bone forms in about 3–6 weeks, and the cast or splint usually can come off.

What Can Affect Bone Healing?

A bone might not heal as well if someone:

• has a severe break
• has damage to the muscles, skin, and nerves in the area of the broken bone
• has a vitamin deficiency
• has a medical condition such as osteoporosis, osteogenesis imperfecta, diabetes, or anemia
• takes certain medicines (such as corticosteroids)
• drinks alcohol
• smokes cigarettes

How Can I Help My Child?

To help your child recover from a broken bone, make sure that he or she:

• eats a healthy diet that includes plenty of calcium and vitamin D
• takes good care of the cast or splint
• follows the health care provider’s directions for rest and/or doing any exercises
• goes to all follow-up appointments

Looking Ahead

A broken bone is a common, treatable childhood injury. Most breaks heal well, and kids can get back to all the activities they enjoyed before the injury.

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Broken Collarbone (Clavicle Fracture) – Johns Hopkins All Children’s Hospital

What Is a Broken Collarbone?

The collarbone (also called the clavicle) is the bone that connects the breastbone to the shoulder. A broken collarbone, also called a clavicle fracture, is when this bone breaks.

How Does a Broken Collarbone Happen?

Falling hard on a shoulder or an outstretched arm can fracture a collarbone. This can happen in sports like football, lacrosse, hockey, biking, skateboarding, and skiing. It can also happen when a young child falls from playground equipment or out of a bed or crib. The collarbone also can break in a car crash or if someone is hit by a car.

What Are the Signs & Symptoms of a Broken Collarbone?

Someone who breaks a collarbone might have:

• pain over the collarbone
• trouble moving the arm or shoulder on that side
• swelling, tenderness, and bruising along the collarbone
• a bulge or “tenting” of the skin above the break

How Is a Broken Collarbone Diagnosed?

To diagnose a collarbone fracture, health care providers:

• ask about the injury
• do a physical exam
• order X-rays

How Is a Broken Collarbone Treated?

Most broken collarbones heal with ice, arm support, pain medicine, and exercises. The arm is supported either by a sling or a shoulder immobilizer. A shoulder immobilizer is like a sling, but also has a strap that goes around the waist.

To care for your child while the collarbone heals:

• Use ice for pain and swelling. Put an icepack, cold gel pack, or bag of frozen vegetables over the collarbone for 20–30 minutes every 2–3 hours. Be sure to put a towel between the ice/cold pack and your child’s skin.
• Use the sling or shoulder immobilizer as directed by your health care provider. Your child will wear it for about a month, but can remove it during bathing and sleeping.
• Follow your health care provider’s instructions on giving medicine for pain.

For about the first 4–6 weeks, your child should:

• Avoid raising the arms higher than shoulder level.
• Not lift anything that weighs more than 5 pounds (2.3 kg). This is about the weight of a 72-ounce bottle of liquid laundry detergent.
• Stay out of all sports and physical education.
• Do all exercises to prevent elbow and shoulder stiffness and to help with muscle strength.
• Go to physical therapy, if needed.
• Go to all follow-up doctor visits.

Call your health care provider if your child has pain or swelling that gets worse.

Will the Collarbone Heal Straight?

Even if the broken bones aren’t perfectly lined up, the body usually can make them straight again. That’s because the collarbone has a thick periosteum (outer layer of the bone). The collarbone periosteum doesn’t usually break, so it acts like a sleeve to hold the bone together while it heals. Rarely, the doctor might recommend surgery if the broken bones are very out of line.

Sometimes, there’s a bump where the bone broke. In kids who are still growing, the bump tends to get smaller and go away within a year. Sometimes the bump doesn’t fully go away. But it doesn’t hurt or cause other problems with the arm or shoulder.

When Can My Child Go Back to Sports?

Your health care provider will see your child again and let you know when it’s OK to go back to sports. This is usually when:

• There’s no pain when the health care provider presses on the collarbone.
• Shoulder strength is normal.
• Your child can move and use the arm and shoulder without pain.

In general, kids can go back to noncontact sports (such as running or swimming) in about 6 weeks and contact sports (such as football, lacrosse, and hockey) in 8–12 weeks.

Looking Ahead

Most broken collarbones heal quickly and completely. Within a few months, your child should be able to do everything he or she did before the injury.

Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2021 KidsHealth® All rights reserved. Images provided by iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart.com

3 Ways to Heal from a Broken Collar Bone

About This Article

Medically reviewed by:

Board Certified Critical Care Surgeon

This article was medically reviewed by Jonas DeMuro, MD. Dr. DeMuro is a board certified Pediatric Critical Care Surgeon in New York. He received his MD from Stony Brook University School of Medicine in 1996. He completed his fellowship in Surgical Critical Care at North Shore-Long Island Jewish Health System and was a previous American College of Surgeons (ACS) Fellow. This article has been viewed 92,634 times.

Co-authors: 14

Updated: April 8, 2021

Views: 92,634

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

Article SummaryX

To heal from a broken collar bone, it’s important to keep your arm supported in a sling for 4-8 weeks. Ice your collar bone several times per day for the first 2-4 days to control any pain and swelling you’re experiencing. You can also take over-the-counter anti-inflammatory medications like ibuprofen or naproxen to manage discomfort. During recovery, eat nutritious food and get plenty of sleep to speed up the healing process. Once you’re able to remove the sling, attend physical therapy 2-3 times per week for at least 4 weeks to strengthen the area. To learn about how acupuncture might help with your recovery, read on!

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Broken Collarbone (Child)

Your child has a broken collarbone (fractured clavicle). The collarbone connects the breast bone (sternum) to the shoulder. This injury may cause pain, swelling, bruising, and a bump (deformity) around the break. A more serious collarbone break may harm nerves and blood vessels in the area, as well as the lungs.

Children can break their collarbone by falling on a shoulder. Infants can break their collarbone during delivery. This may happen because of greater than normal birth weight.

A broken collarbone is usually diagnosed by an X-ray.  But the break may not show up on the first X-rays done, especially in children. Your child may need follow-up X-rays if the break can’t be seen. These are usually done in 10 to 14 days. At that time, they may show that the break is healing.

A broken collarbone is usually treated with a shoulder immobilizer or sling. Younger children often need to keep the shoulder in the immobilizer for 2 to 4 weeks. Adolescents typically need to keep the shoulder immobilized for 4 to 8 weeks. Your child will need to start range-of-motion exercises when the pain from the injury eases. Only rarely is surgery needed for a broken collarbone.

Even after the break heals, your child may have a bump at the site of the fracture.  This may get smaller over the next 6 to 9 months. But sometimes the bump never goes away. 

Your child’s healthcare provider will tell you when your child can go back to playing contact sports. At that point, your child should no longer have any pain when moving the shoulder. He or she should also have regained shoulder strength. This usually takes 6 to 8 weeks.

Home care

Your child’s healthcare provider may prescribe medicines for pain. Follow the provider’s instructions for giving these medicines to your child. Don’t give your child aspirin unless the provider tells you to.

