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Broken collarbone – Diagnosis and treatment
During the physical exam, your doctor will inspect the affected area for tenderness, swelling, deformity or an open wound. X-rays determine the extent of a broken collarbone, pinpoint its location and determine if there’s injury to the joints. Your doctor might also recommend a CT scan to get more-detailed images.
Restricting the movement of any broken bone is critical to healing. To immobilize a broken collarbone, you’ll likely need to wear an arm sling.
How long immobilization is needed depends on the severity of the injury. Bone union usually takes three to six weeks for children and six to 12 weeks for adults. A newborn’s collarbone that breaks during delivery typically heals with only pain control and careful handling of the baby.
To reduce pain and inflammation, your doctor might recommend an over-the-counter pain reliever. If you have severe pain, you might need a prescription medication that contains a narcotic for a few days.
Rehabilitation begins soon after initial treatment. In most cases, it’s important to begin some motion to minimize stiffness in your shoulder while you’re still wearing your sling. After your sling is removed, your doctor might recommend additional rehabilitation exercises or physical therapy to restore muscle strength, joint motion and flexibility.
Surgery might be required if the fractured collarbone has broken through your skin, is severely displaced or is in several pieces. Broken collarbone surgery usually includes placing fixation devices — plates, screws or rods — to maintain proper position of your bone during healing. Surgical complications, though rare, can include infection and lack of bone healing.
Lifestyle and home remedies
Applying ice to the affected area for 20 to 30 minutes every few hours during the first two to three days after a collarbone break can help control pain and swelling.
Preparing for your appointment
Depending on the severity of the break, your family doctor or the emergency room physician may recommend that you or your child see an orthopedic surgeon.
What you can do
It might be helpful to write a list that includes:
- Detailed descriptions of your symptoms and the event that caused the injury
- Information about past medical problems
- All your medications and dietary supplements
- Questions you want to ask the doctor
What to expect from your doctor
Your doctor will likely ask some of the following questions:
- How did the injury occur?
- Have you ever had a broken bone?
- Have you been diagnosed with weakened bones?
Nov. 26, 2020
Clavicle fracture – with follow up at 6 weeks · 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.
|Healing:||This injury normally takes 6-12 weeks to heal.|
|Pain:||Take pain killers as prescribed. You may find it easier to sleep propped up with pillows. Mild pain can continue for up to 3 months.|
Using your arm:
Use the sling for the first 2 weeks to allow the soft tissues to settle.
It is important to keep the shoulder moving to prevent stiffness but not to aggravate the injury.
Avoid lifting and overhead movement for 6 weeks.
You will see a Shoulder Specialist about 6 weeks after your injury.
They may do another x-ray to evaluate the position of the collar bone. The specialist will talk through the next phase of your rehabilitation.
If you have not received this appointment within one week of receipt of this letter please contact your hospitals Appointment Line.
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
Wear the sling during the day, except for exercises and personal hygiene.
It is your choice if you wear your sling at night.
Start the “Initial Exercises” below straight away.
X Do not lift your elbow above shoulder height as this may be painful.
X Try not to use the sling.
Begin normal light activities with the arm and shoulder.
Increase movement as shown in the Stage 2 exercises.
X Avoid heavy lifting for the full 6 weeks.
The injury should be healed.
Resume normal day to day activities but be guided by any pain you experience.
Start to lift your arm over-head.
X Heavy tasks may cause discomfort.
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.
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.
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.
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.
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.
- Swing your arm slowly and gently forwards and backwards.
- Swing your arm slowly and gently side to side.
- 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
Start these exercises 6 weeks after your injury and to do 4-5 times a day.
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.
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.
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.
Recovering From a Broken Collarbone: Part 1
You hear it. The awful sound of carbon snapping and bikes and bodies scraping along the road. You are now flying through the air, having detached from your bike completely, launching head first towards the ground. Suddenly you come to a stop, sit up to dust yourself off, and upon standing realize something is terribly wrong. You cannot lift your arm and instead it just hangs lifeless by your side. Worse still, your shoulder is becoming more painful by the second.
A million things go through your head of what may have happened, but you take your hand and run it along your collarbone only to realize there is a large bump in it that was not there before. Unfortunately, you just joined a large contingent of other cyclists who have had to deal with broken collarbones.
Fear not though, bones will mend and your fitness will return! This post will discuss the different varieties of collarbone breaks and what is typically done to repair them to get you back on the bike as quickly as possible.
Your collarbone (clavicle) is a long thin bone that runs from your breast bone (sternum) to your shoulder blade (scapula). Its purpose is to act as a strut between the two attachment points and the shoulder blade fixed to allow the arm to move about unrestricted. For the purpose of this article, we will divide the types of breaks it into three sections: medial (towards the breast bone), shaft, and lateral (towards the shoulder blade). These are the three places the bone can break or fracture, with the severity and location of the break dictating what is done to expedite healing.
Dealing With a Broken Collarbone
Once the collarbone break is confirmed with an x-ray, the doctor will recommend seeking further advice from an orthopedic specialist. Upon meeting with the orthopedist, they will advise you either to go under the knife and have the collarbone reduced surgically with plates and screws. If the pieces of bone have not separated far and are relatively lined up well you are luck and will not require surgery.
If you are fortunate and the pieces of collarbone are relatively close together and line up well, you will be placed in a sling for 6 to 10 weeks. Every case and orthopedist is different – normally you will be instructed to keep your arm and shoulder as still as possible to encourage the two pieces of bone to mend with the only exercises being pendulums and possibly passive range of motion to discourage the shoulder from freezing.
In other cases, surgery is necessary because the two pieces of bones are separated so much and/or are not lined up well.
Here is my collarbone post-crash. As you can see, the two pieces of bone are very far apart and not lined up well at all. Surgery, here I come.
Surgery is done as soon as possible and involves placing a plate along the length of the collarbone to reinforce it, and screws to align the bones up again and keep them in place. This is called a collarbone O.R.I.F. (Open Reduction Internal Fixation).
Here is my collarbone after the surgery. You can see the surgeon used a plate and screws to affix my collar bone back together to allow it to heal properly.
Similarly, once the surgery has been performed you will be placed in a sling for a set amount of time, but can usually progress faster and move your arm more as the metal plate is providing structure and support for your collarbone. Again, each case and surgeon is different.
Rehabilitation Exercise Suggestions
Once you get the clear from the surgeon to remove the sling and begin using the arm again, you can begin to work on regaining your lost range of motion and strength. You will also usually be sent to physical therapy for expert rehabilitation and guidance. The following is what I recommend to my patients, but should only be followed after being cleared by your surgeon and/or physical therapist. You can perform a Google image search and find pictures of all of these.
Range of Motion Exercises
- Pendulums: Perform two minutes each of front to back, side to side, and both clockwise/counter clockwise circles.
- Supine shoulder flexion with cane: Perform 2 x 20 reps staying in a pain-free range of motion.
- Supine shoulder external rotation with cane: Perform 2 x 20 reps staying in a pain free range of motion.
Ideally, perform these exercises two to three times per day until functional range of motion is regained.
- Sidelying external rotation: This exercise helps strengthen the rotator cuff.
- Prone “I”, “T”, “Y”, and “W”: These exercises help with middle back strength and to regain scapular stability. Start on a flat surface and then progress to a ball.
- Standing shoulder flexion and abduction: These help to strengthen the deltoid and regain functional reaching.
- Rows: Either with bands, cables, or machine. This helps to increase arm and middle back strength. Be sure to focus on engaging the muscles between the shoulder blades and to keep your neck relaxed.
- Lat pulldown: Either with bands, cables, or machine. This helps to strengthen the latissimus dorsi which is involved with many shoulder motions.
- Wall push-ups: These help to maintain pectoral and deltoid strength. Start on the wall and as you feel stronger gradually lower the surface until you reach the floor.
- Shoulder wall flexion: This helps to regain functional overhead motion.
Ideally, these exercises should be performed two to three times per week. Always keep within a pain-free range of motion and be sure to not push into pain. Also, start with just the weight of your arm until you can perform the exercise through the entire range of motion. After this is accomplished, start off with very light weights and gradually progress until functional strength is regained.
In part two of this series I will discuss how you can start training again to regain your fitness.
What Exercises Can I Do After a Broken Clavicle Bone?
Resistance bands are a great piece of equipment to use after breaking a clavicle bone.
Image Credit: pixelfit/E+/GettyImages
Broken bones affect your ability to exercise and do normal daily activities. The clavicle bone, also called your collarbone, is susceptible to fractures from direct blows to the shoulder. Initially, you will have to wear a sling as the bone heals and for protection.
However, when the bone starts to heal, you will be able to do gentle, progressive clavicle exercises for the arm and shoulder to improve range and strength. Speak with your physical therapist or physician prior to initiating an exercise program after a clavicle fracture.
Exercises after a broken clavicle bone include shoulder range of motion and gentle strengthening.
Read more: Collarbone Pain From Lifting Weights
1. Swing the Pendulum
The pendulum exercise is a gentle, passive exercise that decreases stiffness in the shoulder and elbow joints. Do this exercise by bending forward at the waist with a straight back. You can hold onto a wall or table with the non-injured arm for support.
Let the injured arm hang down in front of you toward the floor and start to gently make rotations with your hand. Your shoulder should be relaxed and loose. Continue to make arm circles both clockwise and counterclockwise for 30 to 45 seconds each direction. Repeat up to five times with short rests in between as needed.
2. Squeeze the Shoulder Blades
Because the clavicle attaches to the shoulder blade, also known as the scapula, inactivity can lead to weak scapular muscles and poor posture. Scapular retractions strengthen the muscles around the shoulder blade and also prevents rounding and stiffness of the shoulders. Do this exercise with a resistance band tied to a doorknob at waist height.
Stand tall, arms by sides and elbows bent to 90 degrees. Hold one end of the band in each hand and slide your elbows back behind your body, maintaining their 90-degree angle. Squeeze your shoulder blades together during the action but avoiding hiking your shoulders. Repeat 10 to 15 times, or until fatigue sets in, for two to three sets.
3. Follow the Horizon
The horizontal shoulder abduction exercise helps increase range of movement around the clavicle bone. Do this exercise when your pain has decreased and you are able to lift your arm to 90 degrees.
Stand tall with arms held out in front of you at shoulder-height, palms facing each other. Move your arms apart and out to the sides as far as you comfortably can. Hold for five seconds, return to start and repeat 10 times two to three times per day.
Read more: Exercises for Increased Shoulder Flexibility
4. Resisted External Rotation
External rotation exercises strengthen the external rotator muscles in the shoulder which weaken with inactivity. Do this exercise by standing tall with arms by your sides and elbows bent to 90 degrees.
Hold a resistance band in each hand in front of you. Wrap the band around the hand of the non-injured arm to act as an anchor. With your elbow staying by your side, rotate the hand of the injured arm out to the side as far as you can go while maintaining tension on the band. Return to start and repeat 10 times, or until fatigued, for three sets in total.
