The symptoms of dislocation of the clavicle
To diagnose a dislocated clavicle you need to know its definition. Collarbone - one of the bones of the shoulder girdle, having a curved shape. Collarbone performs in the human skeleton a number of functions:
- a reference for the shoulders and hands;
- protective to cover the space between the neck and the hand, where a number of veins and arteries;
- conductive mechanical impulses from the hand to the spine.
But its main function is to provide movement of the hand. At the same time, due to the presence of a relatively large load on it, the specifics of its location and ease of building, the collarbone is one of the most traumatic of bones in our body.
The types of dislocations of the clavicle
One type of injury the clavicle is dislocated. It is of two types:
- Dislocation of acromial end of clavicle (attached to the scapula).
- Dislocation of the sternal end of the clavicle (attached to sternum).
The cause of such injury is mostly an indirect mechanical pressure: a drop of the shoulder on outstretched arm, on the upper part of the body. Sometimes trauma occurs and with a sharp motion with his hand. But such arbitrary dislocation always accompanies any injury to the clavicle, previously obtained.
Dislocation of the acromioclavicular joint
The outer end of the clavicle with a pair of cords connected to the blade. During the examination of this injury is noted, the damage these two ligaments or just one. The doctors determine the injury or as a complete dislocation (with damage to two ligaments, a subluxation (when damage to one ligament).
Symptoms and causes
The main symptoms of acromioclavicular dislocation can be called pain at the junction of the clavicle and scapula, as well as painful sensation when moving the shoulder or arm.
In addition, it becomes virtually impossible to raise my hand up or to the side. You may also see slight edema and form a bruise. The deformation position of the clavicle: acromial end sticks up and back a little.
A characteristic symptom is the so-called “symptom keys: when pressed on the protruding portion of it falls into place, and then lifted upward. However, often this symptom can be impossible to determine, as clicking on the acromial end of the clavicle causes the victim severe pain.
People who are overweight, the clavicle may be palpable bad that also creates a problem in the diagnosis of the nature of the injury. The degree of bulging of the injured clavicle up depends entirely on the nature of the damage. At full dislocation of the injured both ligaments: the coracoid-clavicular andthe acromioclavicular.
With partial dislocation, called subluxation, affect only the acromial ligament and coracoid remains intact. In this case, the lifting of the clavicle, usually only slightly. If you pull the patient's arm down when the subluxation of the acromion, the clavicle will go down after the shoulder.
At full dislocation, pulling down the arm of the patient, it practically remains in place, visually even more bulging. Therefore non-specialists often confuse full-acromial dislocation of the clavicle with dislocation of the shoulder. But to distinguish these two different injuries is quite simple:
- When the acromial dislocation of the clavicle often there is swelling and deformity of the shoulder end of the clavicle. In dislocation of the shoulder swelling happens very rarely.
- When shoulder dislocation in a patient the feeling that his shoulder is out of place, and the arm movement causes a sharp pain. With dislocation of clavicle pain is moderate.
However, the most reliable method of diagnosis of dislocation is an x-ray of the injured bone.
Dislocation of the sternal-key joint
This type of sprain can be confused with other injury is very difficult. Sternal dislocation is less common than acromion. It is partnerwinner, netgroupenum and chest.
Pridneprovsky the most common of them. Symptom is protrusion of the inner end of the clavicle forward. When netgroupenum clavicle comes forward and somewhat up.
In chest sternal end of the clavicle as if drops in the sternum. This type of dislocation is often observed the color change of the skin due to the fact that the clavicle touches the vessels. Retrosternal dislocation in this context is considered to be the most dangerous doctors. To distinguish a dislocation from a fracture, it is possible that a broken collarbone is basically shifted forward and down.
First aid and treatment
In the case of suspected dislocation of the clavicle is necessary to suspend a hand with any of bandage hung from the neck. Armpit, you must put the rolled cushion fabric (suitable clothing, hat, etc.).
To reduce swelling to the site of injury, it is desirable to apply cold object. After that, the victim needs to get to nearest medical facility (emergency room, clinic, ambulance). Give him pain medication until the medical examination should not - this will make it difficult to establish the nature of the injury.
The exception might be if the victim is very susceptible to pain. You cannot attempt to reducecollarbone - this can only aggravate the injury, which will create additional problems during further treatment.
Treatment of dislocation of the clavicle is both conservative and operational, depending on the type and severity of injury. The main problem here is that insert on the clavicle is fairly easy, but to hold it can be very difficult. Often one of the conservative methods is sufficient for the treatment. But if conservative treatment does not give results, then comes to the aid of surgical intervention.
What are bandage
The most common method of conservative treatment of acromioclavicular dislocation is a bandage, Volkovych. To start the injured place and help reduce a dislocated bone. Then the arm is placed a roller, and the dislocated end - tight cotton-gauze pillow (called a pelota), which is fixed with plaster. For these purposes, use a bandage Desault.In the armpit the same way placed the roller, and then fixed with a tie to the neck hand to the body from shoulder joint to the elbow.
During the course of conservative treatment to the injured clavicle is recommended to apply cold to relieve swelling and pain. If the pain still persists, your doctor may prescribe analgesics to the patient.
However, despite the effectiveness of soft dressings, the best method of treatment is considered to be gypsum. In this case, you use the same application technique as for bandage Desault. The view imposed by the bandage, as the timing of wearing it, is entirely determined by the attending physician.
The average duration of treatment is from one to two months. While inpatient treatment is not necessary.
Surgical intervention and treatment
Surgical intervention in a case of dislocation of the clavicle is performed only when conservative methods failed. With the help of the operation is fixing the bones with the spokes, screws or buttons. The use of needles is the easiest and cheapest way. But at the same time he is the least successful.
When using this method, the probability of re-dislocation in the future. Fixing the clavicle with screws significantly reduces the risk of recurrence of dislocation. However, such rigid fixation of the bone in the future is the cause of reduced mobility of the hands. Fixing “buttons” allows for the greatest degree to restore limb function, however, when applying this method, all the same, the probability of recurrent dislocation. The most acceptable from the point of view of efficiency is a plastic tendons, when the injured ligament is replaced withartificial.
Rehabilitation after injuries and conclusion
Rehabilitation includes the following procedures: physical exercises for the development of the limb, massage, moxibustion UHF.
Rehabilitation takes place under the supervision of the attending specialist is selected for each individual case separately.
Take into account the nature of the injury and the physical condition of the patient.
The main thing is to recognize the nature of the injury and to determine exactly what is dislocation of the clavicle with ligament rupture. When injured you should immediately seek medical care, otherwise it may lead to problems related to the physiological functions of the hands.