General care

• Put an ice pack on the injured area. Do this for 20 minutes every 1 to 2 hours the first day for pain relief. You can make an ice pack by wrapping a plastic bag of ice cubes in a thin towel. Don’t put the ice directly on the skin, because this can cause damage. Continue using the ice pack 3 to 4 times a day for the next 2 days. Then use the ice pack as needed to ease pain and swelling. You can put the cold pack directly on the shoulder immobilizer or sling.

• If your child has a sling, he or she can take it off for bathing and sleeping.

• Your child should avoid raising the injured arm overhead until he or she can do this without pain.

• Encourage your child to wiggle or exercise the fingers of the hand on the injured side often.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. Your child may need follow-up X-rays to see how the bone is healing. If you were referred to a specialist, make that appointment as soon as you can.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done for protection of the child. Please try to be patient and not take offense.

Call

911

Call 911 if any of these occur:

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

• Area of bruising over the collarbone gets larger

• Hand or fingers of the affected arm on the injured side become swollen, numb, cold, burning, or blue

• Pain or swelling gets worse. Babies too young to talk may show pain with crying that can’t be soothed.

• Your child can’t move the fingers of the hand of the injured collarbone

• Tingling in the fingers of the hand of the injured collarbone that is new or getting worse

• Fever (see Fever and children, below)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38. 9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4 or higher in baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older

Nick Foles’ Clavicle Fracture – 3 Dimensional Physical Therapy

Week 1 – Nick Foles’ Clavicle Fracture

This week was the first week of games for the NFL and Eagles fans were happy to be celebrating their win against the Redskins.  But one injury that occurred in a completely different game was almost just as heartbreaking for Eagles fans as if it happened on our own team!  Philly’s own Super Bowl hero, Nick Foles, early in his first game as a Jaguar against the Chiefs, was tackled after making a long throw for a touchdown. The Chief’s defender landed on him and the combined force of them hitting the ground together caused Nick’s clavicle to break.

The clavicle, or collar bone as it is more commonly referred to, is one of the more common bones to break in the human body as it has little protection in the event of a fall. Situated at the top of the chest on either side of the neck, your collarbone can be easily felt and one can imagine how falling directly onto the bone can cause it to break. Sports are common causes for injuries to this bone, but it can also happen with a fall in any setting, especially for those with weaker bones like the elderly.

The main symptom of a clavicle fracture is pain. This bone is the only link between the arms and the rest of the body. The constant pull from gravity on the bone can make the pain worse, which is why many fractures are treated with a sling for several weeks while healing takes place. It is important to limit motion through the affected arm to allow the bone to heal normally. Occasionally surgery will be required to stabilize the bone depending on the site of the fracture.

How can a physical therapist help with a clavicle fracture?
In the initial stages of healing it is important to focus on decreasing pain and swelling using any medication recommended by your doctor and icing several times throughout the day. After a few weeks your therapist will begin gently moving your arm to focus on regaining motion safely. Once you have pain free motion, usually around 6 weeks, you can begin strengthening the muscles around the bone but healing times will vary. Treatment is typically effective in regaining full strength and motion with very few long term complications.

Fortunately for Foles, his fracture occurred on the side of his non throwing arm, but with the impact NFL quarterbacks are subject to, he will most likely not be rushed back into action. If Foles is on your fantasy team you will want to look elsewhere for the next 6-8 weeks!

Stay tuned for next week’s injury review!

Clavicular Fracture at Birth, When Your Child Has

Your newborn has a broken collarbone (clavicle). This is a common and treatable problem in newborns. Babies can easily break (fracture) their clavicle as they pass through the birth canal during birth. Large birthweight babies are more likely to have these fractures. The clavicle almost always heals with no problems.

What are the signs of a clavicular fracture?

• Your baby may hold the arm bent in front of the chest and not move it. This is called “pseudo paralysis.” The arm is not paralyzed. But moving the arm may be painful, so the baby avoids moving it.
• The broken area of the collarbone may move when pressed on, and may feel like it is “crunching.”
• A bump may be seen on the collarbone. This is called a fracture callus and is a sign that the fracture is healing.

How are broken collarbones diagnosed?

The fracture may be found when the baby is examined soon after birth. An X-ray may be done to confirm the fracture. In some cases, the break is so mild that it is not diagnosed until the fracture callus begins to form and a bump is noticed at the collarbone.

How are broken collarbones treated?

Collarbone fractures heal quickly on their own without treatment. The doctor may recommend keeping the infant’s arm and shoulder still for several days. If so, this is done by putting the infant’s arm in a sling or pinning the infant’s sleeve to their shirt.

What are the long-term concerns?

Even for serious fractures, healing is usually excellent with no long-term problems. A bump may remain on the collarbone over the area of the break. This bump will slowly go away over time.

StayWell last reviewed this educational content on 4/1/2018

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Photo report from the operation to remove the metal structure

Miroshnichenko Alexander Pavlovich

Traumatologist-orthopedist

December 8, 2014

We have the opportunity to make a photo report about one of the operations carried out in the Outpatient Surgery Center and clearly show the entire removal process from and to hardware installed after a clavicle fracture. Usually, this operation takes several days, with hospitalization in a hospital. It took several hours in our center.

So, patient Eugene, 30 years old, motorcycle racer. I got a fracture of my collarbone on the track about a year ago. A plate has been installed, which has recently begun to cause discomfort. Since there is no longer any need for it, after consulting a traumatologist, it was decided to remove it. Eugene is an active person, it is difficult for him to fall out of his usual rhythm for several days and go to the hospital, so the opportunity to carry out this operation on an outpatient basis came in handy.

11:00 Eugene arrived at the Outpatient Surgery Center

11:10 – 11:30 anesthesiologist consultation

In the center, doctors have the opportunity to offer the patient any kind of local or general anesthesia.Although more often such operations are performed under general anesthesia, in this case, taking into account the wishes of the patient and the ability to sufficiently anesthetize the process without resorting to it, local anesthesia was chosen.

11:30 – 12:00 preparation for the operation

Evgenia is examined by the operating trauma surgeon, a medical card and informed consent for the operation are filled out, the general condition is assessed, the results of the tests taken the day before. There are no contraindications, you can proceed.

12:00 start of operation

Anesthesia was performed, while waiting for it to fully work, the doctor once again evaluates the scope of work. An incision along the old scar, removal of the metal structure and a cosmetic suture are planned.

12:00 – 13:00 surgery

The operation is proceeding according to plan, the bone has healed well, one of the screws has even begun to move relative to the plate, the removal was carried out in a timely manner.

The patient does not see the process itself, but can ask the surgeon questions during the operation

13:00 the final stage of the operation

The operation went well, the sutures were applied, the last treatment, and the patient is ready to be transferred to the recovery room.

13:00 – 14:00 rest in the recovery room

After the end of the operation, the doctor applies cold to the shoulder to reduce swelling and pain, tells about when to come for a check-up. If necessary, observation until recovery and rehabilitation is carried out by the same doctor who operated.

