Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. A poorly fitting plate can cause soft tissue irritation and possibly skin erosion at the site of implant. Unlike other long bones, however, it has an lntnamembranous origin. Progression criteria the patient may return to sport after receiving clearance from the orthopedic surgeon and rehabilitation. Fractured clavicle the student health provider has diagnosed a fracture break of your clavicle collarbone. A fall onto the lateral shoulder most frequently causes a clavicle fracture. It can occur due to a direct blow, such as from a sports injury or a car accident, or from an indirect injury, such as falling off of a bicycle. Anatomy, shoulder and upper limb, clavicle statpearls. However, recent wellconducted studies demonstrate that plate fixation of displaced midshaft clavicle fractures may result in improved functional outcome and a lower rate of malunion and nonunion, compared. Characteristics of synovial joints articular end plate a thin layer of compact bone over the spongy bone covering the ends of the bones articular hyaline cartilage for shock.
The acromioclavicular ac joint is where the clavicle meets the acromion. It has a softer trabecular tissue inside with a hard shell of compact bone. Clavicle human collarbone anatomy, parts, location and. At each point, the distance and angular position between the clavicle and each subclavian vessel were measured. Clavicle fractures are usually treated conservatively. Observations on the function of the claviclet ncbi. Historically, only unstable distal clavicle fractures were treated operatively. Explore and learn about the clavicle with our 3d interactive anatomy atlas. Abigail hamilton, md a broken collarbone is also known as a clavicle fracture. This type of fracture is fairly commonaccounting for about 5 percent of all adult fractures. Anatomy, shoulder and upper limb, clavicle statpearls ncbi. Original research article anatomy of the clavicle and its.
The clavicle is a sigmoidshaped long bone with a convex surface along. However, recent wellconducted studies demonstrate that plate fixation of displaced midshaft clavicle fractures may result in improved functional outcome and a lower rate of malunion and. Emergency ie, immediate referral is required for open fractures, neurovascular compromise, and tenting of the skin skin stretched tautly over a displaced fracture. Clinical anatomy is the official journal of the american association of clinical anatomists and the british association of clinical anatomists. Mckee md and the canadian orthopaedic trauma society. The clavicle is an sshaped bone, anteriorly concave laterally and anteriorly convex medially. The mean distance of the subclavian artery was greater. The major area of danger in our study is the medial clavicle with distance being less than 1 centimeter over the entire medial half of the clavicle on both right and left. Anatomy the collarbone clavicle is located between the ribcage sternum and the shoulder blade scapula, and it connects the arm to the body. From the division of orthopedic surgery and anatomy. An orthopaedics textbook presented by duke university medical centers division of orthopaedic surgery, in conjunction with data trace internet publishing, llc, is a true head to toe, comprehensive discussion of orthopaedic topics. Anyone seeking specific orthopaedic advice or assistance.
Dec 03, 2015 after completion of this video session, it is expected that you will be able to. Decompression and distal clavicle excision the shoulder is made up of three bones. Original communication the anatomy of the clavicle. It discusses assessment thoroughly and comprehensively, going through all special tests youll ever need to know with pictures or. Orthophyexammagee pdf be the first to ask a question about orthopedic physical assessment.
The clavicle acts as a strut for the shoulder complex, connecting the scapula to the axial skeleton. A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder. Understanding anatomy to avoid complications in clavicle. Falling on an outstretched arm may also result in a clavicle fracture. These processes disrupt the normal anatomy and functional biomechanics of the ac joint. It serves as a connection between the axial and appendicular skeleton in conjunction with the scapula, and each of these structures forms the pectoral girdle. The clavicle is actually a long bone of the body although it is short in length.
Clavicle fracture broken collarbone shoulder doctors. Clavicle fracture broken collarbone orthoinfo aaos. Functional outcomes of conservatively treated clavicle. The rotator cuff keeps the humeral head ball inside the glenoid cavity socket during shoulder motion while also providing muscular. Its a break of the bone that rests between the shoulder blade and the sternum.
Jan 18, 2012 clavicle fractures are very common injuries in adults 25% and children 1015% and represent the 4466% of all shoulder fractures. This is a very common fracture that occurs in people of all ages. The emphasis of this article is on the management of these injuries. This video is the first in the osteology for viva series. A multicentre randomized controlled trial of nonoperative versus operative treatment of displaced clavicle shaft fractures. Faaos, carolyn taliaferro blauvelt, in a manual of orthopaedic terminology. Pdf the clavicle is a sigmoidshaped long bone with a convex surface. Clavicle fracture broken collarbone top washington d. Types of joints synovial diarthroidal freely movable cartilagenous amphiarthroidal slightly movable fibrous synarthroidal immovable.
