SlideShare a Scribd company logo
1 of 72
FRACTURES  OF THE CLAVICLE  Le Kim Trong MD., Le Nghi Thanh Nhan MD.
General Information ,[object Object],[object Object],[object Object],[object Object],[object Object]
Current Debate in Treatment ,[object Object]
Ossification ,[object Object],[object Object],[object Object],[object Object]
Anatomy ,[object Object],[object Object],[object Object],[object Object]
Anatomy Left Clavicle:  Superior & Inferior Views Middle Third Weak to axial load Medial Third Protects brachial plexus, subclavian vessels, & superior lung Convex ventral on medial half Concave ventral on lateral half
Anatomy Weakest region of bone
Anatomy Subcutaneous along entire length  Supraclavicular nerves are only structures to cross anterior to clavicle Scapula and clavicle bound securely by the AC & CC ligaments Main nutrient artery enters just medial to CC ligaments
Clavicle Function ,[object Object],[object Object],[object Object],[object Object],Facilitates the placement of the shoulder in a more lateral position, so the hand can be more effectively positioned to deal with a 3-D environment
[object Object],[object Object],[object Object],[object Object]
Mechanism of Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
VI.Classifications & Treatments   Group I - Middle third  (80-85%) Nondisplaced ,[object Object],nonoperative        Displaced ,[object Object],[object Object],operative 
Group II - Lateral third (10-15%) Type I ,[object Object],[object Object],[object Object],nonoperation                       Type I Group II
Group II - Lateral third (10-15%) Type IIA ,[object Object],[object Object],[object Object],operative                      Type IIA G II
Group II - Lateral third (10-15%) Type IIB ,[object Object],[object Object],[object Object],operative         Type IIB G II
Group II - Lateral third (10-15%) Type III ,[object Object],[object Object],[object Object],nonoperative Type IV ,[object Object],[object Object],[object Object],[object Object],nonoperative Type V ,[object Object],[object Object],[object Object],operative
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classifications
Goals of Treatment ,[object Object],[object Object],[object Object]
Nonoperative Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Closed Reduction Techniques
Immobilisation
Researchs ,[object Object],[object Object]
Researchs   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Researchs ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Indications of operative treatment   (con.)     ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Researchs   ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Close treatment ,[object Object],[object Object],[object Object]
Plate fixation: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Researchs ,[object Object],[object Object],[object Object]
LC-DCP  ,[object Object],[object Object],[object Object],[object Object]
a) Reconstruction plate fixation at the top. b) DCP fixation at the anterior surface .
Researchs   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Researchs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intramedullary fixation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],Intramedullary fixation
McKeever intramedullary fixation of clavicle
Rockwood  intramedullary pin  of clavicle
Researchs ,[object Object],[object Object],[object Object]
Research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Research ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DISTAL CLAVICULAR FRACTURES The literature is more controversial for this fracture type than for the midclavicle
Undisplaced Lateral-End Fractures  (Neer Type I ) ,[object Object],[object Object],[object Object]
Displaced Lateral-End Fractures  (Neer Type II ) ,[object Object],[object Object],[object Object],[object Object],[object Object]
RESEARCHS ,[object Object],[object Object]
RESEARCHS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RESEARCHS ,[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],1. Direct fixation of the fracture site without coracoclavicular stabilization
RESEARCHS ,[object Object],[object Object],[object Object]
Researchs   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
The clavicular hook plate:     +The distal fragment is too small .    +The plate has an offset lateral hook, designed to engage distal to the posterior aspect of the acromion.   + Most surgeons advise routine plate removal at three months after implantation
[object Object],[object Object],[object Object],[object Object]
RESEARCHS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
2. Direct Fixation of the Fracture with Coracoclavicular Stabilization ,[object Object],[object Object],[object Object]
Clinical case
RESEARCHS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RESEARCHS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
3. Coracoclavicular Stabilization With or Without Excision of the Lateral Clavicular Segment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object]
TREATMENT ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

More Related Content

What's hot (20)

Patella fracture
Patella fracturePatella fracture
Patella fracture
 
Pelvic fractures classification and management
Pelvic fractures classification and managementPelvic fractures classification and management
Pelvic fractures classification and management
 
Galeazzi fracture dislocation
Galeazzi fracture  dislocationGaleazzi fracture  dislocation
Galeazzi fracture dislocation
 
Fracture of talus ppt
Fracture of talus pptFracture of talus ppt
Fracture of talus ppt
 
Subtrochanteric fractures
Subtrochanteric fracturesSubtrochanteric fractures
Subtrochanteric fractures
 
Hand injuries
Hand injuries Hand injuries
Hand injuries
 
Rotator cuff Tear and its management
Rotator cuff Tear and its managementRotator cuff Tear and its management
Rotator cuff Tear and its management
 
Distal femur fracture
Distal femur fractureDistal femur fracture
Distal femur fracture
 