Before the patient goes home, the doctor gives recommendations on pain relief, explains what to do if pain occurs at home.In our center, you can call a doctor if something is bothering you, arrange for a nurse to visit if you need a dressing or an anesthetic injection.

In this case, since local anesthesia was used, Eugene was ready to leave the clinic rather quickly. With general anesthesia, the postoperative period can take several hours.

14:00 the job is done, you can go home

Evgeny is feeling well, despite the doctor’s wishes to rest, he is already ready to get down to business.

After the operation, even if it is outpatient, you must not drive. It is necessary that an accompanying person be with the patient, if this is not possible, there is a taxi service of the XXI century medical center. Our employee will take the patient home safely and comfortably, if necessary, he will help him to get to the apartment.

So these few hours passed, Evgeny promptly solved the problem that worried him. We wish him not to break anything else.

The operation was performed by the surgeon-traumatologist Miroshnichenko Alexander Pavlovich, anesthesiologist – Kazhura Mikhail Anatolyevich

Operations on the shoulder joint

Almost every tenth patient complains of shoulder pain.© WavebreakmediaMicro, Fotolia

Shoulder pain can appear for several reasons. Often, discomfort in the shoulder joint occurs due to muscle spasm. However, diseases such as arthrosis, trauma, calcification or inflammation can also cause pain in the complex shoulder joint. In addition to muscles, tendons, ligaments and human bones are affected. According to statistics, the frequency of acute and chronic pain in the shoulder joint has increased significantly.

Currently, almost every tenth patient complains of shoulder pain. This fact is explained by the increasingly popular “sedentary” lifestyle, during which a person begins to involuntarily hunch over.

Shoulder problems often cause prolonged excruciating pain that severely restricts your mobility. Night pain is especially unpleasant. Very often, after injuries or inflammations of the shoulder joint, the patient cannot lie on the sore shoulder for several weeks.In such cases, patients feel stabbing or dull pain.

Causes of pain in the shoulder joint

Damage to the acromioclavicular joint

The acromioclavicular joint, or in other words, the acromioclavicular joint, is the flexible connection between the acromial process (acromion) and the outer end of the clavicle (lat.clavicula). The acromioclavicular joint is the highest point of the shoulder.

In addition, this part of the shoulder is responsible for the process of raising the arm above the head.With any injury to this joint, the person will no longer be able to raise his arm. Acromioclavicular injuries are most common among cyclists, gymnasts, or people who play a ball sport. A fall on the shoulder is usually the cause of the injury.

However, each damage is individual. Depending on the severity of the blow, the ligamentous connections between the acromial process of the clavicle and the clavicle itself may be disrupted. Ligaments between the clavicle and the coracoid process of the scapula may also rupture.

Lesion of the articular lip: avulsion of the articular lip of the shoulder joint

The articular lip (lat.Labrum glenoidale) is the cartilaginous, connective tissue border of the glenoid cavity of the shoulder joint. In addition, Labrum plays a decisive role in the centering of the humeral head in the shoulder joint. The articular lip covers the head of the humerus, thereby increasing the articular surface. This ensures stability and nutrition of the cartilaginous structures of the shoulder.

In the event of damage to the lip after injury, falls or dislocation, the shoulder joint loses its stability.These injuries can cause severe shoulder pain in the armpit. Also, injuries of this kind are not only the cause of a decrease in the initial functions of the shoulder, but can also lead to the development of arthrosis of the shoulder joint (omarthrosis). Sometimes, the only way to treat the disease is shoulder surgery

Rupture of the rotator cuff and supraspinatus tendon

The rotator cuff is a ring of muscles and tendons that is responsible for the development of energy in the shoulder joint in almost all directions.If at least one of the tendons of the rotator cuff is damaged or ruptured (for example, a strong tendon of the supraspinatus muscle), movement in certain directions becomes painful and muscle development is delayed. Specialists in the treatment of the shoulder joint distinguish between acute (as a result of accidents) rotator cuff ruptures, for example, after a fall on the elbow, from chronic pathologies. Often, the chronic form of the disease occurs already in adulthood or due to improper posture, due to impingement of the shoulder joint syndrome.

The focus is on the supraspinatus tendon (Latin m. Supraspinatus), which runs from above under the acromial process of the clavicle and connects to the large tubercle of the humerus. By virtue of its structure, the rotator cuff of the shoulder joint is more likely to suffer from various injuries than other structures of the shoulder. The supraspinatus tendon plays a decisive role in the transfer of energy, making it possible to raise the arm without feeling pain.

The rotator cuff and strong supraspinatus tendon wrap around the top of the humerus and center it at the shoulder joint.© Alila Medical Media, Fotolia

Shoulder impingement syndrome

Shoulder impingement syndrome is a narrowing of the structures of the subclavian region (acromion). Especially when the arm is deviated to the side, there is a contact between the humerus and the acromial process of the clavicle.
As a result of this contact, the muscles and tendons of the shoulder are pinched. The tendon of the supraspinatus muscle of the rotator cuff is most affected in this case. The muscle becomes weak and rupture can occur even with the slightest exertion, which contributes to an increase in the narrowing under the acromion. Sometimes patients notice a clicking sound in the joint at the time of lowering the arm.

If the patient loads the shoulder, impingement syndrome causes increased pain.
In such professions as handball players, volleyball players, tennis players, as well as people who work with their heads thrown back and their arms raised up (for example, a painter), the shoulders are constantly in motion and are subjected to heavy loads. This often leads to the typical painful impingement syndrome.

Pain can radiate from the shoulder to the arm.An unambiguous symptom of a subacromial conflict is severe pain with a delayed raising of the straight arm along the lateral arch. The patient suffers especially unpleasant sensations when the hand passes along the middle part of this arch. If you do not start the treatment of this pathology in time, you cannot do without an operation.

In impingement syndrome, pain causes the arm to be pulled to the side, especially at an angle of 60 ° –90 °. © joint-surgeon

Rupture of the tendon of the biceps (biceps) shoulder

Injuries to the tendons of the supraspinatus muscle are often accompanied by inflammatory reactions or even tears of the biceps.Shoulder impingement syndrome also has a negative effect on the tendons of the biceps brachii muscle, since during this pathology the biceps are compressed, after which painful inflammation can occur.

Tenditis is an irritation of the tendon of the biceps brachii. To diagnose lesions of the biceps in the clinic, a test of resistance to active supination of the hand is performed. By applying pressure to the anterior region of the rotator cuff, the doctor can cause typical shoulder pain. In addition, prolonged wear and tear can lead to tendon rupture.With injuries of the biceps muscle, a characteristic thickening of the muscular abdomen of the biceps appears.

Osteoarthritis of the shoulder joint (omarthrosis)

Osteoarthritis of the shoulder joint (omarthrosis) is a consistent wear of the articular surfaces of the shoulder joint, accompanied by loss of cartilage, painful contraction (stiffness) of muscle fibers and progressive weakness.