Lean forward at the waist, letting your arm hang freely. Pdf anatomy, shoulder and upper limb, clavicle researchgate. Throughout my career as an orthopaedic trauma surgeon, i have encountered. Apr 12, 2020 the clavicle is an elongated, sshaped bone that rests horizontally at the sternum across the upper part of the ribcage, and the acromial end of the scapula this bone is an important part of the skeletal system since it plays an essential role in everyday functional movement, serving as the connection between the axial skeleton and the pectoral girdle. Preferences of orthopedic surgeons for treating midshaft clavicle. Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on the bone that it snaps or breaks. An isolated orthopaedic injury is sustained to the upper extremity with no compromise of skin integrity or neurovascular function. Alright, now in this part of the article, you will be able to access the free pdf download of textbook of orthopedics and trauma 4 volumes 3rd edition pdf using our direct links mentioned at the end of this article. The sterno clavicular sc joint supports the connection of the arms and shoulders to the main skeleton on the front of the chest. Most clavicle fractures can be treated by wearing a sling to keep the arm and shoulder from moving while the bone heals. Rehabilitation guidelines for shoulder debridement. The treatment of midshaft clavicle fractures in latin america is in accordance with the current literature. The clavicle is an elongated, sshaped bone that rests horizontally at the sternum across the upper part of the ribcage, and the acromial end of the scapula this bone is an important part of the skeletal system since it plays an essential role in everyday functional movement, serving as the connection between the axial skeleton and the pectoral girdle.
Clavicle fractures matthew pecci, md, and jeffrey b. The clavicle, or collarbone, is an important part of your shoulder structure, providing stability to the shoulder joint. Malunion of the clavicle is a distinct clinical entity with characteristic orthopaedic weakness, easy fatigueability, scapular winging, neurologic thoracic outlet syndrome and cosmetic droopy, asymmetric shoulder, difficulty with backpacks, shoulder straps etc. This article explains some of the common causes of shoulder pain and describes some general treatment options. The inner end of the clavicle joins the sternum breastbone.
Clavicle fractures are very common injuries in adults 25% and children 1015% 1 and represent the 4466% of all shoulder fractures 2. The anatomy of the clavicle and its in vivo relationship to. Original research article anatomy of the clavicle and its applicability in management of clavicular fractures manjunath cs 1, tejaswi hiremarali lokanathan 2. The goal of clinical anatomy is to provide a medium for the exchange of current information between anatomists and clinicians. The anatomy of the clavicle and its in vivo relationship. Also known as a broken collarbone, a fracture of the clavicle is usually the result of an. Clavicle fracture introduction clavicle fractures are a common orthopedic injury, particularly among infants and young children. The clavicle is an elongated, sshaped bone that rests horizontally at the sternum across the upper part of the ribcage, and the acromial end of the scapula. An isolated traumatic medial third clavicular fracture. The clavicle is a sigmoidshaped long bone with a convex surface along its medial end when observed from cephalad position. The clavicle overlies the brachial plexus, as well as the jugular and subclavian blood vessels. Clavicle fracture broken collarbone shoulder doctors in. Since its introduction, surgeons have utilized the acumed locking clavicle plate system to solve many complex injuries of the midshaft and distal clavicle.
Shoulder pain and common shoulder problems orthoinfo aaos. Orthopedic arix clavicle system jeil medical corporation pdf. Distal clavicle excision understanding shoulder anatomy the shoulder is a large ball and socket joint. Immobilized at all times day and night off for hygiene and gentle exercise only 04 weeks.
Kreher, md, boston university, boston, massachusetts c lavicle fractures constitute 5 patient information. Because so many structures make up the shoulder, it is vulnerable to many different problems and injuries. A 36yearold male fell while skiing and sustained a rightsided displaced comminuted midshaft clavicle fracture. Fractures of the clavicle orthopaedic trauma association. Clavicle has been found thicker and more curved in manual workers 10, 11. Helfet at the hss orthopedic trauma service with ecchymosis and bruising near the fracture site and paresthesia in his right hand appearing to originate in. Clavicle orif 1 6 7 9 17 21 25 prom the intent of this protocol is to provide guidelines for progression of rehab. The head of your upper arm bone fits into a rounded socket in your shoulder blade.
Clavicle injuries can be grossly divided into three distinct anatomical sites. Orthopaedic surgery fractures joint replacement sports medicine clavicle fracture orif protocol dr. Original research article anatomy of the clavicle and. It can be divided into a sternal end, a shaft and an acromial end. The majority of clavicle fractures can heal without surgery. Anatomy of the shoulder joint three bones, the collarbone clavicle, the shoulder blade scapula, and the upper arm bone humerus come together to form the shoulder in addition to its structural function, the clavicle protects major underlying ner ves and blood v essels as they pass from the neck to the axilla. Indications for orthopedic referral there are a number of indications for orthopedic referral of midshaft clavicle fractures that vary in urgency. This article will focus on the specific techniques of evaluation necessary to differentiate symptoms referable to the ac joint from those related to pathologic changes in other areas of the shoulder girdle, as well.
Alteration in this linkage may lead to abnormalities in the static or dynamic position of the scapula 4. Understanding anatomy to avoid complications in clavicle fractures. Variability in anatomical features of human clavicle. This information, together with the automated system, can be applied to future clavicle populations and to the design of fixation plates for clavicle fractures. The clavicle contributes to the anterior and superior aspect of the glenohumeral articulation. Although it is a long bone, the clavicle lacks an internal cavity medullary cavity where bone marrow would be housed in most long bones.
