Broken Collarbone (Clavicle Fracture): Symptoms, Treatment, Healing

Overview

What is a clavicle fracture?

A clavicle fracture is a break in the collarbone. You have two clavicles — long, slender, S-shaped bones connecting the shoulders to the upper chest. Broken collarbones are common, making up about 5% of all adult bone fractures.

Are there different kinds of clavicle fractures?

A collarbone can crack in one place or break into several pieces (comminuted fracture). The broken pieces may still line up or may end up out of place (displaced fracture).

Symptoms and Causes

How do people break their collarbones?

A clavicle breaks when force or pressure causes it to snap. Common causes are:

• Collisions (trauma) when an arm is outstretched, like during skiing, hockey, football and other sports.
• Direct hits to the clavicle, such as in a car accident.
• Falls onto the clavicle or an extended arm.
• Passing through the birth canal for a baby.

What are the symptoms of a broken collarbone?

If you break your collarbone, you may experience:

• Snapping or grinding noise when the bone breaks.
• Sharp pain, which gets worse when you move that area.
• Shoulder slumping down or forward because the bone no longer supports it.
• Difficulty moving or lifting the arm, with a possible grinding feeling when you do.
• Bruising, swelling or tenderness in the area.
• Bump that you can see through the skin.
• Numbness or “pins and needles” (less often).
• Bone poking through the skin, with bleeding (rarely).

Diagnosis and Tests

How is a clavicle fracture diagnosed?

If you think you’ve broken your clavicle, seek immediate medical attention. A healthcare provider will:

• Ask you to describe what happened.
• Examine the area.
• Take X-rays of the injured area to confirm a broken bone. X-rays can also show exactly where the break is, how bad it is and whether any other bones broke.

If the healthcare provider thinks there’s damage to a joint or artery, you may get more tests:

• Arteriography/arteriogram, which uses X-rays and dye to see inside the arteries.
• CT scans, which provide more detailed pictures than X-rays.
• Ultrasound, which uses sound waves to create pictures of what’s happening in the body.

Management and Treatment

What should I do if I break my clavicle?

If you think you broke your collarbone, take these steps immediately:

• Put your arm in a sling to stop it from moving. You can create a sling from a piece of cloth like a towel or shirt. Wrap it around your arm and fasten it to the back of your neck to hold up your arm.
• Apply ice to reduce pain and swelling.
• Take over-the-counter pain medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include ibuprofen (Advil®, Motrin®), naproxen, (Aleve®) or acetaminophen (Tylenol®) if it doesn’t interfere with your other medications or health issues.
• Call a healthcare provider or go to the emergency room.

What does a healthcare provider do to treat a broken collarbone?

Most clavicle fractures don’t need surgery. If the broken parts of the bone are in a good position to heal, healthcare providers may recommend:

• Arm support: A sling can help you feel more comfortable as you heal. It can also prevent broken parts of bone from moving around.
• Medication: Over-the-counter medications can relieve pain as the bone heals. Some healthcare providers may prescribe stronger drugs, such as opioids, for a very short period of time. Those come with risk of drug addiction, though, and should be used only if really necessary
• Physical therapy: A physical therapist can teach you special exercises. These exercises can improve motion in your arm, strengthen your shoulder and prevent stiffness. You may do the exercises in a physical therapist’s office, at home or both.

What if I need surgery?

Sometimes you need surgery to treat a broken collarbone, like when:

• Blood vessels or nerves get injured.
• Fractures break through the skin.
• Pieces of broken collarbone are not in a good position to heal.

Surgery to treat a clavicle fracture is called open reduction and internal fixation. The operation puts broken pieces of collarbone back where they belong (reduction). It then uses metal devices to keep the pieces in place (fixation). An orthopaedic surgeon (specialist in bone and muscle injuries) may perform the procedure using:

• Plates and screws attached to the outer surfaces of the bone. The hardware usually isn’t removed after the bone heals, unless it causes discomfort (this usually happens a year or more after the surgery).
• Pins or screws through the bone. They are usually removed once the fracture has healed.

Prevention

How can I prevent a clavicle fracture?

Clavicle fractures happen suddenly and are difficult to prevent. But certain things can help keep your bones safer:

• Drive safely and wear a seatbelt when riding in a vehicle.
• Eat a well-balanced diet with plenty of calcium to keep your bones strong.
• Use good technique and body positioning for any sports you play or activities you do (such as bike riding).
• Wear protective gear when playing sports or participating in hobbies.

Outlook / Prognosis

What is the outlook for a broken clavicle without surgery?

Most collarbone fractures heal in six to eight weeks, without surgery or complications. Most people are able to start getting back to normal activities by three months or so, but full recovery may take up to six to 12 months.

You may feel a bump where the fracture healed. The bump may get smaller on its own over time, but it might never go away completely. You may also have less strength in your shoulder and arm. But unless you have other injuries, you can often return to normal activities within a few weeks.

What is the outlook for a broken clavicle with surgery?

If you have surgery, you may feel the plate or other hardware inside your body. You’ll also have limited use of your arm for six to eight weeks. After that, you can start using it for normal daily activities such as bathing, dressing and eating. You should wait for your healthcare provider’s permission before doing things that involve lifting, pulling or pushing. You should also wait to play sports. In general, recovery is similar to treating a broken clavicle without surgery with return to normal activity around three months or so and full recovery up to six to 12 months after surgery.

While your break heals, you should follow-up with your surgeon or other healthcare provider to make sure you don’t have complications. Complications after surgery may include:

• Malunion: If the pieces of bone move out of place and heal in the wrong position, healthcare providers call it a malunion. It may need surgery.
• Pain and stiffness: Sometimes the shoulder can get very stiff or painful after surgery. Your healthcare provider may recommend physical therapy or remove any irritating pieces of hardware.
• Wound problems: The place where the surgeon cut your skin may have trouble healing, get infected or bleed.

Living With

What can I do to make sure I heal after a broken collarbone?

Whether you have surgery or not, you should go to all your follow-up appointments. At those checkups, your healthcare provider will:

• Check the motion in your shoulder.
• Talk to you about how you feel and whether you still have pain.
• Take more X-rays if needed.

You should also follow all exercise advice from your healthcare provider and physical therapist. Physical therapy can be slow and uncomfortable, but it’s important if you want to return to your normal activities.

