Diagnosis ɛn Tritmɛnt fɔ Klavikul Fraktrɔs

Sho

klavikul frakshכn na rεlatεvli kכmכn εn i kin kכmכt frכm dayrekt כ indayrekt trauma to di sכlda rijyכn. stכdi dεm we dεn du insay di εli 1960 dεm ripot se di nonunion rεt fכ klavikul frakshכn bin less dan 1%, εn kכnsyuv tritmεnt rεsult in hεy pasεnt satisfεkshכn; wit di divɛlɔpmɛnt we dɛn jɔs dɔn mek fɔ mɛrɛsin, ɔspitul tritmɛnt dɔn mek i wok fayn; so, di klinik pipul dɛm we de wok na di imejensi dipatmɛnt ɔ jenɛral ɔtpeshɛnt klinik fɔ no bɔt di kɔmɔn manifestɔ ɛn kɔmplikeshɔn dɛm fɔ dis injuri ɛn di bɛsis manejmɛnt fɔ am.

Epidemiɔlɔji we dɛn kɔl Epidemiology

klavikul frakshכn de mek 2.6%-5% pan כl di adכlt frakshכn dεm [1,2]. wan Yuropian stכdi we inklud 1,000 kכnsekyutiv klavikul frakshכn kes dεm fכn [3,4] se mכr dan 66% pan klavikul frakshכn de apin na di midul 1/3 pan di klavikul, lεk 25% na lateral 1/3 frakshכn, εn 3% na mεdial 1/3 frakshכn. di insidεns fכ klavikul frakshכn sho wan bimodal distribushכn, we de apin fכs pan man dεm we nכ rich 30 ia, dεn fכlכ di wan dεm we pas 70 ia.

Klinik Anatɔmi we dɛn kɔl

di fכs wan pan di mכtalman skel fכ bigin כsifikכshכn na di klavikul, di כnli bכni kכnεkshכn bitwin di כp an εn di trכnk, we de artikul distal wit di akromiכn, di akromioklavikul (AC) jכint, εn proksimal wit di stεnכm, di stεnoklavikul (SC) jכint. dεn kכl dεn joyn dεm ya atypical synovial joint biכs dεn layn wit fibrocartilage pas hyaline cartilage. di klavikul de ankכr to di skapula bay di akromioklavikul εn rostroklavikul ligament dεm εn i de atak di stεnכm bay di stεnoklavikul ligament.

Di klavikul gɛt 'S' shep. di proksimal haf-ak de projεkt antεriכri, we de lεf rum fכ di nyurovaskul bכndεl na di כp εkstrimiti. di distal haf pan di ak de projεkt bak (kכnkav) εn afta dat i de jכyn di skapula (rostral prכsεs εn acromion). frakshכn na di klavikul kin apin na di jכnkshכn fכ di tu ak dεm (mid-ak), i kin bi fכ di lכk fכ di ligament dεm we de atak di bon dεm we de nia na dis rijyכn εn biכs na di wik pat pan di klavikul. we di klavikul fraktכs dεn displεs, di proksimal sεgmεnt de kכlכsכl כltεm de pul כp (sεfalad) bay di stεrnokliidomastoid mכsul (we de atak di proksimal εnd fכ di klavikul) εn di distal sεgmεnt de displεs dכn (caudad) bay di wet fכ di כp an, εn di klavikul de tεnd fכ 'sכt' (dat na, di frakshכn εnd dεm de intasekt εvri wan), fכs fכ di kכntrikshכn fכ di sכbskapularis εn pεktoralis mεjכr (we insay de rכt di כp an). dis kin bi fכ di kכntrikshכn fכ di sכbskapularis εn pεktoralis mכsul dεm (we insay de rכt di כp an εn pul am tכwεd di chεst).