As in any other joint, the cartilaginous surfaces of the shoulder joint are responsible for its mobility and sliding.A disease such as arthrosis causes a dull and deep pain in the shoulder, which increases during the throw or when the patient is in a position with his head thrown back and arms raised up.

If the articular cartilage is injured due to inflammation, accidents or wear and tear, a feeling of stiffness will gradually join the pain in the shoulder joint. Patients suffering from arthrosis of the shoulder joint most often feel pain in the armpit. Unlike the bearing joints of the lower extremities (arthrosis of the hip joint, arthrosis of the knee joint, arthrosis of the ankle joint), omarthrosis rarely affects the shoulder.

With arthrosis of the shoulder joint, the pain causes the arm to move to the side, especially at an angle of 90 ° –120 °. © joint-surgeon

Calcification of the forearm

Calcification of the forearm (Latin Tendinosis calcarea) is a disease in the tendons of the shoulder joint. Most commonly, calcifying tendonitis affects the tendon of the supraspinatus muscle of the shoulder. The cause of the disease is insufficient blood supply to the rotator cuff, leading to the deposition of calcium salts. The intensity of the loads, as well as previous injuries and falls on the shoulder, do not matter in this case.Most patients with forearm calcification are between 40 and 50 years old.

Inflammation of the mucous membrane of the bag (bursitis) of the shoulder joint

Bursa – the mucous bag of the shoulder joint – is a slit-like sliding cavity containing articular (synovial) fluid. Typically, the bursa is located in areas of greatest friction and balances the high mechanical stress between bones and other tissues such as muscles, tendons, and bone structures. The largest synovial bag in the body is the subacromial bag (lat.Bursa subacromialis). Inflammation of this structure causes frequent acute shoulder pain. Mechanical overload is often observed, for example, due to working with arms raised up and head thrown back. These facts lead to the formation of microtrauma and crystals, causing aseptic (bacteria-free) inflammation. In some cases, for example, when correcting the diet or diets, crystallization of uric acid may occur, if the metabolism of which is disturbed, the patient may develop gout.

Frozen shoulder syndrome – periarthritis of the shoulder scapula

Frozen shoulder syndrome or, in other words, Dupley’s syndrome is a non-bacterial inflammation of the joint capsule of the shoulder joint, which contributes to its contraction. Clinically manifests itself as severe shoulder pain radiating to the arm and limiting range of motion (primary frozen shoulder syndrome). The causes of this pathology are quite diverse and therefore not fully investigated.

Shoulder-scapular periarteritis can also occur as a result of certain diseases or injuries.In this case, doctors consider secondary frozen shoulder syndrome. After an acute inflammatory stage, the shoulder joint may remain motionless for more than six months. Metabolic disorders such as diabetes or thyroid disease only accelerate the described ailment.

Shoulder pain: when is surgery needed?

Sometimes shoulder pain can be treated without surgery: in some cases, conservative techniques such as physiotherapy, injections and shock wave therapy can significantly improve your condition.However, with noticeable restrictions on the mobility and stiffness of the shoulder joint, Gelenk Clinic specialists recommend surgical intervention. If ultrasound and magnetic resonance imaging (MRI) show structural damage to the ligaments and tendons, you will also be referred for surgery. Surgery is indispensable even in the case of degenerative changes (arthrosis), inflammation (eg bursitis), as well as prolonged pain. When conservative methods of treatment do not bring the desired result, Gelenk Clinic performs an operation on the shoulder joint.

How are shoulder surgeries performed at Gelenk-Klinik?

The need and urgency of shoulder surgery depends on the exact diagnosis made by the shoulder specialist and the dynamics of the disease. As a rule, shoulder surgeries are performed at Gelenk Clinic using open and minimally invasive (arthroscopic) surgical techniques. In open surgery, the doctor makes an incision in the skin that allows him to see the surgical site with precision.

A minimal incision of 0.5–1 cm is sufficient for arthroscopic surgery.through which the surgeon inserts special thin tubes with a diameter of several millimeters into the joint. With these devices, the doctor can insert a camera and other small operating instruments into the joint, and thus guide them to the tendons, bones and cartilaginous surfaces. Arthroscopic surgeries are preferred at Gelenk Clinic as they are associated with minimal pain and scarring.

That is why the surgeons of the Medical Orthopedic Center Gelenk Klinik in Germany carry out surgical treatment of the shoulder joint using arthroscopy.Long-term experience of our specialists in the treatment of diseases of the shoulder joint allows them to perform arthroscopic operations when complex tendon sutures are required, removal of the mucous membrane and calcium deposits.

The advantage of arthroscopic surgery is that there is no need for large incisions in the skin, soft tissues and other structures in order to create a good view of the operating field. With the help of a small camera located at the end of a movable thin tube, the doctor has a direct line of sight to the operated area.

Therefore, unlike open surgeries, the patient has minimal trauma and scarring that could subsequently lead to pain in the shoulder joint. The occurrence of postoperative complications and thus a slowdown in the healing process is minimized thanks to arthroscopic surgery. Already one day after such an operation, the patient can begin light shoulder movements.

Your Shoulder Specialist: Which doctor performs the surgery?

One of the most important elements of the work of the employees of the orthopedic medical center Gelenk-Clinic in St.Gundelfingen, near Freiburg, is a relationship of trust between doctors and patients. That is why your attending physician will accompany you from the first appointment to the postoperative period. Thus, if you have additional questions, you can contact your personal doctor at any time. Shoulder joint treatment and arthroscopic surgeries at Gelenk-Klinik are performed by experienced specialists Dr. Markvas and Dr. Ostermaer.

Preparing for shoulder surgery

An extensive clinical examination of the shoulder joint is performed first and the results are presented to the patient based on imaging diagnostics.The clinical examination consists of an explanatory conversation with a doctor and a physical examination of the patient, during which the mobility of the shoulder joint is checked. Imaging examination involves X-ray diagnostics, which provides a complete picture of the condition of the bone structures of the shoulder. In addition, important preoperative elements are MRI (magnetic resonance imaging) and ultrasound (ultrasound), which help determine or exclude the presence of damage to muscles, tendons and bursae of the shoulder joint.

If the results of the above studies do not interfere with the operation, a preoperative consultation is held with the patient, during which the surgeon talks about the course of the operation, and also explains all possible complications after such an intervention. After that, the anesthesiologist talks to the patient, who will once again check his state of health before anesthesia. Shoulder surgery is performed after the permission of the surgeon and anesthesiologist, usually the day after the examination.

Imaging diagnostics by the method (ultrasound) will help the doctor determine the presence of injuries to muscle structures, tendons and synovial bursae. © joint-surgeon

What type of anesthesia is used during the operation?

Shoulder surgeries are performed under general anesthesia. To do this, the anesthesiologist uses a combination of anesthetics specially selected for the patient. During the operation, you sleep soundly and do not feel pain. The anesthesiologist is always there. He checks your vital signs regularly and makes sure you stay awake.

