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





ACROMIAL-CLAVICULAR JOINT SEPARATION

Separation of the acromial-clavicular joint results from falls on the tip of the shoulder. Cases are classified by the amount of upward displacement of the clavicle (Figure 18.4).

Figure 18.4
Figure 18.4


Evaluation

The acromial-clavicular joint is tender to palpation and the end of the clavicle is prominent. X-rays are not essential but confirm the diagnosis and determine if there is a fracture.

Treatment

:: Apply an arm sling to support the weight of the arm and to remove the deforming force from the joint. This will not keep the joint in the anatomical position, but the remaining deformity will cause little functional loss.
:: Release the sling daily to allow elbow extension. Begin hanging arm exercises when comfortable and begin active muscle strengthening by the second week.

> 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  
Make the diagnosis based on the history and a physical examination


Treat with an arm sling



 
When comfortable, begin a range of motion and active muscle strengthening in the shoulder.