Knitting Up Your Broken Collarbone
Knitting Up Your Broken Collarbone
Better known as a broken collarbone, a clavicle fracture is a common injury among people of all ages. Despite its location, the collarbone is not part of the neck, but rather a bone that connects the rib cage and the shoulder blade. A break in the collarbone often occurs in the middle of the bone. Common causes of clavicle fractures include falling on one’s shoulder, involvement in a car collision or sustaining a direct blow to the shoulder.
Signs and symptoms of a broken collarbone often include
- pain that increases with shoulder movement
- swelling, tenderness or bruising
- a bulge on or near the shoulder
- a grinding sound or feeling when you try to move your shoulder
- stiffness or inability to move your shoulder
Although plates, screws, pins and other surgical solutions are sometimes needed to treat a clavicle fracture, in most cases, the break will heal without surgery. Depending on the location of the break, the clavicle fracture will often heal itself as long as there is good blood supply and the ends of the fracture are somewhat aligned. If your physician determines that surgery will not be necessary, you may need to wear a splint or brace for at least six weeks to keep your shoulder in position.
During the six plus weeks your arm is immobilized, you will likely lose muscle strength. As your collarbone heals, you should feel pain relief, at which time your physician may recommend gentle shoulder and elbow exercises to prevent stiffness and weakness, while slowly regaining motion and strength.
If you are recovering from a broken collarbone, we can assist in the healing process. We can design a customized rehabilitation program that will restore strength to your shoulder and give you back your full range of motion.
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Collarbone fracture rehabilitation in a pilates studio setting
The collarbone is an area of the body that is commonly fractured in falls. Collarbone fractures can result from simple activities such as falling off our bicycle, playing tennis, skateboarding, skiing, playing touch football, car accident, or even an accidental trip after a few drinks! This article is about collarbone fracture rehabilitation, of particular relevance for a pilates studio setting:
// A review of the anatomy of the clavicle, also known as a collar bone;
// How the collar bone is commonly injured;
// What the healing process is for repair;
// What the safe and appropriate exercises are for a collar bone fracture.
An anatomy review of the clavicle
The clavicle is a ‘lazy S’ shaped bone that is not fully ossified (becomes adult bone) until we are around 25 years of age. Due to this late maturation and generally higher levels of activity, young people are at a higher risk of fracture. Similarly due to structural degeneration and a higher risk of falls, fracture risk is also high in the elderly population and particularly in women.
The clavicle is important in that it attaches the shoulder girdle to the sternum, providing a strut or anchor point for the shoulder to articulate with the axial skeleton. Its other significant role is that it allows us to further extend movement of the scapula and thereby the arm away from the body. To understand how the arm and clavicle interrelate, put two fingers of your right hand on top of your left clavicle and gently pull down and away from your head. Now try and lift your left arm, note how it can be more difficult to lift that arm when the clavicle is not moving. The major muscles associated with movement of the clavicle and the shoulder include:
// Deltoids (anterior)
// Pectoralis major (clavicular head)
// Pectoralis minor (acts on scapula)
// Trapezius (upper fibres)
// Latisimus dorsi
The clavicle is also a major attachment site for the muscles of your neck, e.g. sternocleidomastoid and platysma muscles.
Focus on breathing work
A focus on breathing is also very important whenever we discuss the collarbone. A lot of muscles involved in breathing attach to the collarbone and if they are affected so to will the person’s breathing patterns and thoracic mobility. The anatomy and some ideas that can be added to collarbone work discussed in this article can be reviewed in our article on Thoracic Spine Exercises.
Most common site for collarbone fractures
The middle 1/3 of the collarbone is the most common site of fracture (~70% prevalence of collar bone factures), particularly in children. Medial fractures are uncommon (~3%), distal is more common (~28%) and has a higher occurrence rate in older people. A displaced fracture is when the bones after the injury have not aligned. Displaced fractures are more common in adults, likely due to the high-energy nature of the trauma e.g. car accidents. In the senior population this injury is more likely to occur from a fall directly onto the shoulder.
Common mechanisms of injury are a fall on the shoulder (lateral force) common in bicycle, football and skateboard injuries. When a person falls and fractures their collarbone they may also to have torn ligaments, particularly if the fracture occurs in the medial or lateral 1/3 as this is where the ligaments attach. This can have implications on healing and recovery time, and ongoing stability in the associated joint.
What is the repair process?
Healing can best occur once the fracture is stable, which generally means immobilisation of those bones. There are many stages to the bone healing, which can take up to 2 years. The primary healing of bone typically occurs in 4-6 weeks, with remodelling and stronger secondary union taking approximately 12 weeks. During the remodelling stage between primary and secondary healing, the bony callus that has formed is still vulnerable to re-fracture or mal-union. To avoid this, weight bearing and lifting loads through the associated limb should be closely monitored and gradually progressed.
Ligamentous healing differs to that of bone in several ways. The healing time frame for a torn ligament is significantly longer relative to bone, and in the case of significant or full tears the strength and elastic properties of the ligament will not return to pre-injury state. Whilst this may sound worrying, it simply means that your body will need to adapt a more active strategy in stabilising these structures. It is important to de-load the ligaments during the first 2-4 weeks, to prevent re-rupture and allow the ligament to regain some elasticity. The most recent evidence indicates that guided return to loading is also extremely important, with gradual low load mobilisation from as early as one week following injury.
The introduction of low load work and range of motion movements should be progressed with supervision over the next 3 months, as the ligament fully heals and begins to remodel best with ongoing controlled loading much the same as bone.
Ligaments have a limited blood supply, therefore the remodelling process can take months and up to a year to reach maximal recovery. As a result rehabilitation and stabilisation of the bones will take time and ongoing management and appropriate progression.
What do you do when dealing with a collarbone fracture?
When you have a collarbone fracture to work with our starting point is that:
// Be aware of the injury site, the person could still do leg work when at the studio but it is probably not a good idea to lay the person on their side during early stages of a collar bone fracture recovery.
// Know what stage the person is at and that there will be a certain focus on the exercises for the arm and shoulder during that period of time. The person’s physiotherapist should have given them some exercises focusing on isometric strength, range of motion and then more global strength. When working with the clients it is important to help them focus on correct alignment and activation of the appropriate muscles. This will ensure that they are doing their homework correctly.
We have broken down the phases of collarbone fracture focus based on standard healing times for bones and ligaments. Understanding these healing times allows you to understand the structure’s capacity for load and movement. It is also important to remember that the bone structure is different for children, young adults and older adults and that this affects some of the healing and management process for these fractures.
Exercises for collarbone fracture rehabilitation
Early stages: Weeks 1-4
Immediately after the injury the collarbone must go through an inflammation and the start of tissue repair. Accordingly, immobilisation is important for the first 3-4 weeks to de-load bone and ligament as they begin to heal. A doctor and physiotherapist will generally recommend a splint of some type.
Children under 11 years old with non-displaced fractures do not usually require follow-up by a doctor or fracture clinic, assuming pain is remitting and there is no further displacement of the fracture as inflammation subsides and they are weened out of the sling. Children older than 11 years and adults will typically require follow-up with a doctor.
Mobilisation out of the sling commences at two weeks depending on pain control and if the fracture shows no sign of further displacement, with specific movements prescribed by the physiotherapist.
To ensure optimal healing and to maintain strength, stability and mobility in surrounding structures, it is important to commence specific exercises in the first few weeks after injury.
The primary focus will be isometric strength and low-load or gravity minimised range of motion exercises, as prescribed by your physiotherapist. These may include: upper limb pendular movements; isometric shoulder movements; rotator cuff stabilisation.
The best approach is to be consistent and commit a small amount of each day to movement and exercises. Some exercises that could be included at this stage are:
// Pendulum exercises for the shoulders.
// Elbow/wrist range of motion exercises: elbow flexion/extension, forearm pro/supination; wrist flexion/extension; radial/ulnar deviation.
// Isometric holds of biceps/triceps/rotator cuff e.g. holds against wall, see rotator cuff video below.
Weeks 4-8: Range of motion and strengthening exercises
During this period of time the bone is starting to remodel and in reality this process can take years to complete, but the 8 week stage is a significant point in the remodelling process because of callus formation.
Children should be checked by their doctor if pain is increasing, or sensation changes abruptly. Sports and activities with physical contact should be avoided for the 8-12 weeks after the sling has been removed. A lump usually develops at the fracture site, which may be visible and palpable for months to years and is not cause for concern unless accompanied by significant swelling, pain or redness.
A physiotherapist will continue treating the soft tissue injuries and identify structural imbalances caused by a clavicle fracture. In addition, the physiotherapist will provide some specific exercises to gradually progress shoulder, elbow and wrist range of motion that you can work on in a pilates studio setting. These exercises can be added to other work with in the studio setting, within the guidelines set by the physiotherapist.
If the person is healing well, there should be a gradual increase in the range of motion exercises and they can begin strengthening exercises.
Exercises for Weeks 4-8
// Supported shoulder range of motion (ROM) exercises e.g. wall walk to comfortable ROM, see video seated knee stretch, seated wall ball roll.
// Wrist, elbow and hand ROM coupled movements e.g. biceps flexion with forearm supination or pronation, e.g. Incy Wincy Spider in the video below.
// Continued isometric work, e.g. the wall knee stretch in the video below.
Theraband neck exercise is another good isometric exercise to add in at this stage, remembering that many neck muscles attach to the collar bone.
The deltoids attach to the clavicle. In injuries they can tighten in protection. These exercises with Makarlu Lotus are about triggering the muscle to relax it rather than stretching it.
Triggering through the triceps can help release their pull on the scapula. Remember that the scapula articulates with the collar bone.
Trigger through the bicep with Makarlu Lotus. In this position you can also achieve a nice pec release.
Weeks 8-12: Range of Motion exercises
During this period the focus will be on working toward a full range of motion in all directions. The strengthening exercise program will continue to progress, but heavy lifting should be avoided. Focus on rebuilding muscle endurance, with light resistance and higher repetitions. This gives bone and ligaments adequate loading to promote remodelling but should avoid over-stressing and causing delayed healing in these structures.
At this stage some of the exercises could include:
// Active ROM exercises e.g. Theraband rows, dowel passovers, Theraband rotator cuff, gradual return to full ROM in all directions of movement with good movement proficiency. Some videos below from the reformer repertoire can be useful.
// Isometric holds throughout ROM to build endurance.
// Shoulder stabilisation, e.g. incline or 4 point kneel shoulder taps, add Makarlu Lotus or ball to challenge.
// Some focused exercises from the pilates reformer repertoire, making sure that there is good movement practice applied.
Weeks 12-16: Strengthening exercises
By this stage a physiotherapist is likely to consider that a person will be ready to progress to increased strengthening work. As always, if there is a significant increase in pain, a sense of instability, or painful catches in a joint during movement, then stop and seek advice.
An example of exercises that could be introduced include:
// Loaded overhead movements e.g. shoulder press. Start with the bottom loaded supine push through bar work and then progress to an overhead press, see images below.
// Begin sports specific skill drills and exercises, e.g. passing, catching, throwing.
Return to specific sports training and competition only when you are cleared for activity and your functional testing shows that your injured side is as strong and mobile as the uninjured side. This is particularly important for high impact sports like football (Rugby, Gridiron, Australian Rules). If your client is not an athlete, and let’s face it the majority of collarbone injuries are in non-athletes, getting your body strong is an important priority for physical safety and confidence.