What assistive devices may I need after shoulder surgery?

After certain injuries, such as a ruptured acromioclavicular joint, the shoulder is fixed with a Gilchrist brace. © Dan Race, Fotolia

During the first days after surgery, pay particular attention to the frequency as well as the intensity of the shoulder movements. Try to keep the shoulder joint at rest. For this, our staff will provide you with a special orthosis-fixation that will stabilize the shoulder.After surgery, due to some injuries, for example, a ruptured rotator cuff, the shoulder joint must be in a certain position. The required angle of inclination allows you to create a special abduction splint, or rather an abduction pillow.

Will my shoulder hurt after surgery?

Operation is a process associated with unpleasant sensations. We try to keep pain after shoulder surgery to a minimum.Typically, the patient is given a special injection that numbes the affected limb for approx. for 30 hours. Thereafter, the pain is relieved and the patient is given the usual medications needed after surgery. Surgeons, as well as all employees of our clinic, will provide you with maximum painlessness after shoulder surgery.

Where will I stay after shoulder surgery?

Solitary ward at Gelenk-Klinik in Gundelfingen

During your inpatient stay at the clinic, you are in a single room with a shower and toilet.Each room has towels, a bathrobe and slippers. Also, you will have a mini bar, safe and TV. You must bring your own medicines, comfortable clothing and nightwear with you. After surgery, the patient is cared for by experienced nursing staff and professional physiotherapists 24 hours a day. Typically, a hospital stay does not exceed three days. Your relatives can stay at a hotel a few steps from the clinic. We will gladly take care of your hotel reservations and will be happy to arrange treatment for you in Germany.

What should you pay attention to after the operation?

Since the shoulder should be at rest after surgery, try to avoid intermittent movements. With the help of a special orthosis, the shoulder joint is fixed for 6 weeks, which allows only light movements aimed at restoring both external and internal rotation of the limb, as well as passive mobility. Vigorous training and muscle recovery exercises should only be resumed 6 weeks after surgery.Depending on the medical indication, you will be referred for manual therapy to eliminate dysfunctions of the musculoskeletal system. The treatment will be carried out by an experienced physiotherapist at our medical center. The stitches are removed between the 5th and 7th days after the operation. After 7 days you will be able to take a shower.

• Inpatient treatment: 3 days
• Recommended in the clinic: 10 days after surgery
• Possible return home: 7 days after surgery
• Recommended return flight: after 10 days
• You can shower: 7 days after surgery
• Recommended sick leave: 6 weeks (depending on professional activity)
• When stitches are removed: 5-7 days after surgery
• When you can drive again: 6-8 weeks
• Outpatient Physiotherapy: 2 weeks

What is the cost of shoulder surgery?

In addition to the cost of shoulder surgery, additional costs for diagnostics, doctor’s appointments and aids (e. g.orthoses). If you intend to undergo physiotherapy in Germany after shoulder surgery, we will be happy to help you arrange appointments with specialists and provide you with an appropriate cost estimate.
Information regarding the cost of staying at the hotel, as well as subsequent treatment in a rehabilitation clinic, can be found on the website of the medical institution itself. We will be happy to assist you in organizing rehabilitation treatment in Germany.

How to make an appointment for an operation for patients from abroad?

If you want to undergo shoulder joint treatment in Germany, you will need to provide us with up-to-date MRI scans and X-ray results.Thus, the orthopedic surgeons of Gelenk-Clinic will be able to assess the condition of the bones and joints of the shoulder. You can send these documents through our website. After that, within 1-2 business days, you will be sent all the necessary information, a preliminary treatment plan, as well as a final cost estimate.

Foreign patients can make an appointment as soon as possible according to their personal time. We will be happy to help you with visa processing after the amount of this service specified in the cost estimate is received on our account.If for some reason your visa application is denied, this amount will be refunded in full.

For patients from abroad, we try to reduce the time between the preliminary examination and the operation itself. Thus, you will not need to come to the clinic several times. During both inpatient and outpatient treatment of the shoulder joint, you can use the services of the staff of the Patient Management Department, whose staff speaks several foreign languages ​​(eg.English, Russian, Spanish, Portuguese). We also provide assistance in finding an interpreter (eg in Arabic), the payment of which is made by the patient on a separate basis. We will be happy to help you organize a transfer, find a hotel and show you how to spend your free time in Germany interestingly for you and your family members.

Osteosynthesis – prices for treatment, consultation with leading specialists

Osteosynthesis is a method of treating bone fractures, in which bone fragments are fixed to each other using a specialized metal structure.The main goal is to bring the bone fragments closer together and stabilize the fracture site during the healing period.

Advantages of method

Osteosynthesis has a huge advantage over conventional plaster fixation in that it allows for patient mobility and quick return to normal life.

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Uncomplicated fractures, as a rule, do not require osteosynthesis, but in the case of complex comminuted fractures, osteosynthesis is the only method that allows to achieve anatomically correct bone fusion.

The absolute indications for osteosynthesis are fractures:

• femoral neck with splinter displacement

• tibia and tibia

• clavicle

• olecranon with damage to the articular bag and joint

• patella

• deerfoot

• heel joint

• feet

• false joint formation

Relative indications are:

• the patient’s desire to minimize the duration of treatment and return to a socially active life as soon as possible

• long-term healing of fractures

• a small amount of bone debris

• severe pain syndrome

• entrapment of nerves at the site of bone damage

Osteosynthesis can be performed both immediately after injury (primary osteosynthesis), and more than 12 hours after injury (delayed osteosynthesis)

The type of metal structure and the method of its installation are always selected individually, taking into account the characteristics of the injury, age, state of health, as well as the patient’s lifestyle.

Doctors of the Hospital Center have a solid skill in performing osteosynthesis of any complexity in patients of different ages.

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Advantages of the Hospital Center

Individual treatment regimen for each patient

For each patient, without fail, even at the prehospital stage, an individual treatment regimen is developed, taking into account all the characteristics of the body: age, health status, medical history, etc.- this approach allows you to minimize risks both during the operation and in the postoperative period, and as a result, to ensure the fastest possible rehabilitation with a minimum period of hospitalization.

Multidisciplinary approach

The medical staff of the Hospital Center is a single team made up of doctors – experts of different specializations, which allows for a multidisciplinary approach.We treat a patient, seeing in front of us not a list of the diseases he has, but a person whose problems are interrelated and interdependent. The therapeutic measures taken are always aimed at improving the overall health, well-being and quality of life of the patient, and are not limited to eliminating the symptoms of a specific disease.

Surgical treatment of any level of complexity

The operating doctors of the Hospital Center possess advanced and high-tech methods of performing operations.The combination of highly qualified doctors and innovative equipment allows for surgical treatment of the highest level of complexity.

High-tech, minimally invasive treatment methods

The basis of the methodology of treatment carried out in the Hospital Center is the principles of minimizing risks for the patient and the fastest possible rehabilitation.