In the first few weeks of physical therapy, you will do gentle exercises to help prevent stiffness and pain. You will eventually start exercises with light weights and stretchy bands. Once the bone fragments rejoin, you will do more aggressive strength training.

A note from Cleveland Clinic

A clavicle fracture is a break in the collarbone that’s often painful. Most people don’t need surgery, but some require an operation to put the pieces of bone back in place. Physical therapy is important to get you back to daily activities. Talk to your healthcare provider about exercises to reduce pain and stiffness and regain strength.

Nonoperative treatment of closed displaced midshaft clavicle fractures

J Orthop Traumatol. 2010 Dec; 11(4): 229–236.

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Cesare Faldini

Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136 Bologna, Italy

Matteo Nanni

Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136 Bologna, Italy

Danilo Leonetti

Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136 Bologna, Italy

Francesco Acri

Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136 Bologna, Italy

Claudio Galante

Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136 Bologna, Italy

Deianira Luciani

Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136 Bologna, Italy

Sandro Giannini

Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136 Bologna, Italy

Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136 Bologna, Italy

Corresponding author.

Received 2010 Mar 20; Accepted 2010 Sep 23.

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

This article has been cited by other articles in PMC.

Abstract

Background

Closed displaced midshaft clavicle fractures used to be treated nonoperatively, and many studies have reported that nonoperative treatment gave good results. However, more recent studies have reported poorer results following nonoperative treatment, whereas the results of operative treatment have improved considerably. The aim of this paper was to report the results of treating closed displaced midshaft clavicle fractures nonoperatively.

Materials and methods

One hundred Edinburgh type 2B clavicle fractures (69 type 2B1 and 31 type 2B2) in 100 patients (78 males and 22 females) aged between 18 and 67 years (mean 32 years) were treated. All patients were treated using a figure-of-eight bandage. Clinical and radiographic assessment was performed at the time of trauma, 1, 2 and 3 months after the trauma, and then at an average follow-up of 3 years (range 1–5 years). The outcome was rated at the last follow-up using the DASH score.

Results

Ninety-seven of the 100 fractures healed. Three nonunions were observed. Average healing time was 9 weeks (range 8–12 weeks). No statistically significant correlation between the type of fracture and the healing time was observed. The average DASH score was 24 (range 0–78) and, based on this score, 81 patients presented excellent results, 12 good, 5 fair, and 2 poor. No statistically significant correlation between the type of the fracture and the score was observed.

Conclusions

We believe that nonoperative treatment is still appropriate in most cases, as it yields good results without incurring the potential complications of surgery.

Keywords: Clavicle, Midshaft fractures, Displaced fractures, Nonoperative treatment

Introduction

The clavicle provides the junction between the chest and the upper limb, so it plays an important role in the whole function of the shoulder girdle. Morphologically, the clavicle normally presents a characteristic S-like shape resulting from the junction of two opposite curves at the level of the midshaft. The bone is thinner and consequently weaker at this junction, which is why most fractures occur at this level [1–3].

Fractures of the clavicle are common, and account for 2–15% of all adult fractures and 33–45% of all injuries involving the shoulder girdle [1, 4–6]. The midshaft is the most frequently affected site, encompassing 69–82% of all clavicle fractures, and most fractures that occur in the midshaft are displaced [1, 2]. The literature reports two peaks of incidence: the first (and largest) is associated with young active males, whereas the second is associated with elderly individuals, with a slight female predominance [2, 4, 7].

Clavicle fractures are often a consequence of direct trauma (e.g., a fall) to the shoulder, where the force typically propagates along the axis of the clavicle from the acromioclavicular to the sternoclavicular joint [8]. Clinical aspects of clavicle fractures typically include pain over the site of the lesion, with visible deformity of the bone’s profile due to the downward displacement of the lateral fragment under the weight of the shoulder and the upward displacement of the medial fragment due to the action of the sternocleidomastoid muscle. The diagnosis of clavicle fracture is usually confirmed by an anteroposterior view radiograph. Functional impairment of the shoulder and the upper limb can be extremely variable; nevertheless, the whole limb should be carefully evaluated, especially to exclude associated lesions involving the brachial plexus or the subclavian vessels, even though this kind of injury is rare [9, 10]. A careful clinical and radiographic assessment is also necessary to exclude associated chest injuries, such as pneumothorax or hemothorax, which are reported in the literature to occur at rates of up to 3% [1, 11].

In the past few years, various classifications have been proposed for clavicle fractures [12, 13]. The Edinburgh classification [2] was proposed recently and has since been widely accepted. This classifies clavicle fractures according to the anatomical site involved (medial end, midshaft, lateral end), articular involvement (sternoclavicular or acromioclavicular joint), displacement, and extent of comminution (Table ).

Table 1

The Edinburgh classification of clavicle fractures

Historically, clavicle fractures used to be treated nonoperatively [1, 13]. Even for displaced fractures, the literature generally reports a high rate of good results with a low nonunion rate [13–15]. On the other hand, recent studies have reported poorer functional outcomes with nonunion rates of up to 20% for displaced, comminuted midshaft fractures treated nonoperatively, whereas the results of operative treatment have improved considerably [16–20]. Thus, while there is general agreement that undisplaced clavicle fractures should be treated nonoperatively, the choice of treatment for displaced fractures is still widely debated.

Therefore, the aim of this paper was to report the results of treating 100 closed displaced midshaft clavicle fractures nonoperatively.

Materials and methods

This study was authorized by the ethical committee of Rizzoli Orthopaedic Institute, and it was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki, as revised in 2000. All patients gave informed consent to participate in this study.

Between 2004 and 2006, 100 clavicle fractures were treated in 100 patients (78 males and 22 females). Average age was 32 years (range 18–67 years). None of the patients had sustained a clavicle fracture before. The right side was involved in 68 cases and the left side in the remaining 32. In 72 cases the fracture affected the dominant limb (Table ).

Table 2

Demographic data of the series considered in this study

All fractures were due to a high-energy trauma: a road accident in 48 cases, a sporting accident in 22 cases, an accident at work in 18 cases, and a domestic accident in 12 cases. All patients came to our emergency room, where they were clinically and radiographically evaluated. Clinically, an altered clavicle profile with a palpable prominence of the fractured bone was present, associated with pain and swelling around the site of the fracture, and with variable functional impairment. The function of the shoulder girdle—particularly in relation to the sternoclavicular and the acromioclavicular joints—was carefully evaluated, as well as the function of the whole upper limb, principally to exclude potential neurologic or vascular lesions. Patients presenting associated injuries, open clavicular fractures and neurologic or vascular lesions were excluded from this series.

