Dislocation of the acromial and the sternal end of the clavicle: symptoms, treatment

Causes, treatment and rehabilitation after dislocation of the clavicle

Clavicles are a pair of long bones that connect the scapula to the sternum. The name clavicle comes from the Latin word «key». The clavicle is one of the bones that is most often damaged in human body.

Clavicle bones are cylindrical with a length of 15 cm in length, curved in the transverse plane, like the letter S. They are located in the upper part of the chest and attached to the first rib.

Each clavicle runs in the transverse direction and forms a joint with the sternum at its medial end and the scapula at its lateral end.

The unique position of the clavicle in the body often leads to sprains and fractures, often as a result of road accidents.

When at the time of injury, the arm is extended, a large part of the force from the fall is transmitted through the arm to the shoulder, which leads to a sudden shift and could break the collarbone.

When a strong force is applied directly to the shoulder, for example, during a car accident or during a sudden fall, the bones of the shoulder can be dislocated medially and lead to dislocation or fracture of the clavicle. It should be noted that the fracture of the clavicle is much rarer dislocation.

Varieties of dislocation of the clavicle

Based on scientific classification, dislocation of the clavicle can be divided into three types, each of which has its unique features. Take a closer look at each of them.

There are three types of dislocation of the clavicle:

  1. Dislocation of the acromioclavicular joint. This type is most common. Most frequently occurs as a result of falling on the shoulder as torn ligaments within the peripheral part of the clavicle. Is characterized by the bulging collarbone and some deformation of the shoulder area. It should be noted that the acromioclavicular joint has a relatively low mobility.
  2. Dislocation of the sternal end. Occurs when the fall of man at the designated hand (indirect injury). This type of dislocation distinguish two subspecies: the front and rear. The most common anterior dislocation, in which the front edge is displaced sternal end of the clavicle.
  3. Simultaneous dislocation of clavicular joint. This is the most dangerous damage to the bone, when at the time of injury is damaged and the acromial end and the sternal end of the joint. This injury is considered a threat to human health and often difficult to treat.

Due to any dislocation of people is difficult to manage the damaged limb. Movements become difficult and painful.

Dislocation of this bone is found more often fractures. At risk can be as young and elderly people (from 17 to 60 years).

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What are the causes of injury

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The collarbone can be damaged by two mechanical impacts: indirect and direct impacts.

In the case of direct trauma effects are seen in the acromial part from the bottom up. It happens when falling or strong impact. In such situations, the bone goes back, resting on the first rib. Indirect mechanical effect is characterized by the fall of man on the shoulder.

Trauma there are several main reasons that most often lead to the dislocation of the clavicle. These reasons include:

  • a blow to the chest;
  • a strong blow directly to the collar bone (can occur during a crash);
  • a fall on the humerus.

Most often, the damage to the bones observed in this group of people:

  • gymnasts;
  • basketball players;
  • volleyball;
  • older adults (over 50 years);
  • patients with low back pain.

Damage to the clavicle may be different degrees. Can be damaged by clavicular ligament, torn capsule. If the damage was significant, rush attached to bones muscles (deltoid and trapezius).

Characteristics of the clinical picture

The main pain with dislocation of clavicle falls on the junction of the clavicle and scapula. A person feels pain during movement of the shoulder or arm. In addition, you cannot take or lift up. You may receive a bruise or swelling.

In acromioclavicular dislocation observed deformation of the bone: the acromial end will bulge up and slightly back.

Thus the characteristic feature of fracture of clavicle is the «key symptom». This is when pressing on the part that sticks out, it is observed that the bone stands in its place.

After you stop pressing, the acromial end of the clavicle is lifted upward again. It should be noted that this feature is in most cases impossible to determine, as when pressing on the injured area the patient is experiencing unbearable pain.

Obese people possible difficult diagnosis, as the clavicle is poorly palpable.

The most reliable diagnostic method is x-ray damaged bones.

