The most wide spread traumas of shoulder and thoracic girdle

Clavicle fracture

This trauma usually occurs in falling to the shoulder and thoracic girdle. The majority of mid and thoracic thirds fractures are treated by immobilization with Delbe’s rings or figure-of-eight [cross] bandage. The fracture of the clavicle’s acromial edge dependently on fragments position usually needs an operative treatment. Octeosynthesis with pins, rods, cerclage or plate with screws is performed. If there is an intermediate fragment crosswise the clavicle’s axe threatening with the damage of vessels or nerves, an operative treatment should be carried out.

Clavicle displacement

The clavicle is usually displaced in clavicle-and-acromial or sternocleideal joints damage. The most common in medical practice are sternocleideal joint traumas manifesting in shoulder deformation, “key symptom” and thoracic girdle edema and function violation. Complete damage of sternocleideal joint is treated operatively and partial one – conservatively (immobilization with a bandage is used).

Shoulder bone fracture

The shoulder fractures tend to displace due to a mass of muscles joining to the bone. In shoulder’s neck fracture the proximal fragment is usually abducted laterally due to deltoid and supraspinous muscles. Fractures located lower the place of m. pectoralis major junction the upper fragment is adducted medially and forward. The shoulder bone fracture has very high prognosis of reparation because of significant blood supply and may be treated conservatively on the assumption of proper position of fragments.

In case when it is impossible to make closed reposition of fragments and in cases of soft tissues interposition when there are muscles, fascias and neurovascular fascicles between fragments, the operative intervention is performed. One of shoulder trauma complications is the radial nerve damage; in its complete damage revision and osteosynthesis are carried out.