Radiographic evaluation was performed with standard radiographs. All of the patients considered in this series presented a displaced midshaft clavicle fracture of type 2B according to the Edinburgh classification [2]. Sixty-nine fractures were classified as type 2B1 and 31 as type 2B2.

A figure-of-eight bandage was applied in all cases (Fig.  ), and radiography was performed after applying the bandage in order to check the alignment of the fragments. Patients were taught about the correct use of the bandage—in particular, how to maintain its proper position and avoid axillary pressure sores and compression of the neurovascular bundle—and active movements of the elbow and the hand were prescribed. All patients were finally discharged and then monitored as outpatients.

Figure-of-eight bandage. a Anterior and b posterior aspects. c An altered bone profile due to the fracture is noticeable

For each patient, clinical and radiographic assessments were performed at 1, 2 and 3 months after the trauma, and then at the last available follow-up. Four of the authors (MN, DL, FA, CG), who were not directly involved in the treatment, independently evaluated each radiograph. Afterwards, each evaluation was compared with the evaluations performed by the other observers. When there were differing opinions among the four observers, a combined assessment was performed and agreement was reached. The figure-of-eight bandage was maintained all of the time until radiographic evidence of callus formation. During this period, shoulder movements were forbidden, while active movements of the elbow (flexion–extension), of the forearm (pronation–supination), of the wrist (flexion–extension), and of the hand were prescribed in order to prevent contractures (particularly in flexion of the elbow and pronation of the forearm) and peripheral edema. Also, isometric deltoid exercises were advised in order to preserve the tone of the muscle (phase 0). After radiographic evidence of callus, the patients were encouraged to perform mild, progressive, passive (with the help of a physiotherapist) and active mobilization of the injured shoulder girdle—without resistance and according to pain—in all planes, avoiding maximal range of motion in abduction, adduction, and rotations. Also, they were invited to gradually remove the figure-of-eight bandage (phase 1). After radiographic evidence of bone bridging at the fracture site, the bandage was completely removed and physiotherapy for the upper limb was prescribed, with active full range of motion and resistance exercises of the shoulder (phase 2).

The fracture healing was assessed via both clinical and radiographic parameters: absence of pain or tenderness on palpation at the site of the fracture, recovered motion of the shoulder girdle without pain, and radiographic evidence of bone continuity with obliteration of the fracture line. Once the healing of the fracture had been clinically and radiographically assessed, a complete physiotherapy program including active movements and muscle strengthening was prescribed in order to progressively regain the complete function of the shoulder girdle (phase 3).

All patients were finally checked at an average follow-up of 3 years (range 1–5 years) after trauma. At the last follow-up, the clinical evaluation was repeated and four of the authors (MN, DL, FA, CG) independently rated the outcome using the DASH (disabilities of the arm, shoulder and hand) score [21] (Table ).

Table 3

Disabilities of the arm, shoulder and hand questionnaire

		No difficulty	Mild difficulty	Moderate difficulty	Severe difficulty	Unable
Patients rated their ability to perform the following activities during the last week
1	Open a tight or new jar	1	2	3	4	5
2	Write	1	2	3	4	5
3	Turn a key	1	2	3	4	5
4	Prepare a meal	1	2	3	4	5
5	Push open a heavy door	1	2	3	4	5
6	Place an object on a shelf above your head	1	2	3	4	5
7	Do heavy household chores (e. g., wash walls, wash floors)	1	2	3	4	5
8	Garden or do yard work	1	2	3	4	5
9	Make a bed	1	2	3	4	5
10	Carry a shopping bag or briefcase	1	2	3	4	5
11	Carry a heavy object (over 10 lbs)	1	2	3	4	5
12	Change a lightbulb overhead	1	2	3	4	5
13	Wash or blow-dry your hair	1	2	3	4	5
14	Wash your back	1	2	3	4	5
15	Put on a pullover sweater	1	2	3	4	5
16	Use a knife to cut food	1	2	3	4	5
17	Recreational activities which require little effort (e. g., cardplaying, knitting, etc.)	1	2	3	4	5
18	Recreational activities in which you take some force or impact through your arm, shoulder or hand (e.g., golf, hammering, tennis, etc.)	1	2	3	4	5
19	Recreational activities in which you move your arm freely (e.g., playing frisbee, badminton, etc.)	1	2	3	4	5
20	Manage transportation needs (getting from one place to another)	1	2	3	4	5
21	Sexual activities	1	2	3	4	5

For each patient, we noted the healing time of the fracture, the clinical score at last follow-up, the time taken before they resumed their previous daily activities, job, or sport, and any complaints. We evaluated whether there was a correlation between the type of the fracture and the healing time using Spearman’s rho, and whether there was a correlation between the type of the fracture and the functional outcome at follow-up using the chi-square test. For all tests, P < 0.05 was considered significant. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS)^® software, version 9.0 (SPSS Inc., Chicago, IL, USA).

Results

Ninety-seven of the 100 fractures healed. Three nonunions were observed. Excluding cases of nonunion, the average fracture healing time was 9 weeks (range 8–12 weeks; Fig. ). No statistically significant correlation between the fracture type and the healing time was observed. Variable residual prominence of the bone profile associated with a slight shortening of the clavicle was noticeable in all cases.

a Radiographic aspect of an Edinburgh type 2B2 clavicle fracture in a 32 year-old man. b Radiographic aspect of the fracture 1 month after the trauma: callus formation is noticeable. c Radiograph shows healing of the fracture two months after the trauma. d Radiographic aspect of the clavicle 6 months after the trauma: the fracture has healed and the bone has been remodeled. A residual prominence of the bone profile is noticeable

The average DASH score was 24 (range 0-78) and, based on this score, 81 patients presented excellent clinical results, 12 good, 5 fair, and 2 poor. No statistically significant correlation between the type of the fracture and the score was observed.

At last follow-up, 77 patients did not complain of any pain, while 23 referred to occasional pain, particularly after prolonged activity. Eighty-one patients presented complete or almost complete function of the shoulder girdle, while 19 presented slight restriction of function. Two patients complained of a loss of strength in the injured shoulder.

