Clavicle Fracture (Broken Collarbone) ,its causes ,symptoms,diagnosis,treatment and its complications.

A clavicle fracture is a crack  inside the collarbone, one of the important bones in the shoulder. Clavicle  fractures are fairly common, accounting for about five% of all  fractures.Most clavicle fractures occour  a fall onto the shoulder or an outstretched arm places enough strain on the bone that it snaps or breaks. A damaged collarbone can be very painful and might make it tough to move your arm.

Many clavicle fractures can be treated through carrying a sling to hold the arm and shoulder from shifting even as the bone heals. With some clavicle fractures, however, the parts  of bone move some distance out of place  while the injury occurs. For those greater complicated fractures, surgical operation may be needed to realign the collarbone.

Anatomy

The clavicle is placed between the ribcage (sternum) and the shoulder blade (scapula). It is the bone that connects the arm to the rest of  body.The clavicle lies above numerous critical nerves and blood vessels. However, these important structures are hardly ever injured while a fracture occurs.

Description

Clavicle fractures are pretty not unusual and arise in human beings of every age. Most fractures arise within the middle portion, or shaft, of the bone. Occasionally, the bone will spoil in which it attaches at the ribcage or shoulder blade.

Clavicle fractures vary. The bone can crack simply slightly or ruin into many pieces (comminuted fracture). The damaged pieces of bone may line up instantly or may be a far out of region (displaced fracture).

Cause

Clavicle fractures are mostly  caused by a  direct  blow to the shoulder. This can occur during  fall onto the shoulder or an accident , like a vehicle collision. A fall onto an outstretched arm also can motive a clavicle fracture. In a newborn , a clavicle fracture can occur during  the passage through  the birth canal.

Symptoms

A clavicle fracture can be very painful and can make it tough to transport your arm. Other sign  and symptoms of a fracture are:

*Sagging of the shoulder downward and forward

*Inability to lift the arm because of ache

*A grinding sensation whilst you try to enhance the arm

*A deformity or bump over the ruin

*Bruising, swelling, and/or tenderness over the collarbone

Doctor Examination

Physical Examination

Your doctor will want to realize how the injury occurred and could ask about your symptoms. They will then cautiously examine your shoulder.In a clavicle fracture, there may be normally an apparent deformity, or bump, at the fractur area. Gentle pressure  over the break area  will bring about ache. Although it's far rare for a bone pieces to break through the skin.

Clavicle fracture physical examination

Tenting of skin over clavicle fracture

Your doctor may even perform assessments to make certain that no nerves or blood vessels have been broken when the fracture happened.

Imaging Studies

X-rays.

 X-rays offer images  of dense structures, inclusive of bone. Your medical doctor will order an X-ray:

*To assist pinpoint the location of the fracture

*To examine more approximately the severity of the wreck

If other bones are damaged, your medical doctor can also order a automatic tomography (CT) test to look the fractures in better element

Treatment

Nonsurgical Treatment

If the broken ends of the bones have no longer substantially shifted out of place, you can not need surgical treatment. Many broken collarbones can heal with out surgery.

Arm sling 

A easy arm sling is generally used for comfort right now after the fracture  and to maintain your arm and shoulder in position  while the fracture  heals.

Medication

 Pain medication, inclusive of acetaminophen, can assist relieve ache as the fracture heals.

Physical therapy

 Although there will be a few pain , it's necessary  to maintain arm motion to prevent shoulder and elbow stiffness. Often, sufferers will begin doing physical activities for elbow motion right away after the harm.After a clavicle fracture, it is not unusual to lose some shoulder and arm strength. Once the bone begins to heal, your pain will decrease and your health practitioner may also start mild shoulder exercises . These exercises will help save you stiffness and weak spot. Follow-up care. You will want to see your medical doctor often until your fracture heals. During those visits, the physician will take X-rays to ensure the bone is healing in a great function. After the bone has healed, you'll be capable of step by step go back for your regular activities.

Complications

*In some instances, a clavicle fracture move  out of location earlier than it heals. It is crucial to follow up along with your physician as scheduled to make sure the bone stays in function.

*If the fracture does not heal, it's referred  as a nonunion.In a few cases  of nonunion, the affected person has little or no pain  and good range of motion , so no similarly treatment is required.In different cases, nonunion can result in considerable pain and might require an operation for repair. 

*A massive bump over the fracture web page may also develop because the fracture heals. This generally gets smaller over the years, but a small bump frequently remains completely.

Surgical Treatment

If the damaged ends of the bones have extensively shifted out of place, your medical doctor may additionaly advice  surgical treatment.

Open reduction  and internal fixation

 This is the technique most often used to treat clavicle fractures. During this procedure , the bone fragments are first repositioned (decreased) into their normal alignment. The portions of bone are then held correct position with special metal hardware.

Common techniques of internal  fixation consist of:

Plates and screws

After being repositioned into their regular alignment, the bone fragments are held in region with unique screws and metal plates attached to the outer floor of the bone.After surgical procedure, you may notice a small patch of numb skin under the incision.Plates and screws are not mechanically eliminated after the bone has healed, until they are cause  pain.If pain  occurs, plates and screws may be removed after the fracture has healed.

Clavicle fracture ORIF

Pins or screws

 Pins or screws can also be used to hold the fracture in position  after the bone ends had been position back in place . The incisions for pin or screw placement are generally smaller than those used for plates.

Complications

 There are risks related to any kind of surgical treatment. These consist of:

*Infection

*Bleeding

*Problems with wound restoration

*Pain

*Blood clots

*Damage to blood vessels or nerves

*Reaction to anesthesia

Risks which occour  to surgical treatment for clavicle fractures include:

*Difficulty with bone recovery

*Lung damage

*Numbness underneath the clavicle.

* Inflammation

Patients who smoke or use tobacco , have diabetes, or are aged are at a better risk  for complications both during and after surgical procedure. They also are much more likely to have problems with wound and bone recovery.