Implementation of such an approach is possible only with the use of the most high-tech techniques, modern equipment and the application of the latest achievements of medical science.

The qualification of doctors in combination with modern equipment allows us to successfully implement this approach to treatment.

Fast-track surgery

Fast-track is a comprehensive technique that allows you to minimize the patient’s stay in the hospital without compromising the quality of treatment.

The approach is based on minimizing surgical trauma, reducing the risk of postoperative complications and accelerating recovery from surgery, which ensures our patients have a minimum hospital stay.

Even such complex operations as, for example, cholecystectomy, thanks to this approach, require a hospital stay of no more than 3 days.

Personal medical supervision in the postoperative period

To completely exclude the development of possible complications, the early postoperative period, all patients, regardless of the complexity of the operation, are carried out in the intensive care unit under the individual supervision of an intensive care physician.

Transfer of the patient to the ward is carried out only in the complete absence of even the smallest possible risks.

Informing relatives 24/7

We are as open as possible and take care not only of the patient, but also of those close to him. Patient health information is provided to relatives seven days a week, 24 hours a day.

Visiting patients is also possible at any convenient time.

Highly comfortable single and double rooms

At the service of patients are spacious comfortable single and double rooms equipped with everything necessary for rest and recovery.

In the pediatric department, our little patients are accommodated together with their parents.

Tax deduction

According to the tax legislation of the Russian Federation, each patient has the right to compensation of up to 13% of the amount spent by him on his treatment, as well as the treatment of close relatives.

Our specialists will prepare for you a package of documents for the tax office for a refund of 13% of the cost of treatment, as well as give recommendations on various ways of interacting with the tax office.

Contacts

+7 (499) 583-86-76

Moscow, Bakuninskaya street, 1-3
Nearest metro station: Baumanskaya

Rupture of the acromioclavicular joint | Operation on the AKC

RUPTURE OF THE ACROMIAL-CLUBJOINT OF THE SHOULDER JOINT

What is the acromio-clavicular joint (ACC)

The shoulder joint, together with the scapula, is connected to the rest of the skeleton using one bone – the clavicle.

The clavicle, in turn, is connected to the sternum through the sternoclavicular joint. And the scapula is connected to the clavicle through the acromioclavicular joint (ACC).

The acromioclavicular joint is held in place by the clavicular-acromial and clavicular-coracoid ligaments.

How can I get a rupture of the acromioclavicular joint of the ACS.

Damage or rupture of the acromioclavicular joint can occur when falling on an outstretched arm during sports activities, rollerblading, ice skating, snowboarding, or when falling on a straight arm in winter during icy conditions.

How do you feel if you damaged the AKC.

At the 1st degree of damage, swelling is determined in the area of ​​attachment of the acromial end of the clavicle to the scapula,

at the 2nd degree we can see “key syndrome”, the clavicle sinks when pressed and, when released, comes back like a piano key.

At the 3rd degree of rupture of the ACS, there is a visible deformation, the end of the clavicle protrudes above the scapula for its entire diameter.

How to help yourself with a shoulder injury.

First aid for a shoulder joint injury consists in applying cold to the place of greatest pain and in immobilizing the upper limb with a kerchief bandage.

The diagnosis can be made on the basis of an X-ray.

What is needed to make a diagnosis in case of damage to the ACS.

To make a diagnosis and to determine the degree of damage to the acromioclavicular joint, the most informative research method is X-ray.

On an X-ray at the first degree of rupture of the acromioclavicular joint, a discrepancy between the clavicle and the acromion will be visible.

In the second degree, we see the protrusion of the clavicle above the acromion at a distance of no more than half of its diameter.

In the third degree, the clavicle protrudes above the scapula to its full diameter and even more.

Based on the X-ray, at the third degree of damage, the patient is additionally assigned an MRI – this study will allow us to determine exactly which ligaments were torn, the degree of rupture and will help with the choice of surgical treatment tactics.

Treatment of rupture of the acromioclavicular joint.

Tactics of ACS rupture treatment are chosen by the doctor based on the degree of joint damage and the duration of the injury.

As a rule, the 1st and 2nd degree of damage is treated conservatively.

On the border between the 2nd and 3rd degree of damage and at the 3rd degree, an operation is required.

There are several ways to surgically treat ACS rupture:

– open surgery, performed through an incision in the tissues of the shoulder joint.

– arthroscopic, most modern, low-traumatic ACS operation.

Open operation on the acromioclavicular joint.

In an open operation, an incision is made in the clavicle area, while the deltoid muscle is separated (separated anatomically without cutting, but by cleaning) from the clavicle, the torn ligaments are exposed, a thin synthetic tape is drawn into the base of the coracoid process, or around it, a thin synthetic tape is drawn, which presses the clavicle to the coracoid process ensuring, thereby, the healing of the ligaments (conical and trapezoidal).

Arthroscopy of the acromioclavicular joint in acute,

up to 2 weeks from the moment of injury, degree of damage.

Having performed arthroscopic approaches under the deltoid muscle and under the acromion, we visualize the torn ligaments. A hole is made at the base of the coracoid, into which we pass a special synthetic 2 mm Fiber Tape and a titanium button Endo Button, which is wedged under the coracoid. Then, between the conical and trapezius ligaments, through the clavicle, without damaging the fibers of the deltoid muscle and the ligament, a second hole is made into which the same tape is passed and then it is fixed on the clavicle using the second reconstructive fixator Endo Button.

Arthroscopy of the acromioclavicular joint with subacute,

up to 3 months from the date of injury, degree of damage.

With a subacute degree of damage to the AKC, we perform a modified WEAVER-DUNN operation.

In addition to the installed buttons, which press the clavicle to the coracoid process, the previously sutured part of the coracoacromial ligament is unfolded and fixed to the clavicle. Thus, non-free plasty of the clavicular-coracoid ligaments is performed using the acromioclavicular ligament.

Modified WEAVER-DUNN operation is not easy to execute. To carry it out with sufficient visualization, a high level of anesthetic support is required, which our clinic is equipped with.

Arthroscopy of the acromioclavicular joint in old,

more than 3 months from the date of injury, degree of damage.

At this time, it is possible to help a patient with a ruptured acromioclavicular joint by performing ACS tendon plasty.During this operation, in addition to the fixation buttons and a synthetic tape from the patient’s semitendinosus muscle, isolated from the popliteal region, a loop is formed, which is drawn around the coracoid process, fixed in the canals in the clavicle and fixed to the acromial process.

Why can we move the coracoacromial ligament?

The coracoacromial ligament is a rudimentary formation that has lost its main importance in the process of evolutionary development, which often causes impingement syndrome and its movement can be considered rather a blessing for the patient.

We use a non-axial tunnel drilling technique at the anatomical attachment points of the ligaments, which allows us to perform a complex operation in the most elegant way. This method of execution is more difficult for the surgeon, but the most optimal for the patient’s recovery.

Why choose arthroscopy method for ACS surgery.

