临床本科上肢骨与关节损伤.ppt

Upper limb trauma of bone joint Li Shao-bo Department of Orthopaedic Surgery Faculty of Clinical Medicine, Dali University Fractures of the clavicle Anatomy The clavicle is located superficially the only bony articulation of the upper limb to the thorax Fractures of the clavicle Anatomy Medially, the clavicle is joined to the thorax via the sternoclavicular joint Laterally, the clavicle attaches to the scapula by the acromioclavicular joint Etiopathogenisis classification 1、indirect violence adult－－short-oblique fracture Child－－greenstick fracture common location is its middle third 2、direct violence uncommon comminuted fracture Mechanism of injury Indirect force through a fall on the lateral shoulder or on an outstretched hand. A direct blow to the subcutaneous clavicle is also a common mechanism for a clavicle fracture. Displacement Proximal----upward backward Distal ----downward, forward inward clinical finding swelling, pain tenderness cannot mobility common pose Roentgenographic findings A standard anteroposterior view of the clavicle usually confirms the diagnosis of a fracture. The amount of comminution and overriding of fracture fragments should be noted. Diagnosis The diagnosis is confirmed by a history of injury with pain localizing to the clavicle. Often, an obvious deformity is evident. Roentgenographic findings are important evidences. Treatment Most fracture medial to the coraoclavicular ligerments are treated by nonoperative methods. Treatment Nondisplaced or minimally displaced fracture are easily treated with a sling-and-swathe bandage for comfort. Treatment Nondisplaced or minimally displaced fracture are easily treated with a sling-and-swathe bandage for comfort. Treatment Displaced fracture, or those with significant cosmetic disruption, may be treated with a commercially available figure-of-8 strap to maintain the sho