Cheatography
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Presentation Management etc.
This is a draft cheat sheet. It is a work in progress and is not finished yet.
Causes
- Fall onto lateral shoulder |
- FOOSA |
- Direct blow |
Classification
- Group 1: fractures involving middle 1/3 of clavicle (most common- not displaced) |
Group 2: Fracture of distal 1/3 of clavicle (direct blow to shoulder - medial fragment has marked displacement in a cephalad direction, caudal displacement of distal fragment) |
Group 3: Medial 1/3 of clavicle (uncommon - strong force to the anterior chest - high risk of neurovascular/intrathoracic injury) |
Presentation
- Hx of trauma |
- Patient cradles affected arm |
-Affected shoulder usually slumped anteriorly and inferiorly |
- Pain intensifies with movement |
- On observation, swelling, ecchymosis |
- Palpation shows tenderness over lesion |
- Gentle movement produces crepitus of the ends |
- Assessment of lung sounds, distal pulses, observe for vascular problems in upper extremity (swelling, discolouration) |
Imaging
- May appear normal on x-ray if non-displaced
- Repeat x-ray 7-10 days after injury or CT
- US
Management
- Rest and protection of non-displaced clavicle |
- Ice and analgesics |
- Arm sling |
- Begin elbow ROM exercises as pain decreases |
- When f# heals, begin shoulder mobility/strength training (usually 6-8 weeks) |
- Surgical referral if group 2 and 3 fractures, multiple fractures, fractures with interposed muscle, evidence of neurovascular compromise, inability to tolerate conservative management |
- Good outcomes with both surgery and conservative care |
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