Some specific exercises during this period include:
// Progress ROM exercises, adding some resistance with Theraband, increased strength.
// Dynamic stability work, e.g. shoulder taps in plank, walk outs using CoreAlign or using the wunda chair as in the video below.
// Strength for scapula and rotator cuff, e.g. PTB press ups, see video below. Also if in a gym setting add in dumbbell shoulder press, reverse fly, overhead squats.
// Sport specific drills if applicable e.g. throwing/catching/passing or low impact contact drills, gradually increasing intensity over the next 8 weeks.
Caddie PTB press ups. Modify the load through the resistance of the spring, slowly progressing load. Once the person has achieved an overhead load clearance start to add in exercises like bottom loaded roll up.
In this series Max is working through plank and other shoulder girdle movements by using the Makarlu hardwood base as a slider to facilitate more dynamic movement.
Remember also that pilates is a life long mind body practice. A good pilates teacher provides individualised focus and adaptation, developing trust with their clients over long periods of time. During times of injuries it is understandable that the client wants to continue their practice and it is important to work in conjunction with the person’s manual therapist to ensure client safety and focus in performing specific exercises for recovery.
This article was written by Carla Mullins (pilates teacher with Body Organics) and Lachlan Loose (physiotherapist with Body Organics).
Carla Mullins is Director of Education at Body Organics with many years experienced in Pilates, Gyrotonic, CoreAlign and other movement modalities. She is currently undertaking a Bachelor of Occupational Therapy at University of Queensland. Carla covers topics such as the collarbone, its movement and injury recovery in courses in Australia and the USA, such as Anatomy Dimensions Upper Limbs.
Hunter JB. Fractures around the shoulder and humerus. In Children’s Orthopaedics and Fractures,3rd Ed. Benson M, Fixsen J, Macnicol M, Parsch K (Eds). Springer, London 2010. p.717-30.
Lenza M, Belloti JC, Andriolo RB, Gomes Dos Santos JB, Faloppa F. Conservative interventions for treating middle third clavicle fractures in adolescents and adults. Cochrane Database Syst Rev 2009; CD007121.
Klein SM, Badman BL, Keating CJ, Devinney DS, Frankle MA, Mighell MA. Results of surgical treatment for unstable distal clavicular fractures. J Shoulder Elbow Surg 2010; 19: 1049-55.
Simon RR, Sherman SC, Koenigsknecht SJ. Clavicle fractures. In Emergency Orthopaedics – The Extremities. 5th Ed. McGraw-Hill, Chicago 2007. p.285-7.
Young SJ, Barnett PL, Oakley EA. Fractures and minor head injuries: Minor injuries in children II. Med J Aust 2005; 182: 644-8.
Symptoms, Complications, Exercises and Recovery Tips
The collarbone (clavicle) is one of the main bones in the shoulder. It’s a long slender bone that runs from the breastbone to each of the shoulders connected via ligaments, and it is a common location for injuries to occur, resulting in a fracture.
Collarbone (Clavicle) fractures account for approximately 5 percent of all adult fractures and are usually due to a fall onto the shoulder or an outstretched hand that puts enough pressure on the bond to snap or break it. The resulting fracture can be extremely painful, making it difficult to move the arm on the affected side.
What does a broken collarbone (clavicle fracture) feel like?
While everyone experiences pain differently, a fracture to the collarbone (clavicle) will most likely cause a sudden sharp, stabbing pain. Initially, when the bone actually breaks, you may hear a pop or click sound that can also be felt. When the arm on the affected side is moved, a grinding or clicking may be felt, with pain steadily increasing the further the arm is moved away from the body. After the initial pain, the area of the fracture will likely produce a dull, constant ache that is made worse when the arm is moved or touched.
Broken collarbone (clavicle fracture) signs and symptoms
It will be very apparent if you have broken your collarbone, and at the very least, you will have some idea that something is wrong. The area with the cracked or broken bone underneath will be very painful, with the following signs also likely being present in that area:
- Swelling or tenderness
- Bruising of the skin
- Bleeding if the bone has pierced the skin (rarely occurs)
- Numbness or the feeling of pins and needles (if a nerve is injured)
You may also experience the affected side appearing slumped downward and forward under the weight of the arm, as the collarbone is no longer supporting the rest of the arm.
What causes a broken collarbone (clavicle fracture)?
Most collarbone fractures occur during a brief moment of direct forceful contact to the shoulder. This can happen during a fall on the shoulder or a car collision. Falling on an outstretched arm can also cause a collarbone fracture and is a common cause seen in the elderly population. Sports that can cause contact between players are also a likely source for a fracture.
Broken collarbone (clavicle fracture): Complications and risk factors
The collarbone doesn’t harden completely until about 20 years old, putting children and teenagers at risk. This risk starts to increase again when people reach more advanced ages. Having a broken bone is usually bad enough, but sometimes complication can subsequently occur, making the process of recovery more difficult. While most broken collarbones heal without difficulty, some may result in the following:
- Nerve or blood vessel injury: Jagged ends of a broken collarbone (clavicle fracture) may injure nearby nerves and blood vessels. If you happen to experience coldness or numbness in your arm or hand, seek medical attention immediately.
- Poor or delayed healing: More severe cases of broken collarbone (clavicle fracture) symptoms may result in slow or incomplete healing. Poor union of the bones during this process may also occur, resulting in cosmetic deformity or shortening of the bone.
- A bony lump: This occurs due to the healing process, and is appreciated at the site of the union of the two bones forming a lump. It can usually be seen easily as it is close to the skin. Some lumps will disappear over time, but other by stay permanently.
- Osteoarthritis: A fracture involving the joints that connect the collarbone to your shoulder blade or your breastbone may increase your risk for eventually developing arthritis in that joint
How long does a broken collarbone (clavicle fracture) take to heal?
The healing process is dependent on age. In adults, it usually takes about six to eight weeks for a broken collarbone to heal, while in children it may take only three to six weeks. Regenerative cells are much more abundant and active when you are younger, making healing times much shorter.
Regaining shoulder strength may take the same period of time, however, in both children and adults.
How is a broken collarbone (clavicle fracture) treated?
Initially, when first seeing a doctor or medical professional for a potentially broken collarbone (clavicle fracture), they will first examine it and determine how it occurred. Then the most likely next course of action will be to get some images, most likely X-rays, of the clavicular bone and surrounding bones and joints to rule out any collateral damage. The doctor will likely next prescribe a form of treatment they feel is suitable for your particular situation. The following are treatments for a fractured collarbone:
Nonsurgical treatment – these are suitable if broken bones have not shifted out of place.
- Arm support: A simple arm sling used for comfort immediately after the break and to keep the arm and shoulder in position while the injury heals.
- Medication: Pain medication, including acetaminophen, help to relieve pain associated with the fracture
- Physical therapy: It is important to maintain arm motion to prevent stiffness, even though there may be pain. Often, patients will begin doing exercise for elbow motion immediately after the injury. It is common to lose shoulder and arm strength after a collarbone injury, but as the bone heals, pain will start to subside. More strenuous exercise will be started gradually once the fractures have fully healed.
Surgical treatment – for broken bones that have significantly shifted out of place.
Open reduction and internal fixation: The procedure used most often to treat clavicle fractures. Here, bone fragments are first repositioned (reduced) into their normal alignment, with the bone pieces then held in place (fixation) with metal hardware. Typical hardware used for broken collarbone surgery includes plates and screws, or pins and screws.
When should I see a doctor?
If you suspect you may have broken your collarbone or suspect someone else has (maybe during a fall or sporting accident), seeing a doctor should be a high priority. A doctor will assess the area and give reliable information on how to proceed.
Going to the emergency department is recommended for anyone with a broken collarbone when these following conditions exist:
- Other injuries suspected
- Bone piercing through skin
- Numbness, tingling, discoloration, or pain in the arm
- Difficulty breathing
- Rapid swelling
- Severe pain
Exercises for Broken Collarbone
Following an exercise program after suffering a broken collarbone can help to improve the functional mobility of your shoulder and arm. Isometric or static exercises should be performed daily to help with healing. Isometric exercises are performed by contracting muscles without movement. Always be sure to work with your physical therapist to design a standard daily exercise program that is appropriate for your condition.
Grip strength exercise – Place a small ball in the palm of your hand (a stress ball works well), and squeeze with gentle but even pressure several times a day.
Pendulum exercise – Bend forward from the waist and dangle the injured arm down toward the ground. Make small circles with your hand, letting momentum move your arm around without effort. Be sure to make circles in both directions, clockwise and counterclockwise.
Isometric triceps exercises – To help strengthen the injured arm, focus should be given to the triceps brachii. This muscle is found on the back of the upper arm and is primarily responsible for extending the elbow. To perform this exercise, rest your injured arm on a table or countertop with your elbow at a 90-degree angle. Make a fist and press onto the tabletop with your entire forearm from first to elbow without moving your arm. This will create a static clavicle fracture exercise for your triceps where the muscle will contract.
Wall crawl exercise – Stand facing a wall and place fingers at waist height. Walk fingers up the wall as high as you can without too much discomfort in the shoulder. Each day try to go a little bit higher to help strengthen muscles in the shoulder.
Pully exercises – Try to perform pully exercises twice a day practicing adduction, abduction to build a range of motion in the injured arm.
Shoulder blade squeeze – Tie a resistance band to a doorknob at waist height. Stand tall with good posture and place arms to the sides. With your elbows bent, hold one end of the band in each hand and slide your elbows back behind your body, maintaining a 90-degree angle. During the action, squeeze shoulder blades together but avoid raising shoulders. Repeat 10 times, or until fatigued.
Rotator cuff exercises – During an injury to the collarbone, the rotator cuff can often be damaged or torn. Talk to your therapist about isometric internal and external rotation exercises to strengthen the rotator cuff.
Complete your collarbone fracture exercises with cross training and cardiovascular exercise such as walking stationary cycling, and stair climbing. Your physical therapist will be able to assess your progress and adjust your program throughout your recovery.
Broken collarbone (clavicle fracture) recovery and prevention tips
Once a broken collarbone is diagnosed and treated, patients are recommended to see their doctor or health care professional in about one week to check on the healing process and to identify any complications. Patients are instructed to avoid contact sports for at least six weeks following the injury, with the possibility of requiring some additional time to return to “normal” activities. The following advice may be helpful during broken collarbone recovery:
- Use an extra pillow at night to keep yourself upright
- Use ice packs or painkillers if pain and swelling continues
- Move your elbow, hand, and fingers regularly when it is comfortable to do so
- When the fracture has started to heal, try removing the sling for short periods at time if comfortable
Preventing a collarbone fracture can be difficult as they can occur at any time. But there are things you can do to at the very least to decrease your chance of becoming a victim. Always wear proper safety equipment during sports, especially for high contact activity like hockey, lacrosse, and football.
If you are unlucky enough to get this injury, as long as you act smart and address it right away by seeking out the help of a medical professional, they will teach you how to heal a broken collarbone in the best way possible, making your recovery will be relatively smooth experience.