Tin dɛn

di gol fכ tritmεnt fכ klavikul frakshכn na fכ minimiz pen εn fכ mek di joyn dεm wok bak. כl di klavikul frakshכn dεm stil de trit fכs fכ kכnsyuv (dεn kin sכt dεm nכ pas 15 mm); kכnsyuv tritmεnt dεm lεk fכg-כf-εt bεndεj, fכ-am sling, Sayre bεndεj, Velpeau immobilizεshכn suit, εn imכbilizεshכn. sכspεns imכbilizεshכn dεn de du am na di akyu fεz, εn dεn kin du di εli rεnj fכ muvmεnt trenin εn trεnk εksεsayz dεm 2-6 wik afta di frakshכn we di pen sכlv. di yus fכ figa fכ 8 bεndεj dεm nכ rεkomεnd as i kin mek di aksila prεshכn sכr dεm εn mכr nכn-union fכ di frakshכn [5,6].

Istri ɛn Fyzikal Ɛgzamin

Klavikul fraktכs kin kכz bay dayrekt impak pan di sכlda afta i fכl εn dεn kin si am pan sכpכt dεm na do pan yכng pipul dεm εn we dεn fכl we dεn nכ no na di ol pipul dεm. I impɔtant fɔ difayn di we aw pɔsin kin wund. Injury wae gɛt ay ɛnaji kin kam togɛda wit injury wae gɛt ed ɛn chɛst, bɔt fraktrɔs wae kin kam wit smɔl trauma kin bi pathologic. distrakshכn injuri dεm nid fכ bigin kwik εn tek tεm kכl di skapula chεst wכl separeshכn, nyurolכjik εn vaskulεr injuri dεm. Klinik wan, swεla εn εkimosis de na di say we di frakshכn, we kכmbayn wit difכmiti εn tεndεns. yu fכ pe atεnshכn to di sכft tisu dεm fכ jack up, we kin mek di skin nεkrכsis εn כlsa.

Imajin

כl di frakshכn dεm kin bi bay simpul anteroposterior raydiograf. 20° ed tilt raydiograf dεm de εliminet di ifekt we di tכraks kεviti dεm we de כvalap de gi. Dɛn fɔ tek di sikman dɛn rediograf na di say we dɛn de sɔpɔt dɛnsɛf fɔ mek dɛn ebul fɔ si di fraktrɔs displeysmɛnt fayn fayn wan. weit-bεri fכ raydiograf de εp fכ ases di integriti fכ di rostral klavikul ligament insay distal klavikul כ akromioklavikulכr jכint injuri dεm.CT de εp fכ si kכmpleks skapul gεrd injuri dεm εn i de gi bεtε vishכnal fכ posεbul proksimal klavikul injuri dεm na di stεnoklavikul jכint. we yu tek chεst raydiograf i de εp fכ rכl כut wan asosiet tכraks injuri, εn dεn kin ases fכ sכt bay we dεn kכmpεr am wit di kכntralateral klavikul, εn bak fכ ruul כut skapulothoracic wכl separeshכn.

Di kayn dɛn we dɛn kin yuz

AO/OTA Frakshכn Dislכkeshכn Tayping: di klavikul frakshכn kכd 15 kכnsis fכ tri sayt dεm: 15.1 proksimal (mεdial), 15.2 dayafisis, εn 15.3 distal (lateral). di proksimal (mεdial) εn distal (lateral) frakshכn dεm dεn kכl dεm tכp A (εkstra-artikulכr), tayp B (patially intra-articular), εn tayp C (kכmplit intra-articular). di trכnk frakshכn dεn kכtכgayz dεm as tayp A (simpul), tayp B (wedge), εn tayp C (kכminet).Di AO/OTA klasifikasiכn fכ frakshכn εn dislכkeshכn nכ de tek in kכnt di digri we di frakshכn de displεs, εn naw dεn de yuz am sכmtεm fכ trit di klavikul frakshכn εn fכ no di prכgnosis.

כlman tayp de bays pan di lכkεshכn we di frakshכn de (I: mεdial, kεdεnt 1/3, II: lateral 1/3, III: mεdial 1/3) (Fig. 7.2.1).