Patients resumed their daily activities after an average of 6 weeks (range 5–7 weeks) from the trauma, and their original work activities after an average of 7 weeks (range 6–8 weeks) from the trauma for sedentary jobs and an average of 10 weeks (range 9–12 weeks) for strenuous jobs. Patients who practiced sports resumed their activities after an average of 10 weeks (range 9–11 weeks) following the trauma. Eighty-one patients did not report any limitation in their performance of daily activities, 17 reported mild limitation, and two reported moderate limitation. No difficulty in performing work activities was reported by 77 patients, mild difficulty was reported by 21 patients, and severe difficulty was reported by two patients, who had to reduce their workloads.

Regarding aesthetic concerns, seven female patients complained about the presence of the residual bone prominence, whereas no complaints were reported by male patients. None of the patients underwent further treatment, even in the cases with failed fracture healing.

Discussion

Traditionally, the treatment of clavicle fractures has been nonoperative [1, 13]. Until recently, the literature reported a high rate of good outcomes with a low rate of nonunions following nonoperative treatment, and there was no evidence of functional benefits resulting from surgery in comparison with nonoperative treatment [1, 13, 22, 23]. Nevertheless, many authors have recently suggested operative treatment for clavicle fractures, particularly in the case of high displacement or comminution, and have reported lower rates of nonunion and better functional outcomes for operative treatment [16–18, 20].

Based on the results of this study, we believe that the treatment of displaced midshaft clavicle fractures should account for various factors, including not only the clinical and radiographic aspects of the fracture but also the characteristics of the patient, such as their general clinical condition, their compliance with the treatment, their functional requirements and their expectations. Nonoperative treatment using a figure-of-eight bandage is simple to carry out. Nevertheless, this device is not able to achieve anatomical reduction of the fracture, and moreover the risk of axillary pressure sores with compression of the neurovascular bundle may produce significant discomfort for the patient. On the other hand, surgical treatment may allow the anatomical reduction of the fracture and sometimes a quicker recovery. However, surgical treatment is associated with many more possible complications [7, 20, 24–28]. The main potential surgical complication is a lesion of the subclavian vessels or the brachial plexus. Despite the fact that the risk of this complication is rarely described in the literature [7, 24, 26], the occurrence of this kind of injury may represent a surgical emergency, requiring the intervention of the vascular surgeon or the neurosurgeon. Furthermore, surgery presents an associated risk of infection, wound-healing complications, and failure of the fixation device. Sometimes, when the patient is young and active, the prospect of an earlier return to work, sport or recreational activity can direct the choice of treatment to surgery. These patients should be properly informed of the risks and the actual possibilities of surgical treatment.

Patients usually respond satisfactorily to self-administrated physiotherapy, without needing specific medical supervision [7]. When the figure-of-eight bandage is applied, patients are taught about the care they must take to avoid shoulder movements while performing active self-mobilization of the elbow, the wrist and the hand; afterwards, when rehabilitation of the shoulder girdle must be undertaken, patients are initially helped by a physiotherapist (home care or outpatient sessions) and then, once they have been adequately taught the correct exercises to perform, they continue the physiotherapy by themselves. In our series, most of the patients tolerated nonoperative treatment with a figure-of-eight bandage well, they easily completed the rehabilitation program, and they returned early to their previous activities.

The functional consequences of clavicle shortening are controversial [17, 19, 28–30]. Hill et al. [17] reported that unsatisfactory results were significantly associated with a clavicle shortening of 20 mm or greater. McKee et al. [19] observed a higher prevalence of dissatisfaction and residual disability in patients with a clavicle shortening of greater than 20 mm. Chan et al. [30] suggested a potential association between clavicle shortening and shoulder dysfunction. On the other hand, other authors have reported that permanent post-traumatic shortening of the clavicle has no clinical relevance. Judd et al. [28], in a comparison study between operative and nonoperative management of clavicle fractures, did not observe a significant difference between late functional outcome of patients with a clavicle shortening of greater than 20 mm and late functional outcome of patients with a clavicle shortening of less than 20 mm. Nordqvist et al. [29], in a 5-year follow-up study, affirmed that permanent shortening of the clavicle has no clinical significance, even though it is common after a fracture. Despite the fact that the healing of the fractures in our series always occurred with some degree of angulation and slight shortening of the clavicle, most patients did not complain of any functional limitation, and they tolerated the residual bone prominence well (Fig. ).

a Radiographic aspect of an Edinburgh Type 2B2 clavicle fracture in a 28 year-old male, and b radiographic aspect at 2 year follow-up: the fracture has healed with evident bone remodeling. Even though a slight shortening of the clavicle is noticeable, no functional impairment was mentioned by the patient at last follow-up

The main limitation of this study relates to patient selection, since we considered a series of patients with a wide range of ages, and we are aware that the healing time of a fracture, as well as functional requirements, can vary greatly between younger and older patients. Furthermore, we rated the functional outcome using a score that does not include objective shoulder function parameters, such as strength and range of motion.

In conclusion, while we are aware that the treatment of closed displaced midshaft clavicle fractures is still debated in the literature, we believe that nonoperative treatment is still appropriate in most cases, as it yields results that are as good as those achieved through surgical treatment in terms of bone healing, functional outcome and patient satisfaction, but without the potential complications of surgery. Therefore, we recommend surgical treatment for closed displaced midshaft clavicle fractures only when vascular or neurologic complications are in progress, thus representing a surgical emergency.

Conflict of interest

None.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

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Undisplaced clavicle fracture  · Virtual Fracture Clinic

This information will guide you through the next 6 weeks of your rehabilitation. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery.

Area of your injury

If you are worried that you are unable to follow this rehabilitation plan, or have any questions, then please phone the Fracture Care Team for advice.

Or, if you are experiencing pain or symptoms, other than at the site of the original injury or surrounding area, please get in touch using the telephone or e-mail details at the top of this letter.

What to expect

Advice for a new injury

Cold packs: A cold pack (ice pack or frozen peas wrapped in a damp towel) can provide short term pain relief. Apply this to the sore area for up to 15 minutes, every few hours ensuring the ice is never in direct contact with the skin.                                                    

Rest: Try to rest your shoulder for the first 24-72 hours. However, it is important to maintain movement. Gently move your shoulder following the exercises shown. These should not cause too much pain. This will ensure your shoulder does not become stiff and it will help the healing process.

Smoking advice

Medical evidence suggests that smoking prolongs fracture healing time. In extreme cases it can stop healing altogether. It is important that you consider this information with relation to your recent injury. Stopping smoking during the healing phase of your fracture will help ensure optimal recovery from this injury.