Related: Shoulder blade (scapula) pain causes, symptoms, treatments, and exercises
Nifontova: rehabilitation after a clavicle fracture will take a month
- injury to the inner third of the bone or the sternum end;
- trauma to the middle third or diaphyseal fracture;
- fracture of the acromial end or injury to the outer third.
- transverse, when the bone breaks across, dividing into two blunt limbs;
- longitudinal, when the fracture goes along the bone;
- oblique – the fracture is at an angle, and as a result, the bone is divided into two parts with sharp ends;
- spiral fracture;
- comminuted when the bone is crushed into several pieces.
Nifontova: rehabilitation after a clavicle fracture will take a month
Nifontova: rehabilitation after a clavicle fracture will take a month – RIA Novosti Sport , 22.07.2019
Nifontova: rehabilitation after a fracture of the collarbone will take a month
Russian motorcycle racer Anastasia Nifontova, who had an accident at the Silk Way Rally, said that rehabilitation after shoulder surgery would take a month.RIA Novosti Sport, 22.07.2019
Silk Way Rally
Silk Way Rally
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MOSCOW, July 22 – RIA Novosti, Sergey Astakhov. Russian motorcycle racer Anastasia Nifontova, who had an accident at the Silk Way Rally, said that rehabilitation after shoulder surgery would take a month.Nifontova had an accident at the fourth stage of the rally, which took place from 6 to 16 July: the participants overcame ten stages across the territory of Russia, Mongolia and China. “I feel fine, I can already move my hand. gym, then I’ll sit at the motorcycle. So wait on the next “Silk Road” – she added.
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MOSCOW, 22 July – RIA Novosti, Sergey Astakhov. Russian motorcycle racer Anastasia Nifontova, who had an accident at the Silk Way Rally, said that rehabilitation after shoulder surgery would take a month.
Nifontova had an accident at the fourth stage of the rally, which took place from 6 to 16 July: the participants overcame ten stages across the territory of Russia, Mongolia and China.
“The step on my way was written in the road book, but I saw it at the last moment through my own fault and ran into it.I could not continue the race because the hand injury was serious. I wanted to replenish my collection with a finisher’s medal, because for several years I had advocated that the motorcycle classification should be included in the Silk Way Rally, ”Nifontova told reporters.
“I feel fine, I can already move my hand. There will be another month of rehabilitation, I need to work out in the gym, after that I will sit at the motorcycle. So wait on the next Silk Road,” she added.
Fracture of the collarbone – Official website of FGBUZ KB No. 85 FMBA of Russia
About the clavicle
Clavicle (lat.- Clavicula) is a typical S-shaped bone, in simple terms, connecting the arm (free upper limb) to the trunk. Like most long bones of the skeleton, the clavicle consists of a body and two ends – the inner or sternum, outer or acromial .
The ends of the clavicle are involved in the formation of 2 joints: sternoclavicular and clavicular-acromial. 6 muscles and several ligaments are attached to the clavicle. The shape and function of the clavicle is of great importance when it is damaged.
Fracture of the clavicle
Clavicle fractures are quite common and account for 2.6-12% of the total number of 90,094 skeletal fractures. 44-66% of cases of shoulder girdle fractures. In 80% of cases, the fracture occurs in the middle third, in 15% – the fracture of the acromial end of the clavicle and in 5% – the sternum.
Clavicle fractures in most cases occur as isolated injuries , less often in combination with other injuries of bones and soft tissues. Damage to the clavicle, as a rule, occurs as a result of the indirect action of high-energy forces (fall on the shoulder brought to the body, fall on an outstretched straight arm, etc.).etc.).
Fractures of the clavicle also occur with direct impact on the bone. Therefore, this damage is common among athletes, active people, as well as in disasters, hostilities and road traffic accidents.
Diagnosis of fractures of the clavicle
Diagnosis of fractures of the clavicle , as well as dislocation of its ends, in most cases is quite simple and is based on clinical (examination, comparative assessment, measurement, palpation, etc.) and X-ray examination of the patient, taking into account the patient’s complaints and anamnesis.
As a rule, the victim is examined by a traumatologist. Already at the sight of the patient, one can suspect a fracture of the clavicle by the characteristic posture of the patient – the patient supports the arm brought to the body on the damaged side. When examining a patient with a fracture of the body of the clavicle, depending on the displacement, it is often possible to reveal deformation in the projection of the clavicle, edema of the soft tissues of the shoulder girdle, and subcutaneous hemorrhage.
If there is a wound with fragments protruding into it (wound), they speak of an open fracture of the clavicle.When palpating (palpating) the clavicle, the doctor can identify the most painful point, as well as identify the zone of pathological mobility – i.e. is the place of the actual fracture . Clinical examination can provide a fairly accurate diagnosis of a clavicle fracture.
Confirmed the diagnosis of clavicle fracture , as a rule, radiographically when performing radiographs in standard settings. In some difficult-to-differentiate cases, X-ray computed tomography (CT) is performed, sometimes, if necessary, magnetic resonance imaging (MRI).
Complications of a fracture of the clavicle
Complications of clavicle fracture and treatment – occur in 5.7 – 25.3% of cases. And they can be associated with damage to the structures surrounding the clavicle: damage to the neurovascular bundle, damage to the apex of the lung are quite dangerous complications manifested by bleeding, neurological disorders in the injured arm, respiratory disorders, requiring immediate surgical treatment.
In the treatment of fractures of the clavicle , both without surgery and operatively with modern methods, there may be a complication in the form of nonunion of the bone or its improper union.
Treatment of fractures of the clavicle
The traumatology and orthopedic department of our clinic treats clavicle fractures, forearm fractures, hand fractures, fibula fractures, and dislocations of its ends, depending on the type and type of injury. There are options for conservative (non-surgical) and surgical treatment.
Radiographs of the fracture of the acromial end of the right clavicle before and after surgery. Osteosynthesis was performed with a hook-shaped plate.
Conservative treatment of clavicle fractures is used in patients with contraindications to surgical treatment, or in case of refusal of the patient from the operation and consists in creating immobility of the fragments with the help of all kinds of fixators, bandages, bandages. Surgical treatment of injuries of the clavicle is based on on the latest achievements of domestic and foreign science in the field of traumatology and orthopedics.
Photo report from the operation to remove the metal structure
We had the opportunity to make a photo report about one of the operations carried out at the Center for Outpatient Surgery and to clearly show “from and to” the entire process of removing the hardware installed after the collarbone 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 perform this operation on an outpatient basis came in handy.
11:00 Evgeniy 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 in, 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 is done, 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 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
Yevgeny is feeling well, despite the doctor’s wishes to rest, he is 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 a surgeon-traumatologist Alexander Pavlovich Miroshnichenko, anesthesiologist – Mikhail Anatolyevich Kazhura
90,000 first aid, therapy, rehabilitation and consequences
Clavicle fracture is a common phenomenon in all age groups of people. In newborns, such an injury is caused by rapid labor activity or improper actions of obstetricians.In adolescents and adults, it can be caused by a fall on the shoulder or a hard blow to the collarbone.
If it so happens that the patient has a fracture of the clavicle, then he urgently needs to provide first aid and refer to a traumatologist. The main method of treatment is to restore the integrity of the bone fragments. The patient can undergo a plaster immobilization in case of a fracture of the clavicle or apply a tight bandage. The choice of treatment depends on the severity of the fracture, so it is important to classify it correctly.
How to identify a clavicle fracture?
Clinical manifestations of a clavicle fracture can be determined visually if a deviation from the natural state of the bone is noticeable. The main symptom that worries the patient is pain in the shoulder area. Any movement causes severe pain in a person. In addition, there is severe swelling or swelling in the patient’s forearm, which clearly indicates a problem.
If such signs appear, then you urgently need to contact a traumatologist, he will be able to accurately diagnose and carry out all the necessary immobilization measures in case of a collarbone fracture or bruise.
Depending on the area in which the fracture occurred, the clavicle fracture is divided into several types:
The second type is considered the most typical.
By the nature of the fracture, there are the following types of clavicle fracture:
Also, fractures are closed when the skin is not damaged. Or open – with violations of the integrity of the skin.
There are many types of clavicle fractures, but 80 percent of patients have a diaphyseal type, which is localized in the middle third of the tubular bone. What kind of immobilization is performed for a clavicle fracture?
First aid for fracture of the clavicle
Fracture of the clavicle is a serious problem that cannot be dealt with at home.But competently provided first aid will reduce the likelihood of complications and reduce the recovery period.
If the first signs of a fracture of the clavicle appear, then it is better to keep the hand pressed to the body. If the patient feels pain in this position, then it is better to leave it in a position in which the discomfort is minimal.
The patient should be given an anesthetic. It can be a non-steroidal anti-inflammatory drug such as Analgin, Ketanov, Ibufen and others.
Also, in case of a clavicle fracture, immobilization is performed, which is the key to a speedy recovery.
Primary immobilization is called temporary immobilization and is done to reduce pain and avoid serious complications. There are many ways, but it is important to know: the longer the bandage is on the patient, the weaker its supporting function becomes. That is why, during prolonged transportation, the bandage should be rewound from time to time in order to improve the degree of fixation.
Simple and effective dressings
There are several methods of immobilization in case of a clavicle fracture:
- Delbe’s rings. You can make such a retainer using available tools, such as a towel or shirt. Two rings must be formed around the forearms. They should fit snugly against the skin, but not squeeze. In the area of the back, a bandage is passed through the rings, which will help to properly pull off the bandage until the patient himself says that the pain syndrome has decreased to a minimum.This method will help to separate the debris and relieve pain. But this method also has its drawback – it does not allow raising the forearms.
- Figure eight band. This method, like the first, helps to spread the shoulder girdle, but it also requires an additional support bandage. You need to start knitting it with the imposition of three rounds for fixation, which are located at the level of the chest. As the gauze passes through the back, soft pillows are placed in the armpits at the level of the shoulder blades. After they are fixed, you can proceed to the bandage itself.When the bandage goes to the front of the body, it should not cross the chest, but go into the armpit, again heading to the back. As a result, it turns out that a vest was put on the patient. The bandage should be tightly so as to spread the shoulders as best as possible so that the patient is comfortable.
- Scallop band. This method is the simplest and most accessible, but only it will not allow immobilization in case of a clavicle fracture in an extended form and will not allow reliable fixation. This type of bandage helps to raise the arm and prevent it from sagging.In this case, the muscles in the area of the clavicle do not stretch and do not provoke the divergence of bone fragments.
- Dezo bandage. It can be done with a simple or elastic bandage. In the chest area, it is necessary to fix a couple of pillows, wrapping them with a bandage, and then from the armpit of the healthy hand the bandage goes to the patient’s shoulder and spreads over it, and then goes down the back to the elbow, bends around it and follows to the armpit of the healthy hand. Goes to the back along the oblique and again bypasses the sore forearm, but only back and forth.Then the bandage goes again to the elbow, but already from the front side of the body, again goes under the elbow and to the armpit of the healthy arm. At the end, you need to make another turn around the body and the pressed shoulder and return to the starting one. If you repeat this sequence again, then you can even better immobilize the upper limbs with a fracture of the clavicle. You can buy such a bandage ready-made.