The most common symptoms of dislocation of the clavicle:

  • severe pain in the clavicle and in the shoulder girdle;
  • reduced sensitivity of the shoulder girdle and upper limb;
  • severe pain when attempting to move the arm;
  • visible deformation of the joint in which the clavicle is connected to another tile;
  • soreness of the skin offset joint;
  • swelling and bruising in the area of deployment;
  • numbness or paralysis of the limb (this may be caused by pressure to nerves and vessels).
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Any damage to the clavicle should give you a signal that as soon as possible need to see a doctor. Try not to eat before coming to the doctor.

Solid food increases the likelihood of vomiting in the reduction of a dislocation, especially if the reduction will be carried out using anesthesia.

First aid

If there is a suspicion of luxation of the clavicle, the injured limb must be hung with the help of a bandage, which will be hung from the neck. Under armpits you need to put cushion (it can be rolled up clothing).

If there is swelling or arm begins to turn blue, then it is desirable to place the injury applying a cold compress (something with the fridge and collect a bottle of cold water). Next you need to call an ambulance or to bring the victim to a trauma.

In any case, not upravlyayte bone independently. So you can only aggravate the patient’s condition and worsen the situation.

It should also give the victim painkillers – this can hinder further examination. Extreme cases can be unbearable pain that simply cannot be tolerated.

Treatment of trauma

Usually, physical examination is sufficient to assess the extent of damage. For confirmation of the diagnosis will need to do an x-ray. He doesn’t show damaged ligaments but will show the degree and direction of movement of the clavicle and possible fractured bones.

Injury first degree treated conservatively. It is recommended to rest, applying ice to the damaged site, use of analgesics and a bandage, since the main task is to correctly fix the position of the bone.

The most severe case, when there is dislocation of the clavicle with ligament rupture. In such situations, you may need surgery.

Conservative treatment in this case usually gives satisfactory results for the patients, but it is for those people who are not affiliated with professional sports for athletes, surgical treatment will bring discomfort during heavy load.

The duration of treatment is 4 to 6 weeks. If assigned to surgery, the therapy lasts at least 6 months. After that the victim will have to undergo a course of rehabilitation.

If the injury is chronic, in such a situation only applies surgery. Most often, surgery will be scheduled according to the method of Bohm, Bendele, Watkins-Kaplan. The goal is to create synthetic materials ligament. After 6-7 months recovering full capacity of the limb.

To prevent injury

Key preventive methods are to completely prevent any injury to the belt of the upper limb.

Any damage, immediately contact the doctor in order to prevent complications and the time to begin treatment.

If you already once had a dislocation of the clavicle, then you need to be on a permanent basis to carry out physical exercises which will prescribe a physical therapist. This will help to strengthen the ligaments and muscles, they become more elastic and prevent the dislocation will be much easier.

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Order ASAP to get in shape, you will need several months of rehabilitation. To strengthen the muscles and ligaments, as well as for proper fixation, the doctor will prescribe an elastic bandage. When some time will pass and the hand will need to develop, for this there are special exercises.

The rehabilitation process

Recovery from injury takes place in several stages.

Step 1 — duration 3 weeks

You need to start to do exercises to strengthen the muscles of the shoulder girdle. The range of motion small, painless. Permissible load on the shoulder joint should not cause pain.

Original position when performing this exercise must include a support shoulder. Execute a circular motion of the shoulder area. You should not implement combined movements of the limb, as they can lead to re-injury.

The movement is done only when there is no pain. Continue to wear elastic bandage to support the upper limb.
Apply something cold (ice, for example) after exercise, if there is puffiness or swelling.

Strengthening of the shoulder girdle — the period up to 3 months

Based on active exercises to restore muscle function of the flexors of the shoulder, adduction of the humerus. Here you can start to try push UPS from an elevated position (e.g. from a chair or the wall).

Do not rush to restore full range of motion.

Return to sport — from 5 months to a year

Uses dumbbells or other weights. They need to strengthen the periarticular muscles of the shoulder joint.

Start to perform movements specific to your sport: shots (e.g., goals), tremors.

The load must be gradually increased while controlling technique of exercise. After you enter the complex coordinated exercises. Avoid stretching of the joint capsule, jerks.

Take care of yourself and your health!