Fractures and Dislocations of Upper Limb
Fractures and Dislocations of Upper LimbFractures and Dislocations of Upper Limb
Fractures and Dislocations of Upper Limb
 
Clavicle fractures
Clavicle fractures Clavicle fractures
Clavicle fractures
 
External fixator
External fixatorExternal fixator
External fixator
 
Pelvic fractures
Pelvic fracturesPelvic fractures
Pelvic fractures
 
Fractures of distal end radius
Fractures of distal end radiusFractures of distal end radius
Fractures of distal end radius
 
Neck of femur fractures
Neck  of femur fracturesNeck  of femur fractures
Neck of femur fractures
 
Elbow dislocations
Elbow dislocationsElbow dislocations
Elbow dislocations
 
Proximal humerus fractures
Proximal humerus fracturesProximal humerus fractures
Proximal humerus fractures
 
Elbow dislocations
Elbow dislocationsElbow dislocations
Elbow dislocations
 
Physeal injuries
Physeal injuriesPhyseal injuries
Physeal injuries
 
Proximal humerus fractures
Proximal humerus fracturesProximal humerus fractures
Proximal humerus fractures
 
39. tibial plafond (pilon) fractures
39. tibial plafond (pilon) fractures39. tibial plafond (pilon) fractures
39. tibial plafond (pilon) fractures
 

Similar to FRACTURES TREATMENT GUIDE

pinal cord injury.ppt
pinal cord injury.pptpinal cord injury.ppt
pinal cord injury.pptAsgraf
 
Fracture and dislocation of the shoulder girdle
Fracture and dislocation of the shoulder girdleFracture and dislocation of the shoulder girdle
Fracture and dislocation of the shoulder girdleomar ababneh
 
paediatric injuries around the elbow.
paediatric injuries around the elbow. paediatric injuries around the elbow.
paediatric injuries around the elbow. yashavardhan yashu
 
U01 clavicle ac_sc_joints1
U01 clavicle ac_sc_joints1U01 clavicle ac_sc_joints1
U01 clavicle ac_sc_joints1drthuraikumar
 
Ac dislocation
Ac dislocationAc dislocation
Ac dislocationsukesh a n
 
femoral neck and trochanteric fracture
femoral neck and trochanteric fracturefemoral neck and trochanteric fracture
femoral neck and trochanteric fractureSoM
 
clavicle fracture new -1.pptx
clavicle fracture new -1.pptxclavicle fracture new -1.pptx
clavicle fracture new -1.pptxNamanSharda2
 
Clavicle fractures&acromio clavicular joint injuries
Clavicle fractures&acromio clavicular joint injuriesClavicle fractures&acromio clavicular joint injuries
Clavicle fractures&acromio clavicular joint injuriesmadhavigopalrao
 
Proximal femoral fractures
Proximal femoral fracturesProximal femoral fractures
Proximal femoral fracturesDr Souvik Paul
 
Supra condylar humerus fracture in children
Supra condylar humerus fracture in childrenSupra condylar humerus fracture in children
Supra condylar humerus fracture in childrenSubodh Pathak
 
Intertrochentric femur fracture by DR.NAVEEN RATHOR
Intertrochentric femur fracture by DR.NAVEEN RATHORIntertrochentric femur fracture by DR.NAVEEN RATHOR
Intertrochentric femur fracture by DR.NAVEEN RATHORDR.Naveen Rathor
 
Shoulder Impingement Diagnosis And Rehabilitat
Shoulder Impingement Diagnosis And RehabilitatShoulder Impingement Diagnosis And Rehabilitat
Shoulder Impingement Diagnosis And Rehabilitatzagstdc
 
Injuries around the shoulder
Injuries around the shoulderInjuries around the shoulder
Injuries around the shoulderSiddhartha Sinha
 

Similar to FRACTURES TREATMENT GUIDE (20)

pinal cord injury.ppt
pinal cord injury.pptpinal cord injury.ppt
pinal cord injury.ppt
 
spinal cord injury
 spinal cord injury spinal cord injury
spinal cord injury
 
Fracture and dislocation of the shoulder girdle
Fracture and dislocation of the shoulder girdleFracture and dislocation of the shoulder girdle
Fracture and dislocation of the shoulder girdle
 
paediatric injuries around the elbow.
paediatric injuries around the elbow. paediatric injuries around the elbow.
paediatric injuries around the elbow.
 