- Velpo headband. You need to arm yourself with a bandage, put your sore hand on the shoulder of your healthy one at an angle of 45 degrees.You should start applying a bandage from the middle of the shoulder of the sore arm. On the front side of the body, the bandage passes to the opposite side and goes over the back. So do a couple of turns, then from the back, throw the bandage on the front side over the shoulder of the sore arm, throw it over the elbow, then onto the side of the healthy one. Following it, it passes along the back and again on the forearm of the injured limb. Thus, it is possible to more reliably fix the loop on the shoulder and prevent it from moving. Perform two or three such cycles, and effective immobilization in case of clavicle fracture is performed.
All these methods of fixation will not only relieve pain, but also prevent the fracture from displacing and damaging nearby tissues.
Treatment of a clavicle fracture
The choice of treatment for a clavicle fracture depends on the age of the patient, but in no case should the therapy be performed at home. In newborns and children under three years of age, clavicle injury can be treated quickly and easily with minimal intervention from the traumatologist.
In those children who are over three years old, the bones will grow together for at least six months.That is why it is recommended to apply a plaster cast, but first, the victim is injected with painkillers.
A much more complicated case is possible, when you cannot do without an operation. Its essence lies in the imposition of a special metal structure, which will allow for reliable transport immobilization in case of a displaced clavicle fracture. With its help, you can completely eliminate the displacement of fragments.
Osteosynthesis is performed with screws or plates. The doctor decides what to use in a particular case, based on the nature of the fracture, because it can be closed or open.
In some cases, immobilization with a Cramer splint is performed in case of a clavicle fracture. It is an aluminum ladder that bends perfectly, therefore it perfectly follows the contours of the body and helps to more reliably fix the fracture not only of the forearm, but also of other bones of the body.
How to treat a displaced fracture?
What to do if the collarbone is broken with displacement? The first step is to properly immobilize. In case of a displaced clavicle fracture, the arm is completely immobilized and the main symptoms are determined.
After confirming the diagnosis, the traumatologist applies a bandage, which is securely fixed with a plaster cast. But this can be done only when the doctor puts all the pieces in place, carrying out the right by pulling the shoulder back. But only an experienced doctor should carry out this procedure, self-medication in this case can only be harmful. Only then is a bandage applied.
If the bone is broken in several places and there are a lot of pieces, then in this case transport immobilization in case of a collarbone fracture provides for the imposition of a special splint, so that as a result all the bones will heal correctly.It is necessary to carry out this procedure if the usual tight bandage did not help and the vessels and nerve endings were damaged. Correct therapy involves recovery for seven weeks, after which all symptoms will go away.
Rehabilitation after a fracture of the clavicle is simply necessary, because due to prolonged immobilization of the hand with a fracture of the clavicle, the muscles partially atrophy. Exercises begin to be done immediately after it becomes possible.The load and type of training are selected by the doctor individually for each patient. Most often, the rehabilitation course lasts from three to seven weeks.
The rehabilitation period is divided into three stages:
- during the period of immobilization with fractures of the clavicle, it is allowed to perform passive gymnastics;
- after the callus has grown and the fixation bandage is removed, gymnastic sticks are used, due to which the range of exercises expands;
- power loads are added.
In order to recover faster and restore hand mobility, they continue to carry out physiotherapy procedures, including water therapy and massage. Thanks to an integrated approach, rehabilitation offers a good chance of full recovery. Thanks to magnetotherapy, ultrasound and UHF, blood enters the affected area faster, and sufficient blood circulation contributes to the early recovery of damaged tissues. Massage improves metabolic processes, improves mobility in the injured limb.
Exercises for developing the clavicle after a fracture
The set of exercises after conservative therapy and surgery is different, but in both cases the load increases gradually.
A set of exercises after surgery:
- breathing and toning gymnastics;
- light rocking of the shoulder joint, the hand at this time in a bandage-scarf;
- alternately strain, and then relax the muscles of the shoulder girdle and shoulder;
- active movements of the elbow joint and wrist, fingers and hand of the injured hand;
- rotation with the forearm;
- strengthening complex for all muscles of the body;
- toning walking and running;
- strength and speed exercises for hands;
- gymnastics to restore coordination;
- active sports.
The first exercises are best done with an assistant and only for a few minutes, and then the time is constantly increased. They move from smooth and measured movements to more intense ones. It takes a lot of effort and patience to develop a collarbone after a fracture.
Therapeutic physical training for a collarbone injury
A special treatment complex helps not only to strengthen weak muscles, but also improves joint mobility, increases blood flow in the injured hand.Only a constant active blood flow to the sore spot helps to recover faster. An important rule of exercise therapy is to accurately observe the sequence of loads and perform exercises regularly.
In fact, exercises begin to be performed on the first day after transport immobilization in case of fracture of both clavicles or only one. Exercise therapy does an excellent job with frozen shoulder syndrome. As mentioned above, the exercises get progressively harder. Initially, the muscles of the hand are being developed:
- you need to clench and unclench your fist, alternately clamp your thumb in your hands or leave it outside;
- alternately connect the pads of the fingers with the thumb;
- knock down a speck with each of your fingers;
- twist with each of the fingers, and then with the whole brush clockwise;
- raise and lower the brush;
- Wave the brush to the sides.
Then you need to start developing the elbow and shoulder.
After removing the bandage, you can perform the following complex:
- put the hands on the shoulders and raise each of the elbows alternately;
- to rotate the elbows clockwise and counterclockwise;
- raise and lower the upper limbs;
- raising your hands, take them back;
- Do scissors with arms straight.
The clavicle is a support for the hand, the most powerful apparatus for the ligament is fixed on it.That is why her fracture can damage her arms. Only competent treatment will help to avoid complications and irreversible consequences.
Consequences of a fracture of the clavicle
If you do not seek qualified help in a timely manner and do not carry out transport immobilization in case of a fracture of the clavicle, then in the end the patient may experience the following consequences:
- bleeding from a wound if the fracture is open;
- damage to soft tissues and nerve endings by bone fragments;
- lesion of the nerve plexus;
- decrease or complete loss of sensation in the hand;
- paralysis of the upper limbs;
- formation of false joints;
- posture disorder;
- development of arthrosis;
- wound suppuration after surgery;
- wound infection with an open fracture;
- shortening of the arm.
Only correctly and timely immobilization will allow a patient who has broken a collarbone to quickly recover and return to their previous lifestyle. First aid is necessary in order to subsequently avoid serious complications.
Recovery after a displaced clavicle fracture. Exercises and other measures for rehabilitation after a clavicle fracture
Clavicle fracture is quite common. The mechanism of formation of this fracture can be direct – as a result of a blow and indirect – as a result of a fall on the hand, elbow or shoulder.Treatment of this injury is usually limited to a fixation method – it can be a Dezo immobilizing bandage, Delbe’s cotton-gauze rings, or an eight-shaped bandage.
In rare cases, a fracture of the clavicle requires surgery. This occurs when bone fragments damage or squeeze nerve trunks and vessels, or if the displacement of bone fragments is very pronounced and cannot be eliminated by other conservative methods. In such situations, an operation is performed, during which bone fragments are exposed and open reduction is performed, and at the end, the fragments are fixed using special plates, pins, and bolts for this purpose.With such fixation, it is possible to achieve reliable retention of the clavicle fragments in the desired position and not to use plaster cast after the operation. As a result, the postoperative period is tolerated by patients more easily and the rehabilitation period is significantly reduced.
Immobilization with bandages, in case of a fracture of the clavicle, lasts for about three weeks. At the same time, it is very important to start rehabilitation activities as early as possible. From the second or third day after injury, therapeutic exercises are prescribed.It initially includes different finger movements, flexion and extension in the wrist joint, in the elbow joint, rotation of the forearm inward and outward, abduction of the arm in the shoulder joint with a simultaneous tilt towards the damaged clavicle. At the same time, in the first days of rehabilitation, movements must be started with assistance and with the arm bent at the elbow, and then the degree of abduction is increased. But, it should be remembered that the degree of abduction, during the period of immobilization, should not exceed an angle of 90 degrees.At this stage, one should not forget about respiratory and general developmental gymnastics, which also plays an important role in the rehabilitation process.
After the bandage fixing the limb is removed, it is necessary to continue the exercise of remedial gymnastics. At this stage, exercises include flexion and extension in the shoulder joint, abduction and adduction in the shoulder joint, exercises for the body using a gymnastic stick. In addition, they continue to develop all the joints of the arms and legs.
Then comes the third stage of rehabilitation, the goal of which is to restore full range of motion in the shoulder joint, as well as increase muscle strength. In addition to all the above exercises, exercises with weights and resistances are added, using dumbbells of varying severity, exercise machines, resistance bands and other sports equipment.
If the fracture of the clavicle was complex and required an operation of osteosynthesis of fragments, then rehabilitation measures begin after removing the stitches, and hand movements exceeding an angle of 90 degrees in about two to three weeks.
In addition to remedial gymnastics, physiotherapy is widely used in the rehabilitation period. It can be magnetotherapy, electrophoresis with calcium chloride, massage, warm baths. Treatment of a clavicle fracture in children is carried out under the supervision of a pediatrician.
From the methods of traditional medicine, various ointments made from herbal ingredients are widely used, these are: mummy ointment, copper sulfate and spruce resin ointment, medicinal comfrey ointment and many others.
In addition, it is very important to monitor your diet, eat foods containing calcium and vitamins, as well as foods rich in silicon: turnips, raspberries, cauliflower.
Consequences of a fracture of the pelvis
Fracture of the ankle without displacement
Doctor A. Deryushev
Ankle fracture occurs, as a rule, as a result of so-called indirect violence (this can be an inward or outward tucking of the foot). This situation can lead to a fracture of one or two ankles, as well as the posterior edge and anterior tibia, in addition, it often leads to a combination with a subluxation (or dislocation) of the foot.
Consequences of cervical vertebra fracture
Fractures of the cervical spine often occur as a result not only of strong extension or flexion of the neck, but sometimes also after a sufficient awkward turn of the head in one direction, and even after a birth injury.
Treatment of compression fracture of the spine in children
Compression fractures of the spine are fairly serious injuries, but they are not so common. Only 1-2% of all spinal injuries. What they are dangerous is that, if improperly treated, they lead to the disability of the child.
Why does a clavicle fracture occur? What are the signs to recognize it. Conservative and surgical treatment of clavicle fractures.
Each bone in the human body performs its own important function.For example, the clavicle, a tubular paired bone of the S-shaped shape, connects a person’s arm and his torso, provides maximum limb mobility, acts as a shield for the nerves, blood and lymph vessels of the neck and arm.
Violation of its integrity (fracture) is not only pain, but also loss (temporary or permanent) of the functionality of the upper limb. In order to be able to live a full life and move freely, after a collarbone fracture, it is necessary to strictly comply with the requirements of a surgeon or orthopedist regarding treatment and rehabilitation.
Most common causes of injury
The clavicle is a hollow inside and rather fragile bone, which consists of three parts:
- sternal end (it is the most dense)
- diaphysis (also called the middle part or body of the bone)
- acromial end (this end, together with the acromial process of the scapula, forms the acromioclavicular joint)
IMPORTANT: Most often the collarbone breaks in the diaphysis. The second place is taken by the fracture of the acromial end of the bone, the third is the fracture of the sternal end
The most common causes of a clavicular bone fracture are:
IMPORTANT: Children and young people are more susceptible to this injury, since the clavicle bone becomes as strong as possible only by 20 years of age
Signs of clavicle fracture
Needless to say, the most obvious complaint that allows one to suspect a collarbone fracture in a person is severe pain that appears immediately at the time of injury or a cut after it.