Kreg bin rifin dis klasifikeshɔn bak pan di bies fɔ Ɔlman, wit mi we na di midul 1/3 pan di klavikul; tayp II na di כta 1/3 pan di klavikul, we dεn bin dכn divayd insay 5 tכp dεm bays pan frakshכn displεsmεnt εn rilayshכn to di rostral klavikul ligament; εn tayp III we na di frakshכn na di insay 1/3 pan di klavikul, we dεn divayd insay 5 tכp dεm bay di digri we di frakshכn displεsmεnt εn if di frakshכn na intra-atikul כ nכ.

di tayp we Neer de tayp di lateral 1/3 frakshכn dεm de εnfaz di imכpכtants fכ di rostral-klavikul ligament: tayp I de apin distal to di rostral-klavikul ligament, wit di mεdial frakshכn blכk we dεn displεs supεriכr; tayp II involv di rostral-klavikul ligament εn i de rizulta in di mεdial frakshכn blכk de displεs supεriכr; εn tayp III de εkstendi to di akromioklavikul jכint wit di rostral-klavikul ligament we de rεst intakt.

Edinburgh typing na wan sistεm fכ klas diaphysis frakshכn dεm akɔdin to di digri fכ displεsmεnt εn kכminushכn.1 Tayp 1 fraktכs involv di mεdial εnd, tayp 2 na dayafisis frakshכn εn tayp 3 na lateral εnd frakshכn. di frakshכn dεm na di dayafisis dεn kכl dεm akɔdin to di prεsεns כ absεns כf kכtikal kכntakt bitwin di frakshכn fragmεnt dεm insay tayp A εn B. dεn kכl di tayp 2A frakshכn dεm fכs as nondisplaced (tayp 2A1) εn angulεt (tayp 2A2),2B frakshכn dεm dεn klas dεm as simpul כ wedge-shεp (tayp 2B1) εn kכmminut (tayp 2B2).3 Tayp 1 frakshכn dεm involv di mεdial εnd fכ di dayafכs εn tayp 3 na di lateral εnd fכ di dayafisis. di mεdial εn lateral εnd frakshכn dεm dεn sheb dεm insay sכbgrup 1 εn 2 akɔdin to if di adjasent jכint de involv.

Semweso, Rɔkwɔd tayp, Jager tayp, ɛn Breitner tayp de.

Indikashɔn dɛn fɔ ɔpreshɔn

Speshal fraktrɔs dɛn

1, opin frakshɔn; 

2, displεsmεnt >2 cm; 

3, we de shɔt >2 cm; 

4, kominyushכn כf frakshכn fragmεnt dεm (>3); 

5, mכlti-segmεnt frakshכn; 

6, כndalayn opin frakshכn wit sכft tisu injuri; 

7, signifyant difכmiti (displεsmεnt εn sכtεn); 

8, skafɔyd injuri.

Kɔmpawnd injuri dɛn

1, Kɔmbayn ipsilateral ɔpa ekstrimiti injuri;

2, Injuri we de na di sholda we de flɔt;

3, bɔku bɔku injuri dɛn;

4, frakshכn we kכmbayn wit nyurovaskul injuri;

5, ipsilateral mכltipכl rib frakshכn dεm we kכmbayn wit chεst wכl difכmiti;

6, di klavikul de sכt fכ mek wan sכlda we gεt wing;

7, Baylatarɛl klavikul fraktrɔs.

Tin dɛn we kin mek pɔsin peshɛnt

1, Di wan dɛn we gɛt bɔku bɔku injuri dɛn nid fɔ bia di wet we dɛn gɛt kwik kwik wan;

2, Pesin dεm we nid fכ kam bak kwik kwik wan to fכnshכn (εgz., ilit εn kכmpitishכn sכpכt).

Di tɛm we dɛn fɔ du di ɔpreshɔn

Dɛn fɔ du ɔpreshɔn witout delay we absolyut indikashɔn fɔ ɔpreshɔn de.

if yu delay di כpεrayshכn pas 2-3 wiks insay rilitiv indikεshכn dεm kin inkrεs di difεlεns fכ rεdukshכn fכ frakshכn, spεshal wan we dεn de pripia fכ klos rεdukshכn intanεt fikseshכn bay pεrkyutan tεknik dεm.