For advice on smoking cessation and local support available, please refer to the following website: http://smokefree.nhs.uk or discuss this with your GP.

Exercises

If you have stiffness in your elbow or hand from wearing the sling, you may wish to perform these exercises first. However, once they become easy you can start with the posture and pendulum exercises.

Initial exercises to do 4-5 times a day:

Finger and wrist flexion and extension

Open and close your hand as shown 10-15 times.

Then move your wrist up and down 10-15 times.

After a few days, hold a soft ball/ball of socks. Squeeze the ball as hard as possible without pain.

Hold for 5 seconds and repeat 10 times.

Elbow Bend to Straighten

Bend and straighten your elbow so you feel a mild to moderate stretch. You can use your other arm to assist if necessary. Do not push into pain. 

Repeat 10-15 times provided there is no increase in symptoms.

Forearm Rotations

Put your elbow at your side. Bend it to 90 degrees. Slowly rotate your palm up and down until you feel a mild to moderate stretch. You can use your other arm to assist if necessary. Do not push into pain. 

Repeat 10-15 times provided there is no increase in symptoms.

Postural awareness

Bring your shoulders back and squeeze your shoulder blades together as shown in the picture. Do this with or without your sling on.

Hold the position for 20-30 seconds and repeat 5 times provided there is no increase in symptoms.

Shoulder pendulum exercises

Stand and lean forward supporting yourself with your other hand. Try to relax your injured arm and let it hang down.

1. Swing your arm slowly and gently forwards and backwards.
2. Swing your arm slowly and gently side to side.
3. Swing your arm slowly and gently in circles clockwise.

Continue for approximately 1-2 minutes in total provided there is no increase in symptoms. Remember to try and relax your arm.

Stage 2 exercises

Start these exercises 3 weeks post injury and to do 4-5 times a day:

Active assisted Shoulder flexion

Use your other hand to lift your arm up in front of you as shown in the pictures.

Repeat 10 times provided there is no increase in symptoms.

Active assisted External rotation

Keep the elbow of your injured arm tucked into your side and your elbow bent. Hold onto a stick/umbrella/golf club or similar. Use your unaffected arm to push your injured hand outwards. Remember to keep your elbow tucked in. Push until you feel a stretch.

If you don’t have a stick you could simply hold the injured arm at the wrist and guide it outwards. 

Hold for 5 seconds and then return to the starting position. Repeat 10 times provided there is no increase in symptoms.

Stage 3 exercises

When you have regained full range of movement in the stage 2 exercises without pain you can start to do these exercises without the support of your other hand. This is known as active range of movement. The, when you have regained full movement without helping with your other arm, you can build up your regular day to day activities.

Start these exercises 6 weeks after your injury and to do 4-5 times a day.

Perform these exercises 10 times each. Only go as far as you can naturally, without doing any trick movements to try and get any further. The movement should increase over time and should not be forced.

Active Forward flexion:

With your thumb facing up, try to move your arm up, keeping it close beside your body.

Active Abduction

With your thumb facing up and outwards, try to move your arm in a big arc out to the side.

Active External Rotation

With your elbow by your side, rotate your forearm outwards, keeping your elbow at about 90 degrees in flexion.

Clavicle Fractures – American Family Physician

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2005;19:504–7.

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Can we predict long-term sequelae after fractures of the clavicle based on initial findings? A prospective study with nine to ten years of follow-up. J Shoulder Elbow Surg.
2004;13:479–86.

14. Robinson CM,
Court-Brown CM,
McQueen MM,
Wake-field AE.
Estimating the risk of nonunion following non-operative treatment of a clavicular fracture. J Bone Joint Surg Am.
2004;86-A:1359–65.

15. Canadian Orthopaedic Trauma Society.
Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am.
2007;89:1–10.

16. McKee MD,
Pedersen EM,
Jones C,
Stephen DJ,
Kreder HJ,
Schemitsch EH,

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Deficits following nonoperative treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am.
2006;88:35–40.

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Vainionpaa S,
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Outcome of clavicular fracture in 89 patients. Arch Orthop Trauma Surg.
1986;105:337–8.

18. Hill JM,
McGuire MH,
Crosby LA.
Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br.
1997;79:537–9.

19. Nordqvist A,
Petersson CJ,
Redlund-Johnell I.
Mid-clavicle fractures in adults: end result study after conservative treatment. J Orthop Trauma.
1998;12:572–6.

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Sequelae from clavicular fractures are common: a prospective study of 222 patients. Acta Orthop.
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Guide | Physical Therapy Guide to Collarbone (Clavicle) Fracture

Most collarbone fractures are treated without surgery. The involved arm will be secured in a sling or a figure-eight brace for support and comfort. Physical therapy usually begins early to help reduce pain and swelling.

Healing times vary from person to person due to differences in age, health, and the extent of the injury. Many patients return to light daily activity after about six weeks. Generally, people can return to more strenuous job duties after nine to 12 weeks.

Your physical therapy treatment program may include some or all of the following:

Patient education. Your physical therapist will teach you about your injury. They will work with you to find any external factors that may have contributed to your injury. Your physical therapist also will recommend ways to change these factors and modify your daily activities.

Pain management. Your physical therapist will design a program to address your pain. This may include treatments such as applying ice to the affected area. They also may recommend changing some activities that cause pain. Physical therapists are experts in helping people manage pain. They can help you reduce or avoid the need for medicines, including opioids.

Range-of-motion exercises. With a collarbone injury, your movement may be limited. This can cause increased stress on your neck or other areas of the arm. In addition, a restriction in the area may force other parts of your neck or arm to work harder. Your physical therapist may teach you self-stretching methods. These will help to decrease tension and restore normal motion of the joints in your upper arm and shoulder.

Manual therapy. Your physical therapist may use hands-on (manual) therapy to gently move your muscles and joints to help improve motion. They also may provide hands-on therapy to guide your joints into a less stressful movement pattern. Your physical therapist also may use their hands to apply resistance while you do exercises to improve strength in the affected muscles.

Muscle strengthening. Muscle weaknesses or imbalances can contribute to ongoing symptoms. Your physical therapist will design a safe strengthening program for you. It likely will include your core (midsection) and the upper arm and shoulder area. Your program may include doing exercises in different positions, including standing or lying on your back. They may have you use elastic bands, tubing, or other equipment to provide resistance. Your physical therapist will choose exercises that are right for you based on your restrictions, pain level, and fitness.