This pain does not go away with a change in body position and does not allow the patient to move the arm. Also characteristic of the injury are the following signs:
- swelling and edema in the area of the bone some time after the fracture
- crunch while passing the arm
- visible lengthening of the arm from the side of the broken clavicle, if the bone fragments are displaced
- the victim of a fracture instinctively holds his hand on the side of the injured bone
- Impaired mobility of the forearm, hand and fingers, if the fracture injures the nerves and blood vessels
IMPORTANT: Signs of a fracture of the clavicular bone, if no displacement has occurred, are blurred in young children: only slight pain and barely visible swelling.Only diagnostic measures help to recognize trauma
The diagnosis is confirmed only after an X-ray examination. Most often, this is a regular scan of the bones of a limb. But if there is a suspicion of injury to the nerves and blood vessels, an X-ray with contrast is done (angiography).
Types of clavicle fractures
Classification of a fracture of the clavicular bone is carried out on the basis of various criteria.
At the place where the fracture occurred, as mentioned above, they distinguish:
- fracture in the body of the bone
- fracture of the acromial end
- fracture of the sternal end
According to the presence or absence of displacement of bone fragments, the clavicle breaks:
- no offset
- with displacement (this type is more common, since during an injury, strong muscles attached to the clavicle contract, and they move bone fragments)
In the direction of the fractures of the clavicular bone are:
By the presence of damage to the skin and subcutaneous layer:
Correct classification of the collarbone bone loss at the time of diagnosis is reflected in the success of trauma treatment.
VIDEO: Fracture of the clavicle
Fracture of the clavicle of a newborn during childbirth, consequences
One of the most common birth injuries in babies is a fracture of the collarbone. Trauma occurs when the bone cannot withstand the pressure as the baby passes through the mother’s pelvic bones. The reasons for this are:
- inconsistency of the mother’s pelvis with the size of the child (narrow pelvis or large fetus)
- Rapid labor
- childbirth with incorrect position of the child
- manual delivery or with special instruments
- medical errors
Clavicle fracture is a common birth injury.
As a rule, an injury is detected in the delivery room if there is a displacement. Fractures of the clavicle at birth in children, if the bone fragments have not displaced, are detected on the second or third day according to the following signs:
- a swelling, hematoma or edema develops on the child’s shoulder
- his handle movements are limited
- newborn worries, eats poorly, loses weight
- A newborn may cry when trying to swaddle
If a congenital fracture is suspected, an X-ray of the upper limb girdle is immediately taken.
As a rule, a clavicle fracture as a birth trauma is treated quickly and without problems – the bones of the newborn quickly grow together. On average, this happens in 10 days.
The therapeutic measure is a tight swaddling with fixing of the handle and shoulders with cotton and gauze rollers.
IMPORTANT: For serious displaced clavicle fractures that occurred during childbirth, surgery is required
Negative consequences of this trauma in newborns, as a rule, do not occur.It is not so much the fracture itself that is dangerous, as the behavior of the baby in the first days after the injury. Parents need to be extremely vigilant and take care of the baby, because whims, refusal to eat, weight loss have a bad effect on his immunity.
VIDEO: Fracture of the clavicle of a newborn
Assisting with a fracture of the clavicle
If a person is injured, there is reason to believe that his collarbone is broken, it is necessary:
- call an ambulance or independently transport the victim to the emergency room
- provide him with first aid on the spot
IMPORTANT: In the case of a person with a broken collar bone, doing nothing is much better than doing wrong.If the victim is in pain, he cannot move his hand, in no case should one try to check the “functional” of the hand. Also, under no circumstances should you try to “correct” the fracture in the wrong place
But these actions before examining the victim by a doctor are quite appropriate:
- An analgesic medication may be given to relieve pain
- fix the arm to avoid further displacement of the bone fragments
- If the fracture is open, apply a pressure bandage to stop the bleeding
Fix the arm from the side of the broken bone in this way:
- make a roller of cotton wool, foam rubber or just a fabric folded several times
- Place the roller under the victim’s armpit
- the victim’s arm is bent at the elbow joint at a right angle
- The headscarf is fixed on the opposite shoulder
IMPORTANT: If it is customary to transport the victim to the doctor on your own, this must be done in a sitting position
VIDEO: Reduction of the clavicle diaphysis fracture
Splint for the treatment of clavicle fractures
If, after X-ray, the clavicle fracture is confirmed, there is a displacement, the doctor decides whether the treatment will be conservative or surgical.
If the fracture is not severe, without fragments, the doctor sets the bone under local anesthesia (novocaine) and decides how the limb will be immobilized.
IMPORTANT: With this type of injury, hand immobilization is carried out for children for 2-3 weeks, for adults for 4-7 weeks
Sometimes a scarf is enough. If the fixation with a bandage is not enough, the patient will have to wear one of the splints:
- Beller’s tire
- Beller’s bus.
- Kuzminsky bus
- Kuzminsky bus.
Double Kramer tires
Plaster of paris for clavicle fracture
A plaster cast is applied if:
- clavicle fracture, closed
- no or insignificant offset
- no displaced bone fragments
IMPORTANT: If the clavicle fracture is classified correctly, it can be treated with plaster cast, but heals in 95% of cases
Plaster cast is considered more reliable than splints.Despite the fact that it is less hygienic, the immobilization of the hand by means of it is much better.
Corset for clavicle fracture
Promotes the formation of callus and does not allow the broken clavicular bone to move and the semi-rigid corset.
IMPORTANT: The corset not only heals a fracture or dislocation of the clavicle, it also corrects posture
- Sold in medical supply stores and on the Internet
- As a rule, it comes in two sizes – for children (up to size 44) and for adults (size 44 – 52)
- The corset, made of modern high-tech materials, can be wetted – the patient can easily take a shower in it
- The product is lightweight and does not cause discomfort to the patient, similar to that which he may experience wearing a cast
Pin for clavicle fracture
Surgical treatment of a clavicle fracture (osteosynthesis) is indicated if:
- open fracture
- closed fracture, but the neurovascular bundle is affected
- nerve plexus compressed
- there are multiple splinters of bone
- soft tissues under the skin are severely damaged
There are two options for anesthesia during surgical treatment of a fracture of the clavicular bone:
- local anesthesia
- general anesthesia
Previously, a wire or pin was used to fix bone fragments:
- The skin and subcutaneous tissue over the site where the clavicular bone had broken were cut.Cut length – 6-8 cm 90 260
- Exposed clavicle
- Wire or pin up to 0.5 cm in diameter: inserted into the medullary canal. The fragments were tied to it with catgut thread
- The wound was sutured
- 3-4 weeks the patient had to walk in a cast or other immobilizing bandage, after 2 months the needle was removed
This method is considered retrograde today. In the process of osteosynthesis, plates and screws are preferred.
IMPORTANT: The operation gives a great guarantee of successful bone fusion.But, unfortunately, in 1 out of 100 operated patients during osteosynthesis, bone infection occurs and osteomyelitis begins to develop
Recovery after a clavicle fracture. Exercises after a clavicle fracture
After the period of immobilization of the hands is over or after the extraction of the wire, the clavicle fracture can be treated, the functions of the limb can be restored using physiotherapeutic methods:
- by ultrasound
- laser therapy
- magnetic therapy
- salt bath
- special exercises
IMPORTANT: Even during immobilization of the limb, the patient is allowed to move his fingers, after two weeks – with his hand in the elbow joint, after 3 weeks – with his shoulder (in the amount that is allowed by a bandage, plaster or splint)
VIDEO: A set of exercises for shoulder injuries
Clavicle injuries are common in both children and adults.The recovery period depends on many factors. Among them, the correct first aid is distinguished, the fulfillment of doctor’s prescriptions, the complexity and type of fracture.
If treatment is not started on time, a fracture can cause serious complications, up to complete atrophy of the key bone. It is very important for the surgeon to immediately identify the type and complexity of the fracture.
For example, the recovery period for a displaced clavicle fracture can take up to 2 months. In addition to the main treatment, you need to visit exercise therapy rooms, do massage, acupuncture after the plaster is removed.
How to behave correctly in case of a clavicle fracture, we will describe later in the article.
Types of clavicle fractures
Surgeons often note that patients treat collarbone injuries almost daily. It is one of the most vulnerable bones in humans. The age of patients usually ranges from 14 to 50 years.
Elderly people suffer from this problem much less often. The clavicle is a triangular tubular bone. It is rather fragile, therefore, with direct contact with the shoulder (severe bruise, direct blow, fall), it breaks in 90% of cases.
It is important to see a specialist immediately, and not to self-medicate. Only the surgeon will be able to correctly identify the type of fracture.
The situation with the clavicles is complicated by the fact that almost every type of fracture is offset. If the correct position of the bone is not restored, further problems with the functionality of the arm may arise.
By types of fractures are as follows:
- No displacement. In this case, hospitalization of the patient is not required, surgical interventions are not performed.The recovery period is on average up to 3 weeks. Treatment is carried out with a medication, or a special tight bandage.
- Offset. Quite difficult cases. Often, patients require immediate surgery. The recovery period is up to 2 months. In turn, displacements can be partial and complete (in the case of an open fracture).
Brain contusions are considered serious injuries as a result of which there is a change in the state of brain tissue …
Displaced fractures need to be discussed in more detail:
- Partial.They happen quite often. Mostly with an unsuccessful fall on the shoulder. The clavicle breaks, but the periosteum remains intact, and does not allow bone fragments to move further and damage soft tissues and blood vessels.
- Full. They are extremely rare. In this case, urgent surgical intervention is required. Bone fragments damage capillaries, skin, and internal tissues.
This is important! A broken collarbone is a serious condition. You cannot cope with it without a specialist. First aid measures are also important.It is necessary to fix the hand by tying it to the body in a bent form. This will prevent debris (if any) from getting into tissues and blood vessels.
The method of treatment should be chosen by a specialist after a complete diagnosis and X-ray results. For injuries of the clavicle with displacement in 90% of cases, doctors perform surgery.
The operation is performed only under general anesthesia. Often, neurosurgeons are involved to connect the capillaries and blood vessels.
Why surgery is needed:
- Correct alignment of bone fragments.
- Reliable fixation.
- Removal of bone fragments from tissues.
The operations performed are considered to be technically difficult. The bones are fixed with metal bolts or pins.
Earlier, the Ilizarov apparatus was actively used in medical practice. But recently, doctors have given up using it. There is a high probability of infection and suppuration.
Brain contusion has symptoms that are directly related to damage to its various departments. However, the most …
Patients after a collarbone injury are prescribed medication. First of all, these are pain relievers, homeopathy, drugs that strengthen bones.