Akses fɔ ɔpreshɔn

Dɛn kin put di pɔsin na di bich chia pozishɔn ɔ sɛmi-sidɔm pozishɔn. di sכlda we afekt dεn de pad am כnda fכ εlevεt di klavikul fכ mek i izi fכ כpεrayshכn, εn dεn de tawεl di an fכ alaw intra כpεraytiv mobilizεshכn. yu kin pik wan transvas insishכn along di lכng aks fכ di klavikul כ wan sab insishכn we paralel to di langer patεn.

Notis: we transvas insishכn de gi big εkstenshכn, we wan lכnjitudinal insishכn de ridyus di risk fכ supraklavikul nεv injuri εn i de mכr aesthetically pleasing.

Intanɛt Fikseshɔn

3.5 dεn kin yuz sistεmatik kכmpreshכn plet, rεkכnstrכkshכn plet, כ plastic LCP fכ fiks klavikul frakshכn. di plet dεm dεn kin put sכft wan oba כ bifo di klavikul. di plet dεm strכng pan bayomεkanikal injuri dεm we dεn put dεm supεriכr, spεshal wan if kכmכnik frakshכn de dכn, εn i simpul fכ si. baykɔtikal fikseshɔn fɔ di skru dɛn nid fɔ de, ɛn dɛn fɔ drɔ di ol dɛn wit big kia, bikɔs risk de fɔ injuri to di nɛv ɛn blɔd vesel dɛn we de dɔŋ. Advantej: sef drɔlin fɔ di antɛriɔr plet skru chanɛl, plet appɔzishɔn, izi kɔntɔrin.

Notis: Bɔku tɛm, dɛn nɔ kin nid fɔ graft bon fɔ di fɔs tin we dɛn kin du; afta intanεt fiksεshכn, i implεnt fכ sutura di myofascial layεr fayn fayn wan fכ kכba di plet εn fכ mek i nכ infεkshכn.

Fikseshɔn we de insay di mɛdula

di divays dεm we de fכ fiks di intramεdula naw inklud Kirschner pin dεm, Rכkwud pin dεm, Hagie pin dεm, taytaniכm εlastik intramεdula pin dεm, olo skru dεm, εn εlastik lכk intramεdul nel dεm; eg, taytaniכm εlastik nel dεm nכ de alaw fכ statik lכk, dεn nכ de alaw fכ kכntrכl di lεngth εn rotashכn, εn i kin rili rεsult in sεkכnd sכt we dεn yuz am fכ kכminit frakshכn. di intramedullary nailing tεknik kin כnli aplay to simpul, transvas כ oblique klavikul frakshכn.

Advantej dɛn we pɔsin kin gɛt

sכm sכm insishכn, mכr aesthεtik, lεs sכft tisu strip, lכw risk fכ εndofayt protrushכn, εn stεbiliti we kכnεkt wit skab fכmeshכn.

Di bad tin dɛn we kin apin

di skin iritashכn כ difεkt dεm na di pכynt we i de insay.

Notis:Klos ridyushɔn fɔ klavikul fraktrɔs kin at sɔmtɛm ɛn dɛn kin avɔyd fɔ ɔva ɛksplɔz di ɔpreshɔn in an to raytin we dɛn de du ɔpreshɔn.

Minimally invasive plet fikseshɔn

dεn tink se di minimal invasiv plet כstiosεntesis fכ di klavikul de gi big bayomεkanikal trεnk we i de avכyd di disavantej dεm we de fכ opin plet fikseshכn כ intramεdulari fikseshכn.

intraopεraytiv plesmεnt fכ di 3.5 sistεm LCP antεriכr to di klavikul, i bεtε fכ de bifo dεn dכn di klavikul, de alaw fכ rεfrεns to di hεlty klavikul, we de mek i izi fכ shep di plet bifo tεm εn fכ gεt lכng skru aperchכ.

di εli aplikεshכn fכ minimally invasive plet osteosynthesis kin bi fכ supraklavikulכr nεv injuri, pwεl alaynεmεnt כ sכtεn fכ pe waya dεm we de afekt fכnshכn, εn plet bεnd כ frakshכn.

plet fikseshכn fכ frakshכn dεm na di lateral εnd fכ di klavikul

di choice fכ di plet implant dεm dipכnt pan di sayz fכ di lateral bon blכk. 3 baykortikכl skru dεm nid fכ di lateral bon blכk. I fayn fɔ yuz tɛnsiɔn skru fɔ ɔblikɛt fraktrɔs. if di bon blכk tu sכm fכ fiks, dεn kin yuz klavikul huk plet.