Functional training. Once your pain, strength, and motion improve, you will need to safely transition back to more demanding activities. To minimize the stress on your collarbone and shoulder, it is important to learn safe, controlled movements. Your physical therapist will create a series of activities to help you learn how to use and move your body correctly and safely.

Braces and other assistive devices. Your physical therapist will work with you and other health care providers to determine if bracing will help you. Braces may be used for a short time, to rest the area.

Treatment After Surgery

Physical therapy after surgery is similar to that provided for people who do not need surgery. However after surgery, your program will progress by following a strict schedule set by your surgeon. It is typical for physical therapy to begin immediately following the operation. Eight to 12 weeks of physical therapy is common after surgery.

During the first week after surgery, your physical therapist will help you control pain and swelling. They may begin some gentle motion exercises. You will wear a sling or brace for support and comfort.

Over the next few weeks, your physical therapist will help you gradually increase your exercise program.

After about four weeks. If X-rays show good collarbone position and stability, your physical therapist will guide you to achieve full shoulder range of motion.

At six to eight weeks. If X-rays show enough healing, treatment will progress to include strengthening and resistance exercises.

These time frames will vary based on your age, health, the extent of your injury, and any surgery you had.

Broken Collarbone (Clavicle Fracture) (for Parents)

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.

Displaced Midshaft Clavicle Fracture Union Can Be Accurately… : JBJS

Background: 

It is unclear if clinical recovery following a midshaft clavicle fracture can accurately predict fracture-healing. The additional information that can be assessed at 6 weeks after injury may have superior predictive value compared with information available at the time of the injury.

Methods: 

A prospective study of all patients (≥16 years of age) who sustained a fully displaced midshaft clavicle fracture was performed. We assessed patient demographic characteristics, injury factors, functional scores, and radiographic predictors with a standardized protocol at 6 weeks. Conditional stepwise regression modeling was used to assess which factors independently predicted nonunion at 6 months after the injury as determined by computed tomography (CT). The nonunion predictor 6-week model was compared with a previously validated model based on factors available at the time of the injury, which included smoking, comminution, and fracture displacement.

Results: 

At 6 months, 200 patients completed follow-up. The CT-defined nonunion rate was 14% (27 of 200). Of the functional scores, the QuickDASH (the abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire) had the highest accuracy on receiver operator characteristic (ROC) curve analysis with a 39.8-point threshold, above which was associated with nonunion (area under curve [AUC], 76.8%; p < 0.001). Sixty-nine percent of the cohort had a QuickDASH score of <40 points at 6 weeks, and 95% (131 of 138) of these patients had fracture union. On regression modeling, a QuickDASH score of ≥40 points (p = 0.001), no callus on radiographs (p = 0.004), and fracture movement on examination (p = 0.001) were significant predictors of nonunion. If none were present, the predicted nonunion risk was 3%, found in 40% (80 of 200) of the cohort. Conversely, if ≥2 of the predictors were present, found in 23.5% of the cohort, the predicted nonunion risk was 60%. The nonunion predictor model at 6 weeks appeared to have superior accuracy (AUC, 87.3%) when compared with the nonunion predictor model at the time of injury (AUC, 64.8%) for fracture-healing on ROC curve analysis.

Conclusions: 

Delayed assessment at 6 weeks following displaced midshaft clavicle fracture enables an accurate prediction of patients who are likely to have union with nonoperative management. One in 4 patients are at an increased risk of nonunion and may benefit from operative intervention.

Level of Evidence: 

Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

90,000 Treatment of bruises, bruises and fractures in children in Mines

Bruises – bruises, and not only

At first glance, bruises seem harmless, which is generally correct when it comes to soft tissue bruises, that is, skin and subcutaneous tissue. The pain occurs immediately after the fall and can be significant, but subsides after a few hours. It is accompanied by swelling, a hematoma (or simply a bruise) that grows for some time, and a slight dysfunction of the limb while maintaining passive movements, that is, an outsider can freely bend the injured limb of the victim.

A fresh bruise looks purple at first, after 3-4 days it turns blue, after 5-6 days it acquires a greenish tint, then yellow and gradually disappears.

To relieve the pain of a bruise, it is enough to cover the sore spot with a cloth and apply cold (ice) to it. A pressure bandage and an elevated position of the limb will help prevent severe swelling. There is no need for medical attention. Exceptions are head bruises, which may be accompanied by a concussion, as evidenced by loss of consciousness, lack of memories of the injury itself, headache, tinnitus, visual impairment – in this case, you need to contact the trauma center.

Sprains

Sprains of the ligaments of the joint usually occur with movements that exceed the physiological capabilities of the articulation, or with movements in an unusual direction for the joint. Most often, sprains of the ankle ligaments occur when the foot is twisted or the ligaments of the wrist joint are stretched when falling on a straightened arm.

Pain after a fall resembles a bruise, but swelling in the joint area, hematoma and dysfunction of the joint are more pronounced.If passive movements in the joint and the geometry of the limb are preserved, the pressure on the bone along the axis of the limb does not cause severe pain, it is enough to apply an anesthetic drug in the form of a gel or cream to the skin, apply a pressure bandage, apply cold to the sore spot and maintain complete rest.

Dislocation of joints

Dislocated joints are injuries in which the articular surfaces of the bones forming the articulation are displaced relative to each other. In this case, the capsule of the joint and the ligaments that secure it are most often ruptured.When falling on the arm, the wrist or shoulder joint is most often dislocated, when the foot is twisted, the ankle joint, less often there are dislocations of the hip joints.

Signs of dislocation – pain after a fall, sharply increasing when trying to move in the joint, violation of the geometry of the joint, blockage of both active and passive movements in the limb.

Reduction of dislocation is a medical procedure, so there is no need to try to force the limb to a normal position, this is fraught with injuries to blood vessels and nerve fibers, moreover, no one can guarantee that, along with the dislocation, the injury did not lead to a fracture.

Pain after a fall in case of dislocation can be relieved by applying cold to the joint and immobilizing the limb in the position that it took after the injury. Additionally, you can take an anesthetic drug and, without wasting time, go to the nearest trauma center.

And if there is a fracture?

Fracture doctors call injuries, accompanied by a violation of the integrity of the bones. Fractures can be open, in which case the bone breaks the skin and comes out, and closed when the skin is intact.

