Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
Traumatology and orthopaedics
Acute Trauma Management
Trauma in perspective
Principles of Primary Trauma Care
Six phases of Primary Trauma Care
Procedures
Orthopaedic Techniques
Traction
Casts and Splints
Application of external fixation
Diagnostic imaging
Physical therapy
Crania burr holes
Orthopaedic Trauma
Upper extremity injuries
The hand
Fractures of the pelvis and hip
Injuries of the lower extremity
Spine injuries
Fractures in children
Amputations
Complications
War related trauma
General Orthopaedics
Congenital and developmental problems
Bone tumours
Infection
Degenerative conditions
Trauma in Perspective
 

> CLAVICLE FRACTURES
> ACROMIAL-CLAVICULAR JOINT SEPARATION
> SHOULDER DISLOCATION
> PROXIMAL HUMERUS FRACTURES
> HUMERAL SHAFT FRACTURES
> SUPRACONDYLAR FRACTURES OF THE HUMERUS
> OLECRANON FRACTURES
> FRACTURES OF THE RADIAL HEAD AND NECK
> ELBOW DISLOCATION
> FOREARM FRACTURES
> DISTAL RADIUS FRACTURES
> CARPAL FRACTURES AND FRACTURE DISLOCATIONS





CLAVICLE FRACTURES

Evaluation

A physical examination shows tenderness over the mid or distal clavicle, with swelling, visible and palpable deformity and, often, crepitus. X-rays confirm diagnosis, but are not essential (Figure 18.1).

Figure 18.1
Figure 18.1


Treatment

:: Apply a sling as shown in Figure 18.2; a figure-of-8 splint provides some comfort, but is not essential for fracture healing
Figure 18.2
Figure 18.2

:: Fractures are rarely positioned anatomically, but will heal satisfactorily with little or no functional loss. The patient should continue with the sling until pain free. This will take 4–6 weeks in adults and 3–4 weeks in children.

Rehabilitation

Begin elbow extension and hanging arm exercises in the sling within a few days (Figure 18.3).

Figure 18.3
Figure 18.3

> CLAVICLE FRACTURES
> ACROMIAL-CLAVICULAR JOINT SEPARATION
> SHOULDER DISLOCATION
> PROXIMAL HUMERUS FRACTURES
> HUMERAL SHAFT FRACTURES
> SUPRACONDYLAR FRACTURES OF THE HUMERUS
> OLECRANON FRACTURES
> FRACTURES OF THE RADIAL HEAD AND NECK
> ELBOW DISLOCATION
> FOREARM FRACTURES
> DISTAL RADIUS FRACTURES
> CARPAL FRACTURES AND FRACTURE DISLOCATIONS



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  Kep Points  
Diagnose fractures from the history and by physical examination


Treat with a sling and early range of motion



 
Fracture healing takes 4 weeks in children and 6–8 weeks in adults.