Tritmεnt fכ akromioklavikulכr jכint dislכkeshכn

di akromioklavikul joyn injuri dεm de mek 12% pan di skapula gεrd injuri dεm εn i kin apin bכku tεm pan ful kכntakt atlet dεm.

Di stej sistɛm we dɛn kin yuz mɔ na di Rɔkwɔd stej. Tayp I na wan sprain na di akromioklavikul ligament wit di rostroklavikul ligament intakt; tayp II na we di akromioklavikul ligament de te wit di rostroklavikul ligament we intakt; tayp III na tεar fכ כl tu di akromioklavikul ligament εn di rostroklavikul ligament; tayp IV na di posita displεsmεnt fכ di distal klavikul we de impal di trapezius; tayp V na komplit tεar fכ כl tu di akromioklavikul jכint εn rostroklavikul ligament, wit mכr dan 100 pasεnt displεsmεnt fכ di jכint; εn tayp VI injuri dεm nכ kin bכku, wit di distal klavikul we dεn displεs dכn dכn dכn di rostral prכsεs.

Kɔnsɔvativ tritmɛnt wit shɔt tɛm brek wit kantil sling na in dɛn kin advays fɔ tayp I ɛn tayp II injuri. Di manejmɛnt fɔ tayp III injuri na tin we pipul dɛn kin agyu bɔt, wit sɔm buk dɛn we de sho se dɛn kin gi kɔnsavayv tritmɛnt fɔ yɔŋ pipul dɛn we de wok tranga wan. di fכnshכnal rεkכvεshכn gud pan כl we i kin bi difrεn digri dεm fכ difכmiti in apinεns. Tayp IV - VI injuri dεm na mכr siriכs εn dεn rεkomεnd fכ כpεrayshכn.

naw, di sכjεkshכn dεm we dεn kin yus na: Bosworth rostral lכk skru tεknik wit wan stej ripa כ nכ ripa di ligament;, klavikul huk plet fikseshכn, we sכm kayn we lεk di lateral εnd fכ klavikul frakshכn; Taytrop in tab plet fikseshɔn ɔ ankɔ pin sutura tru atrɔskɔp ɔ smɔl insayshɔn; εn rostral lכk ligament sutura כ rεinfכs sכspεns, wit atifishal mεtirial כ tεndon bitwin rostral εminεns εn di klavikul.

I nɔ klia us ɔspitul tɛknik go bɛnifit mɔ, ɛn pan ɔl we sɔm digri kin lɔs fɔ risurfacing, di las ɛfifikɛshɔn fɔ ɔl dɛn tɛknik ya kin satisfay.

Tritmεnt fכ di mεdial εnd klavikul frakshכn εn stεrnoklavikul jכint dislכkeshכn

Dɛn injury ya nɔr kin bɔku, ɛn bak dɛn nɔr kin gɛt tritmɛnt gaydlain wae de bays pan mɛrɛsin wae gɛt pruf.

di mεdial klavikul frakshכn kin bi εkstra-atikul frakshכn wit insignifikant displεsmεnt εn dεn kin trit am kכnsyuv wan. di epiphysis fכ di mεdial εnd fכ di klavikul kin kכloz we i ol 23-25 ​​ia εn na di las epiphysis we de kכloz insay di bכdi. fכ dat, plεnti mεdial injuri dεm na rili epiphyseal plet frakshכn dεm fכ Salter-Harris tayp I כ II. kכnvεshכnal εks-ray dεm at fכ no, wit di advantej se 40° ed tilt raydiograf εn kכmpεr to di hεlty sayd kin sho displεsmεnt fכ di mεdial εnd fכ di klavikul, εn CT de gi di bεst diagnostik imej.