Pain after a fall with bone fractures occurs instantly, it can be so severe that sometimes the victim loses consciousness. Any attempt to move a limb causes a sharp increase in pain, so there is no need to try to undress the victim in order to examine the injured limb – this will be done in the hospital. The task of eyewitnesses to an injury in the presence of signs of a fracture is to call an ambulance.

Fracture Signs:

• sharp pain, aggravated by the slightest movements,
• limb reshaping,
• swelling and bruising in the fracture area,
• limb shortening,
• abnormal immobility of the limb and bone.

While the ambulance is traveling, the victim needs to be given an anesthetic and with improvised means, using boards, cardboard, magazines folded in several layers, blankets, towels, ensure the motionless position of the injured limb. Sometimes it is enough to bandage the arm to the torso or chest or one leg to the other – the main thing is that the improvised splint securely fixes the limb in two joints, above and below the fracture area.

Fracture of the spine in a fall

A spinal fracture is a very serious injury, accompanied by pain in the damaged area, loss of sensitivity and paralysis of the legs.If, after a fall, the victim has these symptoms, it is better not to touch him at all, but to leave him lying in the place where he fell, while providing additional safety.

If a situation arises in which an injured person has to be delivered to a hospital on their own, then this should be done on a shield or in a prone position. If the injury occurs in the cervical spine, then the victim is left lying on his back, carefully placing a roller under his neck.Pain relievers can help reduce pain.

Treatment of fractures in children

It is necessary to talk about the treatment of fractures in children and various injuries in connection with the special activity and mobility of babies and adolescents. No one is immune from injuries; it is quite rare for a child to grow up without bruises, sprains and fractures. This is usually due to the lifestyle of children, for whom a minute of rest is especially difficult. Most often, it is these children who get into everyday troubles, traffic accidents when crossing the street thoughtlessly and get bruises and blows on the street or on sports grounds.Fractures of the elbow joint and forearm bones are most common, and infantile leg fractures are less common.

How do the symptoms of fractures manifest, what are the signs that this is not just a bruise, but a fracture? First of all, it should be noted a violation of the motor activity of the affected limb, pain in the lower part of the forearm and deformity, the presence of edema and bruising, if we are talking about a fracture of the clavicle in children or the radius.

Features of children’s injuries are associated with increased elasticity and strength of the periosteal tissue, which often provides fractures without displacement of bone fragments, the so-called subperiosteal.Among specialists – pediatric traumatologists and surgeons, the term “green twig” is used, this is how a child’s limb fracture sometimes looks when only one side of the bone is broken, which allows treatment without surgery.

Therapy of fractures without displacement of bone fragments is carried out by imposing a plaster cast on the desired segment of the circumference of the arm or leg. Such fractures do not require inpatient treatment; they can be performed on an outpatient basis under the supervision of a physician.

An alarming signal for the child and parents is the increasing pain and swelling under the plaster cast, impaired sensitivity in the fingers of the hand or foot. The application of a plaster cast is the simplest and safest method, but, unfortunately, not always effective, not all fractures can be cured this way. An urgent visit to the doctor when the fragments are displaced can end with an operation, which in itself is not difficult, but it is carried out under general anesthesia and requires further stay in the pediatric trauma department.In the case of an unstable fracture, percutaneous fixation with metal wires is used to prevent re-displacement, the method of treatment is quite long and reliable, although it requires special care and dressings.

Clavicle fracture in babies

This type of fracture occurs quite often in children, and accounts for up to 15% in the structure of all injuries. Such an injury occurs when falling on the shoulder, straight outstretched arm or elbow. The child complains of pain in the shoulder, forearm, restriction of movement, and severe pain when trying to move the arm.It is not difficult to determine a fracture of this type even visually; deformation and shortening of the shoulder girdle is found.

In babies, clavicle fractures most often occur as a “green twig” without violating the integrity of the periosteum. In the treatment of this type of fracture, the most important thing is to ensure peace of the hand, fix it bent at a right angle at the elbow joint, hanging it on a scarf. A clavicle fracture, like any other type of injury, can be without displacement of bone fragments or with displacement, closed or open with oblique, comminuted, transverse or oblique character of the fragments.

For an experienced traumatologist, the diagnosis of a fracture does not present any difficulties: the child complains of sharp pain on palpation, pathological mobility and loss of limb function are felt. X-ray examination confirms the level of the fracture, the extent of the injury, and the presence of displacement. It must be understood that reduction should be done immediately to avoid improper fusion and to ensure that the bones of the forearm can be rebuilt.

In the presence of a closed fracture without displacement of bone fragments, rest is provided with a plaster cast fixed at a right angle for up to 5-8 weeks, depending on the child’s age and the type of fracture.During the first two days, the control and supervision of a doctor is shown in order to notice in time signs of a violation of the blood supply in the fingers of the hand. If the displacement has been eliminated and the axis of the forearm is preserved, in the process of further growth, the child will fully recover the healthy structure of the bone tissue and the function of the limb.

At such a moment, the parents’ task is to help the child cope with the illness, teach him possible and necessary self-care techniques, provide reliable care and rehabilitation, and not strive for early removal of the plaster cast and understand that this can lead to a curvature of the forearm.In the process of bone fusion, the baby needs careful and attentive care, as well as a control X-ray examination to exclude a possible displacement of the bone.

A complete and varied diet is an important part of restorative rehabilitation, which involves the use of protein in the menu as the main building material, foods with calcium, magnesium, and boron. Daily sunbathing to strengthen bones as a source of vitamin D, increased blood circulation and metabolic processes promote healing and recovery without complications.

A timely visit to a doctor will help earlier diagnosis and successful treatment of the identified disease!

The medical center “CARDIOPLUS” is located in the area of ​​the public business center “City of the Future” at the address: Shakhty, st. Shishkina 162.

Phones for making an appointment: 8 (8636) 28-84-33, 8 (8636) 23-69-34, 8 (960) 450-94-37.

Order a call back for consultation and appointment with a specialist!

