5. PRIMARY SURVEY MNRH
• A : Able to talk, not tender along c-spine area
• B : Clear both lungs, Equal breath sound, CCT negative, O2 sat 100 %
• C : BP 155/100mmHg,pulse rate 106 bpm, no active bleeding
• D : E4V5M6, pupils 3 mm RTLBE ,motor power grade 5 all extremities
• E : Ecchymosis at left clavicle, swelling at left shoulder, limit ROM of left
due to pain, no external bleeding
6. SECONDARY SURVEY
• A : no history of drug or food allergy
• M : no current medication
• P : no underlying disease
• L : 18.00 pm.
• E : motorcycle accident with blunt chest injury
7. PHYSICAL EXAMINATION
• Head and maxillofacial : no wound
• Cervical spine and neck : C-spine not tender
• Chest : CCT negative, Clear and Equal breath sound both lungs
• Abdomen and pelvis : soft, not tender, no guarding
• Musculoskeletal : Ecchymosis at left clavicle, swelling at left shoulder, limit ROM of
left shoulder due to pain, stepping at left clavicle.
• Neurological : E4V5M6, pupils 3 mm RTLBE, grade V all extremities
14. CLINICAL PRESENTATION
• The patient has pain over the fracture site, and the affected extremity
is held close to the body.
• The head is often tilted toward the injured side in an attempt to relax
the effects of these displacing muscular forces.
• Ecchymosis, crepitus, and a palpable or visible deformity may be
noted over the fracture site.
29. SUMMARY OF TREATMENT
• Non-operative treatment
• Group I : non- displaced
• Group II : stable type
• Group III : anterior displacement
• Gentle ROM exercises at 2-4 weeks
32. POSTOPERATIVE REHABILITATION
• On sling for 7-10 days folowed by active motion
• Strengthening at 6 weeks when pain free motion
• Full activity includeing sports at 3 mounths