frakshכn כ dislכkeshכn dεm we dεn displεs antεriכri kin kכlכs εn riposishכn, bכt bכku tεm dεn nכ stebul εn lobotomized fכ ri-displεs. Palliative care na rεkomεnd fכ persistent dislocation or displacement biכs bכku tεm dεn nכ kin rεsult in fכnshכnal impεryans. dislokeshכn fכ di mεdial εnd fכ di klavikul posita nכ kin rili rizulta in כp mεdiastinal injuri, inklud vaskulכr injuri כ ivin trakial obstrכkshכn εn aywe kכmpreshכn. fכ dislokeshכn εn frakshכn usay di mεdial fragmεnt tu sכm, dεn kin brij plet dεm kכros di jכint fכ fiks to di stεnכm.

Ɔda we dɛn fɔ fiks

fכ egzampl, εksternal fiksεshכn wit stent, εksternal fiksεshכn wit klavikul plet, εtk.

Manejmɛnt we dɛn kin du afta dɛn dɔn ɔpreshɔn

di כp an fכ nכ muv insay sling εn dεn fכ stat fכ tren di sכlda pεndulum wantεm wantεm. 2 wik afta dat, dɛn fɔ fala di pɔsin fɔ chɛk di wund ɛn rivyu di X-ray, we dɛn kin pul di fɔram sling ɛn bigin fɔ tren di jɔyn mobiliti we nɔ gɛt ɛnitin fɔ du wit am, bɔt dɛn fɔ tɛl di pɔsin se i nɔ fɔ es di wet wit di limb we afɛkt. trεnk trenin kin stat na 6 wik afta di כpεrayshכn we sayn dεm fכ di bon dεm we de hεl de sho. Kɔntakt spɔt ɔ ekstrim spɔt fɔ avɔyd fɔ 3 mɔnt afta di ɔpreshɔn te di fraktrɔs dɔn wɛl ɔl.

Di prɔblɛm dɛn we kin apin.

Kɔmplikɛshɔn dɛn we kin apin kwik kwik wan

di wund infεkshכn dεm we de afta di כpεrayshכn kin apin insay 4.8% pan di kes dεm;

nכmbnεs na di sabklavian rijyכn na di mכst kכmכn kכmplikεshכn, wit nεchכral histri stכdi fכ 83% pan di sik pipul dεm we gεt dis simptom, we de dכn ova tεm εn nכ de mek dεn nכ de wok fayn, pan כl we i kin de te 2 ia afta dεn dכn כpεrayshכn;

εndofayt protrushכn εn skin agitεshכn, kכmכn wit di yus fכ voluminous plet כ ​​nel tel we nכ gεt gud sכft tisu kכvεrej;

ri-frakshכn, we kin apin afta כl tu di כpεrayshכn εn kכnsyuv tritmεnt; di ri-injuri afta di sכjεkshכn kin rili mek di εndoprostεsis bεnd כ brok, כ frakshכn rawnd di εndoprostεsis;

nonunion, wit 15% nonunion rεt wit kכnsyuv tritmεnt εn 2% nonunion rεt wit sכjεk tritmεnt fכ komplit displεs diaphyseal frakshכn; komplit displεsmεnt fכ di frakshכn, sכt pas 2 cm, smok, inkrεs εj, hεy-εnεji injuri, ri-frakshכn (mεkanikal instεbiliti), rεkalsitrant dayaphyseal dislokeshכn, pwεl bon kwaliti, εn bon bon dεm we de lכs pasmak.