In 30 percent of cases, with trauma to the acromioclavicular joint, there is a rupture of the anterior-superior segment of the articular lip of the shoulder joint – SLAP.That is, every third patient performing an operation on the ACS arthroscopically, using the same approaches, we can additionally perform an arthroscopic suture of the articular lip. If in an acute state damage to the articular lip can be fixed in the anatomical position, then in advanced cases tenodesis of the tendon of the long head of the biceps is performed, which is somewhat non-physiological.

Timely arthroscopic treatment aimed at eliminating instability in the acromioclavicular joint ensures fusion not only of the ligaments, but also of the intra-articular disc.The shoulder joint begins to function physiologically, thereby preventing the development of arthrosis of the ACS, the development of shoulder impingement syndrome and, as a result, such a formidable condition as a rupture of the rotator cuff of the shoulder.

Postoperative period in operations on the acromioclavicular joint.

The ACS ligaments grow together 3-4 weeks from the date of the operation.

During this time, the patient was recommended to be immobilized in a soft abduction splint with neutral rotation.

A rehabilitation program is prescribed for 3-4 weeks, with the successful completion of which and after 4 months after the operation, any sports activities are possible without any restrictions.

Fractures and dislocations in a cat: causes, symptoms, treatment

Contents of article

Cats are extremely active, restless and curious animals. It is because of these natural traits of character that they often receive injuries of the musculoskeletal system – fractures and dislocations.Moreover, it is often difficult to distinguish these two pathologies from each other.

Causes of the disease

Fracture – violation of the anatomical integrity of the bone and adjacent tissues. It can be acquired or congenital and occur under the influence of external force or pathology, respectively.

If we talk about congenital pathologies of the bone structure, only 1-2% of the total number of visits to veterinary clinics with fractures are diagnosed.The reasons for the birth of kittens with fractures of the limbs are intensive labor activity of the uterus, osteoporosis, rickets, osteomalacia in the expectant mother.

Veterinarians distinguish between two types of acquired bone damage, based on the cause of their occurrence: pathological and traumatic. The first group includes fractures due to osteosarcoma, osteomalacia, etc.

Traumatic fractures occur not only due to various injuries sustained as a result of falling from a height, being hit by the wheels of a car, fighting with an opponent, but also due to unprofessional obstetrics.

Unlike a fracture, a dislocation is a violation of the anatomical location and a change in the physiological functions of the joint. The bone remains intact. Dislocations also fall into two categories: acquired and congenital. The causes of dislocation are similar to fractures.

No animal is insured against acquired dislocations and fractures. Breeds such as Persians, Maine Coons, Himalayan cats are predisposed to congenital joint pathologies.

Main symptoms

In case of fractures and dislocations, the animal has general clinical signs: pain syndrome, impaired motor function (lameness), swelling of the damaged area.

Fractures are of three types – closed, open, with displacement. Cracks are also serious damage.

Signs of an open fracture in a cat:

• violation of the integrity of the skin;
• the bone is broken, its ends are displaced and protrude outward;
• rupture of tissues in the area of ​​the fracture;
• bleeding;
• severe pain.

With open wounds, the risks of tissue necrosis and infection are very high.

For a closed fracture without displacement, the following symptoms are characteristic: the broken bone is in its usual position, the skin and tissues swell, turn blue, redden. With a displacement fracture, the bone diverges in different directions, the soft tissues are partially damaged. There is a danger of internal bleeding.

A crack can be easily confused with a bruise. The bone remains intact, its edges do not diverge and are kept intact. The cat can move carefully, while it is in pain.

Simple dislocation is recognized by the following features:

• leather and fabrics remain intact;
• lameness;
• inability to lean on the surface;
• pain when touching an injured limb;
• The dislocated part of the body is asymmetrical.

Complex dislocation, accompanied by rupture of ligaments and tendons, is characterized by the appearance of hematomas in the injured area.

Diagnostics in the veterinary clinic

The fact that the pet was injured can be seen immediately, however, an appeal to the veterinary clinic is still necessary.After examining the pet and conducting a series of diagnostic tests, the veterinarian will determine the degree of damage and prescribe appropriate treatment.

The necessary diagnostic methods include general and biochemical blood tests, X-ray in two projections, ECHO of the heart. In some cases, an abdominal ultrasound is required.

Home care

If you witnessed a cat hit by a car or fell from a great height and you suspect it has a fracture, a splint should be applied to the damaged paw.This procedure will immobilize a broken limb. A flat board can be used as a tire or, in the absence of such, a thick cardboard folded several times.

The splint must be applied in such a way as to be able to fix two joints close to the fracture from below and from above. The structure should be wrapped with a bandage in several layers. After that, it is necessary to take the victim to the veterinary clinic.

In case of open fractures, the wound is closed with sterile gauze napkins, and a splint is applied on top.

If you are sure that the cat has a dislocation, then in no case try to correct the injured limb yourself! With your inexperienced actions and ignorance of feline anatomy, you can cause irreparable harm to your pet. Apply an ice pack to the affected limb, apply a tight bandage, and take the pet to the veterinary clinic.

To alleviate the condition of the cat and relieve it from traumatic shock, many owners inject pain relievers.However, veterinarians advise against doing this at home. Without feeling pain, the cat can harm itself even more.

In addition, analgesics distort the symptoms of trauma. Finally, sedation will be mandatory during the X-ray examination, and the preliminary giving of anesthetic can negatively affect the health of the pet.

The animal should be transported to the veterinary clinic while lying down in the back seat of the car.The pet should be placed on a horizontal surface – plywood, board, car panel – and fixed in the area of ​​the shoulder blades and pelvis with a rope or belt.

The owner’s task is to provide the pet with the most comfortable conditions during the treatment of fractures. A cat’s mobility can negatively affect its well-being, so freedom of movement should be limited. The ideal option would be to place the animal in a cage for 2-3 weeks.

This structure should be free enough, but at the same time not allowing the pet to move a lot.A tray, bowls of food and water must be placed in the cage.

How to treat fractures and dislocations

Simple fractures are treated with conservative methods. These include anesthesia, elimination of pain shock. Immobilization with splints and splints is used to restore the damaged bone. For anesthesia, drugs such as Traumeel, Butomidor are used. The splints and braces are removed only after the veterinarian authorizes them to do so.

For complex types of fractures, surgery is indispensable.Osteosynthesis involves the removal of small fragments of bones and reduction of large ones. Surgical intervention using retaining metal structures should be performed immediately after a fracture is diagnosed.

Pins, plates and spokes made of a special alloy with titanium remain in the animal’s body for life.

Antibiotic therapy is indicated after surgery, as well as in the case of open fractures.

The regeneration process will be accelerated by drugs that improve fusion, vitamin therapy, physiotherapy.

If the cat has been diagnosed with a dislocation, then treatment includes anesthesia and reduction of the injured limb, followed by the imposition of a fixation bandage. In severe cases, surgical intervention is indicated.