Spinal injury
Spinal injurySpinal injury
Spinal injury
 
U01 clavicle ac_sc_joints1
U01 clavicle ac_sc_joints1U01 clavicle ac_sc_joints1
U01 clavicle ac_sc_joints1
 
Ac dislocation
Ac dislocationAc dislocation
Ac dislocation
 
femoral neck and trochanteric fracture
femoral neck and trochanteric fracturefemoral neck and trochanteric fracture
femoral neck and trochanteric fracture
 
FRACTURE.pptx
FRACTURE.pptxFRACTURE.pptx
FRACTURE.pptx
 
clavicle fracture new -1.pptx
clavicle fracture new -1.pptxclavicle fracture new -1.pptx
clavicle fracture new -1.pptx
 
Clavicle fracture
Clavicle fractureClavicle fracture
Clavicle fracture
 
Clavicle fractures&acromio clavicular joint injuries
Clavicle fractures&acromio clavicular joint injuriesClavicle fractures&acromio clavicular joint injuries
Clavicle fractures&acromio clavicular joint injuries
 
Proximal femoral fractures
Proximal femoral fracturesProximal femoral fractures
Proximal femoral fractures
 
Supra condylar humerus fracture in children
Supra condylar humerus fracture in childrenSupra condylar humerus fracture in children
Supra condylar humerus fracture in children
 
E.N.T 5th year, 2nd lecture/part one (Dr. Hiwa)
E.N.T 5th year, 2nd lecture/part one (Dr. Hiwa)E.N.T 5th year, 2nd lecture/part one (Dr. Hiwa)
E.N.T 5th year, 2nd lecture/part one (Dr. Hiwa)
 
Intertrochentric femur fracture by DR.NAVEEN RATHOR
Intertrochentric femur fracture by DR.NAVEEN RATHORIntertrochentric femur fracture by DR.NAVEEN RATHOR
Intertrochentric femur fracture by DR.NAVEEN RATHOR
 
Ariunaa spine trauma
Ariunaa spine traumaAriunaa spine trauma
Ariunaa spine trauma
 
Shoulder Impingement Diagnosis And Rehabilitat
Shoulder Impingement Diagnosis And RehabilitatShoulder Impingement Diagnosis And Rehabilitat
Shoulder Impingement Diagnosis And Rehabilitat
 
Injuries around the shoulder
Injuries around the shoulderInjuries around the shoulder
Injuries around the shoulder
 
Clavicle fracture
Clavicle fractureClavicle fracture
Clavicle fracture
 

More from lenhan68

Khoan giảm áp cổ xuơng đùi
Khoan giảm áp cổ xuơng đùiKhoan giảm áp cổ xuơng đùi
Khoan giảm áp cổ xuơng đùilenhan68
 
Ghep xuong mac vi phau
Ghep xuong mac vi phauGhep xuong mac vi phau
Ghep xuong mac vi phaulenhan68
 
KHÁM KHỚP
KHÁM KHỚPKHÁM KHỚP
KHÁM KHỚPlenhan68
 
Vat gian cot sau.pptx
Vat gian cot sau.pptxVat gian cot sau.pptx
Vat gian cot sau.pptxlenhan68
 
Gãy mắt cá chân
Gãy mắt cá chânGãy mắt cá chân
Gãy mắt cá chânlenhan68
 
Gay xuong ho
Gay xuong hoGay xuong ho
Gay xuong holenhan68
 
Tât dan hoi dung trong y khoa
Tât dan hoi dung trong y khoaTât dan hoi dung trong y khoa
Tât dan hoi dung trong y khoalenhan68
 
BÀN CHÂN ĐÁI THÁO ĐƯỜNG
BÀN CHÂN ĐÁI THÁO ĐƯỜNGBÀN CHÂN ĐÁI THÁO ĐƯỜNG
BÀN CHÂN ĐÁI THÁO ĐƯỜNGlenhan68
 

More from lenhan68 (9)

Khoan giảm áp cổ xuơng đùi
Khoan giảm áp cổ xuơng đùiKhoan giảm áp cổ xuơng đùi
Khoan giảm áp cổ xuơng đùi
 
Ghep xuong mac vi phau
Ghep xuong mac vi phauGhep xuong mac vi phau
Ghep xuong mac vi phau
 
KHÁM KHỚP
KHÁM KHỚPKHÁM KHỚP
KHÁM KHỚP
 
Vat gian cot sau.pptx
Vat gian cot sau.pptxVat gian cot sau.pptx
Vat gian cot sau.pptx
 
Gãy mắt cá chân
Gãy mắt cá chânGãy mắt cá chân
Gãy mắt cá chân
 
Gay xuong ho
Gay xuong hoGay xuong ho
Gay xuong ho
 
Tât dan hoi dung trong y khoa
Tât dan hoi dung trong y khoaTât dan hoi dung trong y khoa
Tât dan hoi dung trong y khoa
 
BÀN CHÂN ĐÁI THÁO ĐƯỜNG
BÀN CHÂN ĐÁI THÁO ĐƯỜNGBÀN CHÂN ĐÁI THÁO ĐƯỜNG
BÀN CHÂN ĐÁI THÁO ĐƯỜNG
 
Khoa
KhoaKhoa
Khoa
 

FRACTURES TREATMENT GUIDE