And, of course, the clavicle needs to be fixed. In addition to plaster, the following type of dressings are used:
- Delbe’s rings.Use as. Installation may only be performed by a specially trained person, such as a trauma surgeon. On the back of the patient, several small rings are made from scrap materials. They are connected with a rope that is fixed around the torso. This method helps to immobilize the collarbone, the patient does not experience pain.
- Dezo bandage. It is done with an elastic bandage. Ideal for normal fracture without displacement. Also used after plaster removal.
- Composite dressing.The clavicle is fixed in the same way as with a plaster cast. But the advantages are in lighter weight and smaller dimensions, breathable fabrics.
This is important! The type of dressing, as well as the method of treatment, is chosen by the doctor in any case. It all depends on the severity and type of the fracture.
Rehabilitation after clavicle fracture
In order to restore the function of bones and muscles, the patient must undergo some rehabilitation. It usually begins almost immediately after applying the bandage (if the fracture is not open).Includes specific steps:
- Overlay. The period of wearing a tight bandage or cast takes at least 2-3 weeks. But for 5-7 days, the doctor may prescribe a special exercise therapy procedure. The patient’s task is to make simple movements with the fingers, to unbend and bend the wrist.
- After removing the tight bandage, use gymnastic sticks. They help develop the shoulder joint.
- At the last stage, exercise therapy, massage and physiotherapy procedures, exercises in the gym with lifting dumbbells and weights are still used.
What procedures help to speed up muscle recovery and arm functionality:
- Special warm baths using medicinal herbs. They are carried out if there is no risk of tissue infection.
- Massage. It is carried out only by an experienced specialist. A massage therapist must work in a hospital. It is undesirable to use the services of private specialists, this can lead to sad consequences.
- Acupuncture. Perfectly helps to restore correct blood flow. The procedure is mandatory after surgery.
This is important! It is impossible to independently develop the sternum and back after a collarbone fracture. The procedures are prescribed by the surgeon after a visual examination and X-ray.
Possible consequences and complications
If the collarbone fracture was without displacement, then there is no need to worry about complications. Bones grow together quickly, no problems are observed.
The only thing to remember is that after the fracture has been treated, it is worth undergoing a rehabilitation course. Without this function, the hands will recover for a long time.
Falling on the side or on a bent arm, or with a direct impact, can break the collarbone. Treatment is usually without surgery; an oval splint is placed in the armpit, attached to the body through the healthy shoulder with bandages. The forearm, bent at the elbow at an angle of 35-45 degrees, is supported by a scarf, the ends of which are connected at the neck.
Physical therapy begins on the second day after the injury, and the first period lasts from the moment the fracture is fixed until the splint is removed (approximately 3 weeks).
The complex includes breathing, general developmental, and special exercises for the fingers.
A set of special exercises for a fracture of the clavicle in the first period
1. Spread the fingers to the sides, then connect again (Fig., A). Repeat 6-10 times.
2. Bend your fingers into a fist – the thumb is on top, straighten the palm, then squeeze again – the thumb is inside the fist (Fig.b). Repeat 6-10 times.
3. Connect the tip of each finger to the end of the thumb, forming a ring (Fig. C). Repeat 6-10 times with each finger.
4. Clicking with each finger (fig. D). Repeat 6-10 times with each finger.
5. Bend the nail and middle phalanges of all fingers (“claws”) (Fig. E). Repeat 6-10 times with each finger.
6. Circular movements with each finger clockwise and counterclockwise (Fig. E). Repeat 6-10 times.
7. Move the brush down and raise it.Repeat 3-4 times.
8. Move the brush from right to left and vice versa. Repeat 3-4 times in each direction.
9. Circular movements with a brush clockwise and counterclockwise. Repeat 6-10 times in each direction.
Perform all exercises at a slow pace 6-8 times a day.
A week later, the kerchief is removed and exercises for flexion and extension of the arm at the elbow are started: when the arm is bent, they perform movements in the shoulder joint 8-10 times (move the elbow upward – away from an angle of 80 degrees, then lower and connect the shoulder blades).This exercise is done 4-6 times a day.
In the first period, movements of the hand forward are contraindicated, abduction in the shoulder joint by more than 80 degrees and turning the hand with the palm down, as this leads to displacement of the fragments.
The second period begins after the formation of a callus (as confirmed by X-ray), when the splint is removed, approximately 3 weeks after the injury. During this period, it is important to restore the function of the shoulder joint. Exercises are performed synchronously with a healthy hand.
A set of special exercises for a fracture of the clavicle in the second period
1. I. p. – sitting or standing. Hands on the shoulders. Raise your elbows up and down. Repeat 8-10 times.
2.I. p. – the same. Circular movements of the elbows clockwise and counterclockwise. Repeat 8-10 times.
3. I. p. – the same, arms along the body. Raise your hands up, return to and. p. Repeat 8-10 times.
4. I. p. – the same. Raise your hands up, take them back and lower them. Repeat 8-10 times.
5.I. p. – the same. Swing movements with straight arms – left forward, right backward and vice versa. Repeat 8-10 times.
6. I. p. – the same, in the hands of a stick. Raise your arms above your head and lower. Repeat 8-10 times.
7. I. p. – the same, stick in bent hands. Circular motion of the stick in front of the chest clockwise and counterclockwise. Repeat 8-10 times.
8. I. p. – the same, holding the ends of the stick with straight hands. Lift the left end of the stick up, then the right. Repeat 8-10 times.
9.I. p. – the same.Raise the stick over your head, put it on your head, raise it again and put it behind your head on your shoulders. Repeat 8-10 times.
10. I. p. – sitting or standing. Tilt the torso forward and perform swinging movements with your hands crosswise in front of the chest (either right or left at the top). Repeat 8-10 times.
11.I. p. – the same. Swinging movements with hands to the sides. Repeat 8-10 times.
12. I. p. – the same, in the hands of a rubber ball. Throw the ball to hit the floor or wall, then catch it. Repeat 8-10 times.
13.I. p. – the same. Throwing the ball into the volleyball basket. Repeat 8-10 times.
14.I. p. – the same. Lean forward and roll the ball between your legs. Repeat 8-10 times.
15.I. p. – the same. Throw the ball up, catch it. Repeat 8-10 times.
Perform the complex at an average pace 4-6 times a day.
Exercise should not cause muscle fatigue and pain.
The second period lasts until full recovery of movement in all directions (approximately 2 weeks).
The third period is training, in which the main physical load falls on the injured limb.The following exercises are performed.
A set of special exercises for a fracture of the clavicle in the third period
1. I. p. – standing at the gymnastic wall, holding the ends of the rail with your hands at shoulder level. Sit down, then return to and. p. Repeat 10 times.
2.I. p. – the same. Bend your elbows and lie with your chest on the bar of the gymnastic wall, then return to and. p. Repeat 10 times.
3. I. p. – standing on the third rail with your back to the gymnastic wall, holding the other rail with your hands at shoulder level.Bend the left leg at the knee, and lower the straight right leg together with the body down, hang for 10-15 seconds, then return to and. p. Repeat 10 times.
4. I. p. – the same. Lower your legs down, hang for 10-15 seconds, then return to and. p. Repeat 10 times.
5. I. p. – standing, holding a medicine ball weighing 3-5 kg.
Raise the ball over your head, lean forward, roll the ball across the floor between your legs. Repeat 8-10 times.
6. I. p. – Standing with a medicine ball overhead. Circular motion of the ball over the head clockwise and counterclockwise.Repeat 8-10 times.
7. I. p. – standing, holding a medicine ball. Throw the ball up and catch. Repeat 10 times.
8. I. p. – standing, in the lowered hands dumbbells 2-4 kg. Raise your hands up, then return to and. p. Repeat 6-8 times.
9.I. p. – the same. Raise the right hand forward and upward, the left upward and backward, then vice versa. Repeat 8-10 times.
10. I. p. – standing, dumbbells in arms outstretched to the sides. Circular movements of the hands clockwise and counterclockwise. Repeat 6-8 times in each direction.
Perform all exercises at an average pace 4-6 times a day.
In some cases, an operation is used for a fracture of the clavicle, and then therapeutic exercises are prescribed on the second day after the operation. The method of training is the same as for conservative treatment. The first period lasts until the sutures are removed, but it is allowed to withdraw the arm in the shoulder joint to an angle of 80 degrees not earlier than after 2 weeks, and more than an angle of 90 degrees – after 3 weeks.
Rupture of the acromioclavicular joint
In case of rupture of the acromioclavicular joint, it is sutured, and the arm is placed on the abduction splint at a right angle in the shoulder joint for 5-6 weeks.In the first period of physical therapy on the second day after the operation, all kinds of movements are performed for the fingers (see Fig.), The wrist joint and flexion and extension of the arm at the elbow on the abduction splint.
After removing the splint in the second period, the movements in the shoulder joint are restored, performing exercises with a gymnastic stick, rubber and volleyball balls, as in the case of a collarbone fracture. The terms of restoration of functions are individual and depend on the characteristics of the operation, age, degree of physical fitness.
One of the most common injuries is a fracture of the clavicle. In newborns, a fracture occurs with the rapid passage of the birth canal or the wrong actions of obstetricians. In adults and older children, a clavicle fracture occurs when a fall on the shoulder or as a result of a strong blow to the clavicle region.
The rehabilitation period depends on how quickly medical assistance was provided and what methods were used. The rehabilitation period is the final and important stage, because the functions of the bone and shoulder in the future largely depend on it.
The bones of the clavicle grow together within a month, and a thickening forms at this place. In this case, the motor function is impaired. Its restoration is possible only after a complex of medical and physical exercises.
Treatment of a clavicle fracture rarely requires surgery. The operation is performed in the case of a complex displaced fracture.
The fracture is treated by a traumatologist.
Initially, the doctor should:
- to give the bone the correct position by pulling the shoulder up and back;
- after a special plaster cast is applied to the fracture site;
- Further, the fracture site is bandaged.
At the same time, the bandage is not rigid, which allows the hand to perform some of the actions that are necessary for rehabilitation. It takes place in three stages and allows you to completely restore physical activity. If the treatment and rehabilitation is carried out correctly, then the fracture will never remind of itself in the future.
What recovery methods are shown
In case of a clavicle fracture without displacement, the rehabilitation period begins long before the bandage is removed.This is necessary for the speedy bone healing, exclusion of stagnation of fluid and blood.
During the recovery period, the doctor prescribes a special set of procedures.
Physical activity can be accelerated using the following methods:
- physiotherapy procedures;
- medical and prophylactic complex;
- special diet.
The recovery period should be supervised by the attending physician.
Physiotherapy is indicated at the earliest possible date.To achieve a positive effect, it must be read a week after the fracture.
The following procedures apply:
- UHF therapy allows for a short period of time to reduce tissue edema and relieve pain.
- Magnetotherapy. During the therapy, a constant and alternating magnetic field is applied to the lesion site. For the procedure, special devices are used. This improves the fusion of bone tissue, while significantly reducing the risk of complications.The procedure can even be performed through a plaster cast.
- Interference currents can speed up the process of edema resorption, relieve pain. The procedure is carried out in the following way. 4 electrodes are attached to the area of the body where there is no plaster cast. If it is necessary to fix them specifically on the area of plaster, then special holes are cut in the bandage.
