Monday, July 31, 2017

Clavicle Injuries and Symptoms

The clavicle, whose name is derived from the Latin term Clavicula, is a small, but important
bone in our body. Clavicle injuries are especially prominent during the summer months, when
people tend to be more active. Over activity and hyperextension are often the cause of
clavicle fractures and other health related issues. Despite how pervasive clavicle-related
injuries are, many medical professionals continue to struggle with understanding where these
injuries stem from and how the bone itself functions due to a general lack of medical-related
data. Although fractures tend to heal regardless of treatment, complications may very well
arise from clavicle-related injuries.

There have been several attempts to devise a classification scheme for these types of
fractures, and after lots of careful consideration and deliberation, clavicle fractures have come
to be classified by their location. There are three main types of clavicle fractures:

  • Group/Type I Fractures: Middle third injuries
  • Group/Type II Fractures: Distal third injuries
  • Group/Type III Fractures: Medial (proximal) third injuries

While several people experience one of the three types of injuries, Type I fractures are by far
the most prominent. It is not difficult to spot symptoms of clavicle fractures, as they can cause immediate pain and readily impact upper extremity movement and overall mobility. Some common signs of a fracture include:

  • Swelling, ecchymosis and tenderness around or over the clavicle
  • The shoulder may appear shortened relative to the opposite side and may droop
  • The patient may cradle the injured extremity with the uninjured arm
  • Difficulty breathing or diminished breathing sounds may indicate a pulmonary injury
  • Palpation of the scapula and ribs may reveal a concomitant injury
  • Abrasion over the clavicle may be noted, suggesting that the fracture was from a direct mechanism

If any of the aforementioned signs can be observed in a patient, it is vitally important that you
seek medical attention immediately. Diagnosis can be done through a variety of laboratory
studies and typically takes very little time to do. A Complete blood count (CBC) may be
mandatory is a vascular injury is suspected. This procedure checks the patient’s hemoglobin
and hematocrit values. An Arterial Blood Gas (ABG) may also be necessary if a pulmonary
injury is suspected or identified. There are also a wide variety of imaging studies that may
assist in the diagnosis process. These studies include chest radiography, which obtains an
expiration poster-anterior (PA) chest film (along with the aforementioned ABG test) if a
pulmonary injury is suspected or identified. A CT (Computed tomography) scan,
ultrasonography or radiography of the clavicle and/or shoulder may be needed to better
understand the fracture, where it came from and possible solutions to the injury, as well.

The majority of clavicle fractures are able to heal correctly with nonoperative management,
which includes the use of a simple shoulder sling or brace. However, this doesn’t mean that
surgery is never required. If the patient experiences a complete fracture displacement, tenting
skin. Fractures with 2 cm of shortening, comminuted fractures, neurovascular compromises,
or open fractures, for example, may indicate that surgery is necessary in aiding the healing
process. When surgical fixation is required for a mid-shaft clavicle fracture (type I & III), the
most commonly performed procedure involves open reduction of the fracture, which is then
followed either by insertion of an intramedullary device or fixation with a plate and screws. In
a distal clavicle (Type II), stable fixation may be achieved in several different ways, including
combinations of coracoclavicular screws, Dacron or Mersilene tapes, tension banding, a
Kirschner wire (or, K-wire), and clavicular plates. Regardless of the technique used to fix the
fracture, the same basic principles of fracture reduction and stabilization apply.

The key to avoiding clavicle-related injuries and fractures is remaining diligent in injury
prevention, regardless of how strenuous your exercise routine may be. If you are in need of a
clavicle splint or support item, please visit our Ossur Clavicle & Rib store. If you have any tips
on how to aid the healing process of clavicle fractures, please share your thoughts in the
comment section below!

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