Orthosis for fracture of the clavicle for children

Orthosis for fracture of the clavicle for children

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Orthosis for securing the clavicle, size XL ORTEX 012. Indications: injuries and operations in the area of ​​the clavicle and the acromioclavicular joint, requiring fixation of this section. HEALTH. 577 reviews. Similar orthosis MF-I60 2OP Children’s wrist orthosis (left) The wrist orthosis for children helps to reduce pain and accelerate healing in injuries such as bruises and sprains.Children’s semi-rigid Med-Magazin.ru. 1,833 reviews. Orthopedic bandages and orthoses. orthosis for fracture of the clavicle in a newborn. Search results in all categories. Orthopedic bandages and orthoses. Orthosis for securing the clavicle, size XL ORTEX 012. Manufacturer: ORTEX. Type: orthosis. for children. purpose: ankle and foot. suitable for left and right feet. Clavicle fractures. The clavicle is a thin bone that connects the bones of the arm to the skeleton of the body. It acts as a platform for the attachment of the critical muscles of the neck and chest.In addition, the collarbone protects the artery, vein, and nerve plexus underneath it. A typical mechanism of injury with a fracture of the clavicle is a fall on the side or an accident. The main form of treatment for fractures of the clavicle without displacement of the fragments is its fixation with a special bandage for the entire period. It is believed that due to the peculiarities of the anatomy, the clavicle heals better without surgery than with surgical treatment. The presence of displacement is an indication for reposition (reduction) of fragments. This is usually done under local anesthesia.Clavicle fracture is an injury most commonly seen in children and young adults. Fracture is usually caused by a direct blow to the clavicle, its strong squeezing or falling on its side on an outstretched arm, and the first place among the causes of fracture is taken by sports injuries and road accidents. A fracture of the clavicle in children is sometimes called a fracture of the green twig – that is, the fragments of the bone are held by the periosteum and therefore grow together much faster, and fixation with such a fracture may not be absolute. For young children, a bandage or reclinator is also indicated instead of plaster.Dressings and bandages can be supportive and fixing. An adult or children’s clavicle bandage is an orthopedic product that allows you to tightly fix the clavicle area using elastic bands, special cloths that help to strengthen and support the area of ​​injury or injury. Functional purpose. It is used for various pathological disorders in the clavicle area. Therefore, patients’ expectations are reduced to the following: To securely fix the product, providing a good compression effect.Stabilization of the clavicle region, immobilization for the purpose of quick rehabilitation after injury or fracture. Functional support after braid surgery. Also, the orthosis is used during rehabilitation periods after wearing a plaster cast, after injuries and surgeries of the clavicle, acromioclavicular joint, shoulder joint, scapula. All indications. Price: 756.00. Buy. Delivery to 881 pharmacies in Moscow tomorrow – Free. Payment upon receipt. Upper limb retainer in ind / unitary enterprise, universal size, article 3902.Keep out of the reach of children. Composition. Polyester – 35%. Polyurethane foam – 65%. Description. The retainer is made of combined materials. Orthoses for fracture of the calcaneus. Lateral stabilization orthoses. Bone leg support. Hip braces for children. A thigh bandage after a fracture. Fixing bandage on the hip joint. Sports thigh bandage. Everything about wearing bandages and orthoses for injuries of the shoulder and shoulder joint: types of products, their purpose, how to choose, advantages of use.Bandages and orthoses for shoulder and shoulder injuries: how to choose and wear. Shoulder injuries do not make up a significant share in the overall statistics of injuries (about 5%), but quite rightly they are among the most uncomfortable injuries for the patient. Complications that can occur as a result of a fracture or dislocation of the shoulder, as well as stretching or tearing of tissues, include: limitation of the mobility of the upper limb (for example, the arm does not rise above shoulder level) Orthoses, bandages, tapes. Orthoses, bandages, tapes All goods.Orthoses. The Orlett CS-160 (P) pediatric reclinator (clavicular dressing) is intended for the correction of pediatric posture or conservative treatment of uncomplicated clavicle fractures. Due to the effective abduction of the shoulders back and the shift of the scapula angles to the spine, Orlett CS-160 (P) can be used as a reclinator for various posture disorders. Thanks to the effect of the clavicular bandage, the spine is straightened, the tension of the muscles of the shoulder girdle is reduced, the effect of muscle hypertonicity on the clavicle and the spine is excluded.Clavicle support, Ligaflex clavicular straps JuNiOR. Delivery from Kursk. 63% of 54 for the year. Children’s reclinator for fixing the shoulder girdle (Splint for the treatment of fractures of the clavicle) IC-30 size 2OP (58-72cm), Orliman Spain. Delivery from Moscow. 43% of 23 for the year. Braces and orthoses on the shoulder joint. Types of braces and orthoses on the shoulder. How to choose a shoulder orthosis and brace. Shoulder brace with strong fixation. Rules for applying a bandage to the shoulder joint. Taping of the shoulder and collarbone.How to apply the tape on the shoulder. Tips for wrapping the shoulder. does not allow the occurrence of discomfort when moving the hand, turning or tilting. Wearing fixation devices limits the dynamics of the striated muscles, which has a positive effect on the condition of the ligaments. They are significantly injured with dislocations, especially the abdominal end of the clavicle. For uncomplicated closed fractures of the shoulder or collarbone, the bandage will have to be worn for about a month. Whether it is possible to remove the bandage at night, the doctor should tell the patient.Shoulder bandage Klondike. To buy shoulder orthoses, braces on the shoulder joint in Rostov-on-Don, Azov and Bataysk is offered by the Eskulap network of orthopedic salons. We always have in stock: children’s braces for the shoulder joint; Klondike supporting bandages; braces on the shoulder joint with additional fixation

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90,000 MOS (metal osteosynthesis) of fractures – Clinic Manufactura

Osteosynthesis

(also MOS fractures) is a modern method of treating complex injuries of bones and joints using special implants: plates, rods and wires for external fixation, which are fixed on bone fragments and restore the unity of bones.For the manufacture of fixing implants, titanium or high-strength metal alloys are often used. The stability of the connection, achieved by osteosynthesis with fixators, can be relative or absolute. Absolute stability consists in complete fixation of bone fragments of the fracture, creates conditions for fusion without the formation of callus. With relative stability, micromotions in the junction area are possible, which not only do not interfere with healing, but also stimulate bone fusion.

MOS is currently one of the most effective interventions in traumatology and orthopedics. With the help of MOS, it is possible to fully or partially restore functionality after complex splinter injuries, fractures, congenital or acquired defects of bone tissue. Usually, in some cases, treatment with MOS can be prolonged, but the successful results justify both the duration of treatment and the effort expended. It is worth noting that only a highly qualified specialist can determine which fixation scheme should be used in a particular case.