Dislocations of a clavicle meet rather often and make about 5% of total number of dislocations. Dislocation of a clavicle results from an indirect trauma – falling on a shoulder or the taken-away hand. Sharp compression of area of nadplechiya in the cross direction becomes more rare the dislocation reason. Dislocation of a clavicle can happen both in an akromialny part, and in the place of its joint to a breast. Pain and hypostasis, increase in a vystoyaniye of a clavicle in the place of dislocation is observed. Diagnostics is performed by results of clinical examination and the anamnesis of damage, the X-ray analysis in addition can be carried out. Complexity of treatment of dislocation of a clavicle consists in problematical character of deduction of a clavicle in the correct situation after its reposition.
Dislocations of a clavicle meet rather often and make about 5% of total number of dislocations. A clavicle – the only bone fastening bones of the top extremity to trunk bones. The clavicle is attached by the grudinny end to a breast. The Akromialny end of a clavicle connects to an akromialny shoot of a shovel.
Dislocation of a clavicle results from an indirect trauma – falling on a shoulder or the taken-away hand. Sharp compression of area of nadplechiya in the cross direction becomes more rare the dislocation reason. Both the akromialny, and grudinny end of a clavicle can be dislocated. Dislocation of the akromialny end of a clavicle meets approximately by 5 times more often.
Dislocation of the akromialny end of a clavicle
The patient shows complaints to pain in the field of damage. Local hypostasis of soft fabrics is observed. The Akromialny end of a clavicle is stuck out up and a little kzada. There is a symptom of "key": when pressing on the acting end of a clavicle it rises into place and when pressure is stopped – again rises. The palpation of the place of damage is painful, the movements are limited.
Extent of protrusion of the akromialny end of a clavicle depends on weight of damage. Allocate incomplete (partial) and complete dislocations of a clavicle. At complete dislocations the klyuvovidno-clavicular ligament, the capsule and ligaments of an akromialno-clavicular joint is injured. At incomplete dislocations the klyuvovidno-clavicular sheaf remains intact.
At incomplete dislocation of a clavicle protrusion is expressed slightly or moderately. If to pull a hand of the patient down, the clavicle together with a shoulder will move from top to bottom and degree of a vystoyaniye of a clavicle will not change. At complete dislocations of a clavicle the pandiculation of a hand of the patient is followed by increase in protrusion down.
The diagnosis, as a rule, does not raise doubts. For confirmation of the diagnosis carry out a X-ray analysis. At incomplete dislocations of a clavicle the comparative roentgenogram of both akromialno-clavicular joints, sometimes – with functional loading in certain cases is required (the patient takes small freight in hand).
In traumatology incomplete dislocation of a clavicle in most cases treat conservatively. The immobilization of an akromialno-clavicular joint for the term of 2-3 weeks is carried out. In the subsequent appoint physiotherapy exercises and physiotreatment: electrophoresis, magnetotherapy, ozokeritolecheniye, etc.
At complete dislocations operation as nothing it is very simple to put not withheld akromialny end of a clavicle into place, but, because of features of an anatomic structure of this area is shown, it is almost impossible to hold in the correct situation. During operation the clavicle is set and fixed by a mylar tape or silk thread. In some operational techniques additional fixing is applied by a spoke.
Dislocation of the grudinny end of a clavicle
The Grudinny end of a clavicle can be dislocated in three directions: up (nadgrudinny dislocation), back (zagrudinny dislocation) and forward (perednegrudinny dislocation). Perednegrudinny dislocation of a clavicle is more often observed. The patient shows complaints to pains in the field of a grudino-clavicular joint. Visually hypostasis and deformation is defined. At perednegrudinny dislocation of a clavicle in the field of damage protrusion is defined, at zagrudinny – a zapadeniye. The palpation is painful, the movements are limited. For specification of the diagnosis conduct a radiological research.
At dislocation of the grudinny end of a clavicle reposition is performed without special difficulties, however, it is possible to hold a clavicle on the place not always. There is a special conservative technique of treatment at which after reposition the eight-figurative plaster bandage is applied. Operational methods of treatment are in most cases used. The lavsanoplastika is applied to restoration of sheaves.
Chronic dislocations of a clavicle
If from the moment of dislocation of the grudinny or akromialny end of a clavicle there passed more than 3-4 weeks, such dislocation is considered old. Incomplete chronic dislocation of the akromialny end of a clavicle can proceed almost asymptomatically. The only complaint of patients sometimes is deformation of an akromialno-clavicular joint.
At complete chronic dislocations of a clavicle of patients pains in the field of damage and decrease in force of a hand disturb. Chronic dislocations of the akromialny and grudinny end of a clavicle can be eliminated only by means of operation.