As for the prognosis for fractures and dislocations, in most cases it is favorable. The only exceptions are spinal fractures with damage to the structure of the spinal cord. If during a fracture there was a rupture of large vessels of a limb or peripheral nerves, then for a cat this ends in the loss of a limb.

Dislocations should not be underestimated: if the damage is not treated, subsequently it can lead to complex deformities of the muscles, destruction of the articular surfaces. As a result, the cat will limp for the rest of its life.

Rehabilitation period

How long the recovery phase will take depends on the severity of the fracture, general condition and age of the cat. In juveniles, it usually lasts three weeks, with a maximum of 30 days. In an old cat, the healing process is longer – 35-40 days.

To monitor the correct fusion of the bone structure, the pet should be taken monthly to a follow-up appointment with a veterinary surgeon.

To restore the motor function of the injured limb, elasticity and muscle tone, manual massage should be carried out, the technique of which will be introduced by the veterinarian. Daily massage procedures stimulate blood circulation, the healing of peri-bone tissues and accelerate the process of bone healing.

Cat food should be balanced, nutritious and easily digestible.The animal needs foods fortified with phosphorus and calcium. However, it must be remembered that an excess of these components often leads to the formation of stones in the gallbladder and kidneys.

Vitamin and mineral supplements will also contribute to the speedy recovery of the pet, but they can be given only after consulting a specialist. The veterinarian prescribes vitamins based on the animal’s needs.

Preventive measures

Of course, you may not always be able to control your pet in order to protect it from being hit by the wheels of a car or falling out of a window.However, no one cancels the observance of elementary safety rules. Make sure that the cat does not climb tall trees, close windows and vents during your absence.

Examine your pet for injuries after each walk. If you suspect a fracture or dislocation, immediately contact your veterinary clinic.

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90,000 What is a hygroma.Treatment of hand hygroma and other localizations

Causes, symptoms, diagnosis of hygroma. Treatment of hand hygroma and other localizations

Hygroma is a volumetric formation located in the area of ​​the joints and is a cavity filled with fluid. It is both a cyst and a tumor. There is no danger in it, but quite often it leads to the appearance of cosmetic defects and tangible pain. Treatment of hand hygroma is a frequent manipulation in the operating practice of orthopedists, when conservative treatment is ineffective.

Causes of hygroma

There is still no consensus about the causes of this disease. There are three theories, each of which has only been partially proven:

• inflammatory;
• tumor;
• dysmetabolic.

According to the first, the triggering factor for the development of the disease is the inflammatory process. Proof of this is, first of all, a clearly traced connection between occupational injuries and the tendovaginitis caused by it, bursitis, and the appearance of hygromas in the area of ​​the joints.Usually, the cavity arises in the weak point of the tendon canal or joint capsule and communicates with the cavity of the main capsule. Over time, the canal connecting the cavity can be closed with scar tissue and the hygroma becomes an independent formation.

According to the second theory, hygroma is considered a benign tumor that grows from atypical cells outwards. At first, it is just a microscopic nodule, in which a cavity subsequently forms. This is evidenced by the frequent detection of atypical cells in its contents during puncture of a cyst.The second proof is the recurrence of the hygroma with its careless removal, when sections of the capsule wall remain in the joint area.

The third theory suggests that in some diseases that are often associated, the production of synovial fluid by the joint capsule at some point begins to exceed the capsule’s ability to absorb it back. With an increase in intra-articular pressure, a protrusion is formed, which subsequently becomes a hygroma.

The causes of neck hygroma in the fetus are completely different.This form of the disease occurs due to a violation of the development of the lymphatic system in the prenatal period (about 12 weeks). This hygroma is correctly called lymphangioma, as it grows from the lymphatic vessels and has nothing to do with the structures of the joints.

Symptoms

The main symptom is the presence of a mass of the corresponding localization. Sometimes it is accompanied by pain, especially severe in cases where the growing cyst compresses the nerve trunks located nearby.In parallel, there is a violation of skin sensitivity in the area of ​​innervation of the corresponding nerve. Pain can also be caused by tissue malnutrition if arteries are compressed.

Sometimes there is a violation of the mobility of the corresponding joint. This is usually associated with painful sensations arising from movements in it.

Diagnostics hygrom

• X-ray, which allows you to distinguish hygroma from osteosarcoma, hematoma, lipoma, tuberculous focus, osteomyelitis;
• computed tomography, which allows to determine not only the structure of the tumor, but also to reveal its exact location and connection with the articular structures;
• a puncture biopsy, with the help of which the contents of the cyst are obtained for analysis for the presence of atypical cells – this allows you to distinguish a benign process from a malignant one.If pus, caseous masses, blood are found in the punctate, the diagnosis of hygroma is considered doubtful.

Treatment of hygroma

Traditional medical practice shows that it will not be possible to get rid of this formation with conservative treatment. And let miraculous folk methods sign on the Internet, telling, for example, how to treat a hygroma on the leg, it will not be possible to do without an operation. Perhaps this is due to its partly tumor nature, contributing to recurrence.

Before the intervention, the patient should be prepared: the doctor determines the blood coagulation capacity, the level of glucose and electrolytes. In the presence of hemophilia and other blood pathology, the level of clotting factors should be adjusted in advance.

The operation is usually performed under local anesthesia. Before starting it, a test is carried out for the anesthetic that is supposed to be used. Also, before the operation, a broad-spectrum antibiotic is prescribed for prophylactic purposes (usually cephalosporins of 3-4 generations).

The incision is made so as to gain maximum access to the cyst, while remembering that a bad incision is a guarantee of poor healing. Hygroma is isolated by a blunt method, trying not to damage its capsule, the leg is crossed between two clamps, the base is either bandaged or sutured. Then the wound itself is sutured. The removed hygroma is sent for histological examination.

Removal of hygroma on the wrist with a laser is carried out according to the same rules as with the traditional method.The difference is that a laser scalpel is used instead of a conventional scalpel. This helps to reduce blood loss. A laser scalpel can be removed in any location, for example, the hygroma of the knee joint. After the operation, restoration of working capacity occurs within 2-3 weeks.

Postoperative period

In the absence of inflammation in the postoperative wound, the sutures are removed after 5-7 days. If the wound becomes infected, they may be removed earlier to re-debride the wound with antiseptics. In this case, recovery may take a longer period of time.

After removal of the hygroma of the wrist joint, a patient whose work is associated with permanent injuries in this area is recommended to change profession. Only in this way can the likelihood of relapse be reduced to a minimum. Foot hygroma in children is most often caused by flat feet, therefore, its timely correction is required. This will avoid not only the recurrence of this pathology, but also the development of other problems in adulthood.

Special situations

Sometimes the patient can crush the hygroma.Previously, they tried to treat her in this way and operated on only in case of a subsequent relapse, which came very often.

The consequences of a bursting hygroma on a finger are usually negligible, since its contents are sterile. However, the patient should observe the place where she was. In case of signs of inflammation or its rapid subsequent growth, the specialists of our clinic dobrobut.