Broken collarbones occur in babies usually during birth, children and adolescents because the clavicle does not completely ossify, or develop, until the late teens, and athletes because of the risks of being hit or falling and during many types of accidents and falls. Here we have discussed the osteology pearls for clavicle, its parts, muscle and ligaments attachments, the fracture classification and. Seventy clavicle fractures were nonsurgically treated in the orthopedics department at the tuanku jaafar general hospital, a tertiary care hospital in seremban, malaysia, an average of six months after injury. Understanding the subacromial decompression and distal. It is by no means intended to serve as a substitute for clinical decision making.
The anatomy of the clavicle and its in vivo relationship to the vascular structures a 2d and 3d reconstructive study using ct scans steinmetz, garrett md. Clavicle anatomy made easy animated attachments side. League baseball team orthopedic surgeons resulted in 72% 2028. There are two clavicles, one on the left and one on the right. A patients guide to shoulder anatomy compliments of. We help you diagnose your clavicle case and provide detailed descriptions of how to manage this and hundreds of other pathologies. Each clavicle was divided along its length into specific points of measurement. In terms of their more complex anatomy, clavicles can be long and slender, thick. A clavicle fracture is also known as a broken collarbone. After completion of this video session, it is expected that you will be able to. A clavicle fracture, or broken collarbone, is a very common type of fracture. Progression through each phase of rehab is based on. Despite the high frequency the choice of proper treatment is still a challenge for the orthopedic surgeon. The subclavian vein is the vascular structure at highest risk during clavicle fracture fixation.
In this article, we shall look at the anatomy of the clavicle its bony landmarks and clinical correlations. Explain why the clavicle commonly fractures between the middle and lateral. Alright, now in this part of the article, you will be able to access the free pdf download of textbook of orthopedics and trauma 4 volumes 3rd edition pdf using our. The deforming forces these muscles can produce on clavicular fracture must be considered.
If you continue browsing the site, you agree to the use of cookies on this website. Dec 17, 2018 pdf the clavicle is a sigmoidshaped long bone with a convex surface along its medial end when observed from cephalad position. Clavicle fracture broken collarbone a broken collarbone is also known as a clavicle fracture. The clavicle, or collarbone, is a long bone that serves as a strut between the shoulder blade and the sternum breastbone. The clavicle fractures were treated conservatively with an arm sling and a figureeight splint for three weeks. Together with the shoulder blade, it makes up the shoulder girdle. A threedimensional cadaveric study amit bernat,1 toon huysmans,2 francis van glabbeek,1 jan sijbers,2 jan gielen,3 and alexander van tongel4 1department of orthopedic surgery and traumatology, university hospital of antwerp, antwerp, belgium 2imindsvision lab, department of physics, university of antwerp, antwerp. Figure 3 rotator cuff anatomy image property of primal pictures, ltd. Pain and tenderness directly over the collarbone are the most common symptoms of a clavicle fracture.
Textbook of orthopedics and trauma 4 volumes 3rd edition pdf free download. Manjunath cs, assistant professor, department of anatomy, hassan institute of medical sciences, sri chamarajendra hospital campus, hassan. Clavicle fracture rehabilitation protocol range of motion immobilizer exercises phase i 06 weeks 04 weeks. The clavicle see diagram is a long, thin bone located in the upper, front chest. Clavicle fractures most commonly occur from a direct contact injury, such as a fall while landing on the shoulder or a motor vehicle accident. Sean griffin weeks full time in sling avoid ir behind the back, lifting more than 12 lbs, and horizontal adduction. Both ends grow, but generally one end will grow faster than the other. For these more complicated fractures, surgery may be needed to realign the collarbone. A threedimensional cadaveric study amit bernat,1 toon huysmans,2 francis van glabbeek,1 jan sijbers,2 jan gielen,3 and alexander van tongel4 1department of orthopedic surgery and traumatology, university hospital of antwerp, antwerp, belgium 2imindsvision lab, department of physics. The clavicle lies horizontally on the anterior aspect of the chest wall and articulates medially with the manubrium sterni and laterally with the acromion of the. The clavicle is the only long bone in the body that lies horizontally. Long bones grow from the epiphyseal plate growth plate at each end. This journal embraces anatomy in all its aspects as applied to medical practice.
Trauma is the most common cause of a clavicle fracture. A patient s guide to shoulder anatomy central orthopedic group. Precontoured clavicle plates a precontoured clavicle plate is a plating system that is anatomically precontoured which assists in restoring the original. Facing forward, the medial aspect is convex, and the lateral aspect concave. Textbook of orthopedics and trauma 4 volumes 3rd edition. The clavicle, also referred to as the collarbone, is a long bone located at the top of the chest. Orthophyexammagee pdf orthophyexammagee pdf orthophyexammagee pdf download. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Dyskinesia can be a clinical sign of potentially harmful alteration of clavicle anatomy. Manjunath cs, assistant professor, department of anatomy, hassan institute of medical sciences, sri chamarajendra hospital campus, hassan 573201.
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