Di kɔmplikeshɔn dɛn we kin apin let

כstioarthritis fכ di akromioklavikul jכint de apin mכr wit intra-artikulכr frakshכn (Edinburgh tayp 3B2); we di tritmεnt we de sho di sik εn kכnsyuv nכ de wok, dεn kin rεsεkt di distal klavikul wit atroskopik כ bay opin כpεrayshכn;

difכmiti hilin, we de apin to difrεn digri dεm na כl di kכnsyuv trit displεs frakshכn dεm; di sכt we di skapula gεrd de kכmכn wit rotashכn fכ di distal frakshכn blכk kin rili mek di ultimate sכlda trεnk εn εndurance dכn, spεshal wan we di sכlda abdukshכn; di narrowing of di thoracic outlet kin rili mek di simptom dεm fכ di brachial plexus kכmpreshכn; εn di malalaynmεnt fכ di skapulothoracic wכl jכint kin mek di skapula tilt antεriכr εn prodyuz sכlda pen εn myalgias, if i klia se di simptom dεm na frכm difכmiti We di hεl de apin, כsteotomy kכrekshכn εn plet fiksεshכn de fεsibul dipכnt pan di sikman in nid.

Prognosis ɛn autkam

Wan stɔdi we gɛt fɔ du wit dis na Yurop bin ripɔt se ɔspitul tritmɛnt fɔ displaced midclavicular fractures bin wok fayn, ɛn in mɛta-analysis sho se di insidɛns fɔ malunion we de lid to fracture nonunion ɛn symptom-producing malunion bin rili smɔl na di ɔspitul grup pas di grup we dɛn trit kɔnsavayv we dɛn kɔmpia ɔpreshɔn wit kɔnsavayv tritmɛnt; apat frɔm dat, di ɔspitul grup bin dɔn ridyus di pen ali, ɛn di impruvmɛnt pan Kɔnstant ɛn DASH fɛnshɔnal skɔ bin mɔ pronɔns.

Sɔmari tɔk bɔt dis

Mɔs pan di klavikul fraktrɔs na bay dairekt ɔ indayrɛkt vaylɛns, ɛn dɛn kin kategoriz di tritmɛnt as kɔnsavayv ɔ ɔspitul tritmɛnt. We i kam pan tritmɛnt, pan ɔl we bɔku pan di klavikul fraktrɔs we nɔ gɛt signifyant displeysmɛnt kin trit kɔnsavayv wan, di ɔspitul tritmɛnt opshɔn fɔ fraktrɔs we gɛt signifyant displeysmɛnt na sɔntin we pipul dɛn kin agyu bɔt. fכ displεs klavikul frakshכn, כspitul tritmεnt gεt hכy rεt fכ bon hεl εn εli fכnshכnal autkam kכmpεr wit kכnsyuv tritmεnt.

Rifrɛns dɛn

[1] Postacchini F, Gumina S, De Santis P, Albo F. Epidemioloji fɔ klavikul fraktrɔs. J Sɔlda Ɛlbɔ Surg 2002; 11:452.

[2] Eiff, M. P., Hatch, ɛn ɔda pipul dɛn. Klavikul ɛn skapula fraktrɔs. In: Fraktrɔs Manejmɛnt fɔ Praymari Keya, 2nd ed, W. B. Saunders, Filadɛlfia 2002. p.198.

[3] Robinson C. M., ɛn ɔda pipul dɛn. Fraktrɔs na di klavikul na di big pɔsin. Epidemiology ɛn klasification. J Bon Jɔyn Surg Br 1998; 80:476.

[4] Neer CS 2nd, we de na di 2nd. Frakshכn dεm na di distal tכd pat pan di klavikul. Klin Ɔtɔp Rilat Rɛs 1968; 58:43.

[5] Andersen K, Jensen PO, Lauritzen J. Tritmɛnt fɔ klavikul fraktrɔs. Fig-ɔf-ɛit bandej versus wan simpul sling. Akta Ɔtɔp Skan 1987; 58:71.

[6] Ersen A, Atalar A. C., Birisik F, ɛn ɔda pipul dɛn. Kכmpεreshכn כf simpul arm sling εn fכg כf et klavikul bεndεj fכ midshaft klavikul frakshכn: wan randomizεd kכntrold stכdi. Bɔn Jɔyn J 2015; 97-B: 1562. Di wan dɛn we de stɔdi.