- Electrophoresis is used to accelerate the process of bone formation. During the procedure, areas of tissue are exposed to current.The time of the procedure is no more than 20 minutes. The positive effect is visible after 10 treatments.
- Paraffin baths and mud therapy are effective.
The presented list of procedures allows you to improve blood circulation and thereby accelerate the process of fusion.
If the collarbone fracture is without complications, massage procedures are prescribed. They are prescribed on the 10th day after the fracture. The massage therapist massages healthy tissue near the fracture, which has a beneficial effect on the entire upper limb.
At the first stage, the movements of the masseur should be light and calm, so as not to cause additional discomfort to the patient. For the procedure, apply a special oil or cream. After removing the bandage, you can gradually move on to increasing the intensity of the massage.
During the rehabilitation period, a person needs to adhere to a diet rich in calcium. For its better assimilation, vitamin D is needed. Silicon will allow the body to synthesize its own calcium.
The following products should be preferred:
- cottage cheese;
- jellied meat;
It is worth limiting the intake of smoked and pickled dishes, as well as completely abandoning coffee, black tea and alcohol.
If you follow all the doctor’s prescriptions, you can fully develop the arm in a short period of time.
The medical and prophylactic complex is prescribed even before the dressing is removed. The first exercises are to work with your fingers and a hand. It is forbidden to raise the arm and develop the shoulder joint.
Movements should be light and fluid, with few repetitions. A few minutes a day is ideal.
If during the exercise the patient experiences uncomfortable sensations, it is necessary to stop and postpone them for a later time.
In case of a displaced clavicle fracture, rehabilitation after surgery begins only after removing all the stitches.
Exercises are selected individually, taking into account the nature and degree of damage, as well as the general well-being of the patient.
Most often exercise therapy is carried out in three stages. Let’s take a closer look at each of them.
The first phase of restorative medicine begins immediately after the application of the cast and continues until the dressing is removed. During the day, the patient should perform at least 5 approaches, each exercise should be performed 10 times. After completion, a short break is required.
List of exercises in the first stage:
- Pinching and spreading the fingers on the injured hand.
- Flexion and extension of the arm into a fist.In this case, the thumb must be bent alternately to the inner, then to the outer surface.
- Click each finger.
- Each finger must be rotated in a circle.
- Hand movements up and down, to the sides.
- Circular rotation of the hand.
After removing the bandage, the exercises are aimed at flexing and extending the injured arm in the elbow joint.
Rehabilitation after a displaced clavicle fracture is carried out under the supervision of a doctor.
Exercises in the second stage:
- Place your palms on your shoulders and raise and lower your elbows.
- Circular motions with elbows at least 10 times.
- The well-known exercise of the mill, only swinging movements are performed forward and backward.
- Raising and lowering up and down straightened arms with a gymnastic stick.
- Swinging cross movements with hands, slightly tilting the body forward.
The duration of this stage depends on the degree of the fracture, age characteristics of the patient.Basically, it is 20 days.
The third stage involves the development of the limbs until the full restoration of motor function.
Rehabilitation after a clavicle fracture includes exercises:
- The patient holds a special exercise ball over his head. Leaning forward, pushes the ball between your legs.
- Tossing and catching a special ball.
- Holding dumbbells in his hands, the patient makes alternate raises of his arms above his head.
To date, many restorative complexes have been developed, which include rehabilitation exercises after a displaced clavicle fracture, the video of which can be found here.For complete recovery, it is important to systematically perform exercise therapy.
Osteosynthesis of the clavicle (clavicle fracture) – surgery in Moscow – Clinic “Doctor near”
Osteosynthesis of the clavicle – surgical operation , which allows you to connect deformed bones and restore their integrity using metal structures. The treatment is complex, but effective. Patients quickly return to their normal lifestyle. Surgery is indicated in the presence of collarbone injuries.The neurovascular bundle located between the first rib and the clavicle is compressed, and when the fragments move, there is a risk of damage to the skin.
Unlike plastering , osteosynthesis allows you to quickly solve the problem of bone tissue fusion. A person does not need to wear a plaster cast for a long time and adhere to a certain daily routine.
Surgical treatment of a clavicle fracture is aimed at removing the fragments, their reliable fixation and fastening the damaged bones with metal structures.A special plate, a nail-bolt, flexible pins, screws, etc. are inserted into the bone. The shape of the plates can be different: curved, S-shaped, straight, in the form of hooks, etc.
The patient is immersed in a deep sleep, bone fragments are exposed and connected with metal structures. X-ray installations allow observing how the bones are connected. Osteosynthesis reliably removes fractures, after therapy there is no need to maintain immobility, you can return to an active rhythm of life.
After fresh injuries, osteosynthesis of the clavicle is performed if:
- open fractures formed;
- there are closed fractures of the clavicle, accompanied by ruptures of the neurovascular plexuses;
- there was an implantation (interposition) of soft tissues between the bone fragments, which complicates the compilation and fusion of bones;
- there is a high risk of bone rupture of the skin surface;
- bone fragments are located vertically and can injure neurovascular bundles.
In the presence of chronic injuries, osteosynthesis is necessary if:
- clavicle fractures heal very slowly;
- there are improperly fused bones, which disrupts the work of the limb;
- there are cosmetic flaws.
Treatment of fresh fractures is carried out immediately, chronic disorders are eliminated in a planned manner.
Clavicle osteosynthesis is impossible in the following cases:
- extremely serious condition of the patient due to injuries, injuries, chronic diseases;
- during the period of acute infection;
- in the area of the shoulder girdle there are abscesses, non-healing wounds, abrasions, etc.
How the procedure is performed
The operation is performed under general anesthesia. On the operating table, the patient lies on his back, special rollers are placed under the shoulder blades from the damaged side. Traumatologists-orthopedists choose metal structures taking into account the injuries received. Most often, titanium plates are used for reconstruction; their shape depends on the nature of the damage.
To detect the problem area, a longitudinal skin incision is made above the collarbone.Traumatologists remove blood clots, align bone fragments, apply plates and fix them with screws. When installing structures, damage to the neurovascular bundle and the development of necrosis are excluded. The wound is sutured, closed with a sterile bandage, and drainage is applied. After 8-12 weeks, the installed structure is removed. In some cases, this is not necessary.
In Moscow, the reconstruction of the clavicle is successfully carried out in the CDC “Doctor near” is located on Simonovsky Val
- Fast and effective reconstruction of the clavicle, the bones heal reliably.
- After the operation, the patient very soon returns to the usual rhythm of life.
- The collarbone locomotion and performance are restored.
- There are no cosmetic defects.
Preparation for operation
No special preparation for osteosynthesis of the clavicle is required. On the eve of the operation, it is recommended to refrain from taking alcohol, drugs that slow down blood clotting, to exclude stress and increased strength loads.
How is a clavicle fracture diagnosed?
Displacement and fracture of the clavicle bones can be the result of sports injuries, falls, accidents, etc. It is not difficult to identify it: sharp and severe pain occurs in the fracture zone, the skin in this area is strongly stretched, there are skin disorders. Often there is a crunch when raising the hand.
If there is a suspicion of damage to the collarbone, the doctor sends X-rays and other studies.All necessary examinations can be done at the Doctor Nearby CDC on Simonovsky Val.
Are complications possible after osteosynthesis of the clavicle?
With proper treatment and the use of high-quality metal structures, the results of the operation are usually excellent. Complications occur in cases when short pins were used to connect the bones, bone fragments were poorly fixed, the diameter of the drills for reaming the cavities was incorrectly selected. In this case, there is no fusion of the clavicle, infectious complications and cosmetic defects appear.
During the reconstruction of the clavicle, surgical interventions are carried out in the area where there are no large vessels. Violation of the operating technique can lead to damage to the vessels located directly under the collarbone, which leads to profuse bleeding. That is why the choice of the clinic and the doctor for the operation is of decisive importance.
What are the advantages of the Doctor near clinic?
CDC “Doctor near” is located on Simonovsky Val.The clinic has advanced equipment, qualified traumatologists and orthopedists work. Specialists take into account the peculiarities of injuries, correctly select plates and pins for fixation.
The center uses modern variations of the introduction of metal structures: without open access to bone fragments. A large selection of high-quality and affordable plates for clavicle osteosynthesis.
After competent and professional treatment, the patient does not have cosmetic defects, healing occurs in an accelerated mode.Immediately after the operation with the injured limb, you can perform simple actions without significant stress.
REHABILITATION OF A BROKEN CLUSTER AFTER OPERATION – MEDICAL
Fracture of the clavicle or collarbone is a common injury. The clavicle is also known as the clavicle and is the bone that connects the arm to the body. In most cases, broken collarbones are treated without surgery by fixing the arm in a bandage for several weeks.If your clavicle is misaligned, or aligned, or aligned properly, surgery is required. Post-surgery rehabilitation can help you regain normal arm and shoulder mobility.
After clavicle surgery to correct a displaced fracture, your only rehabilitation task is to keep your arm relatively still in an arm band or figure-of-eight. A bandage is similar to a bandage, but wraps around your body and gives more support to your arm, shoulder, and collarbone.Your doctor will monitor your healing for the first six to eight weeks after surgery before starting physical therapy exercises. You can use the affected arm for simple daily activities such as bathing, eating, and dressing, but limit your movements as much as possible. Do not lift, reach, push, pull, or stretch the affected arm.
- After clavicle surgery to correct a displaced fracture, your only rehabilitation task is to keep your arm relatively still in an arm band or figure-of-eight.
Rehabilitation after surgical repair of the clavicle continues with stretching exercises. Under the supervision of a physician, you can begin this phase of rehabilitation approximately eight weeks after the procedure. Rehabilitation may include range of motion exercises such as shoulder shrugging, pendulum swing, and shoulder flexion. Shrugs should be performed at this stage without weighting the arms. To swing the pendulum, rest your good hand on a table or heavy furniture.Slowly rotate the injured arm as far forward as possible and then backward, stopping if severe pain is felt. Shoulder flexion is performed by placing the injured arm against the wall. Your hand should be facing your body and your forearm should be touching the wall. Slowly lift your hand up the wall until your shoulder also touches the wall. Glide as high as possible without pain.
- Rehabilitation after surgical repair of the clavicle continues with stretching exercises.
- To swing the pendulum, rest your good hand on a table or heavy furniture.
Strengthening exercises for rehabilitation are suitable for most patients with a fractured clavicle and begin about three months after surgery. This type of rehabilitation will help you regain the strength you lost during fracture recovery and subsequent surgery. Arm curls work the biceps and triceps muscles and can be performed with arm weights ranging from two to five pounds, depending on your overall strength and condition.Keep your arm fully extended, grab your weight, and bend your arm as hard as possible without pain. Hold the position for 10 seconds before releasing. Breast lift is usually part of a rehabilitation program after clavicle straightening surgery. Lie on your stomach with your arms at your sides. Lift your chest off the ground and hold for five seconds. This exercise should be done hands-free and is not the same as push-ups.
- Rehabilitation strengthening exercises are appropriate for most patients with a fractured collarbone and begin about three months after surgery.
- This exercise should be done hands-free and is not the same as push-ups.
With physical therapy, you will see an improvement in range of motion and less discomfort, but the overall recovery time after aligning the clavicles can be several months.