Etamed💉💊
Photo
🔸history and ph.E:
Pain
swelling
deformity
The shoulder may appear shortened
neurovascular status:brachial plexus injury
subclavian venous injury:decreased pulses/Venous stasis, discoloration, and swelling
🔸mechanism:
direct:falls onto the lateral shoulder
indirect:fall onto an outstretched hand
🔸workup:
Radiography of the clavicle and shoulder
Computed tomography (CT) scanning with 3-dimensional (3-D) reconstruction
Arteriography
Ultrasonography
🔸Treatment:
nonoperative:
Reduction and immobilization - Typically with figure-of-eight brace
operative:
Complete fracture
Severe displacement causing tenting of the skin with the risk of puncture
Fractures with 2 cm of shortening
Comminuted fractures with a displaced transverse "zed" (or z-shaped) fragment
Neurovascular compromise
Displaced medial clavicular fractures with mediastinal structures at risk
Polytrauma
Open fractures
An inability to tolerate closed treatment
Fractures with interposed muscle
Established symptomatic nonunion
Concomitant glenoid neck fracture (floating shoulder)
@etamed
Pain
swelling
deformity
The shoulder may appear shortened
neurovascular status:brachial plexus injury
subclavian venous injury:decreased pulses/Venous stasis, discoloration, and swelling
🔸mechanism:
direct:falls onto the lateral shoulder
indirect:fall onto an outstretched hand
🔸workup:
Radiography of the clavicle and shoulder
Computed tomography (CT) scanning with 3-dimensional (3-D) reconstruction
Arteriography
Ultrasonography
🔸Treatment:
nonoperative:
Reduction and immobilization - Typically with figure-of-eight brace
operative:
Complete fracture
Severe displacement causing tenting of the skin with the risk of puncture
Fractures with 2 cm of shortening
Comminuted fractures with a displaced transverse "zed" (or z-shaped) fragment
Neurovascular compromise
Displaced medial clavicular fractures with mediastinal structures at risk
Polytrauma
Open fractures
An inability to tolerate closed treatment
Fractures with interposed muscle
Established symptomatic nonunion
Concomitant glenoid neck fracture (floating shoulder)
@etamed