Nội dung text Ortho Trauma UL
UPPER LIMB FRACTURE & DISLOCATION CLAVICLE # ANATOMY - Type: Long bone, horizontal, no medullary cavity, Convex medially & concave laterally - Medial→ Manubrium, Lateral→ Acromion of scapula - Weakest point= junction of the outer and middle third (thinnest part of the bone + not protected/reinforce with muscle & ligament attachment IMPORTANT RELATION Posterior surface capsule and sternohyoid, subclavian vessels, lateral cord of brachial plexus, nutrient artery from suprascapular, trapezius occipital fibers. Anterior surface pectoralis major, deltoid. Cephalic vein lies in between the two muscles. Supraclavicular nerve Upper surface base of posterior triangle. Sternocleidomastoid and trapezius with the two layers of cervical fascia Lower surface costoclavicular ligament, subclavius muscle and clavipectoral fascia, conoid ligament, trapezoid ligament Preval ence -Adults→ common(2.4 % - 4 % of fractures) & approx 35% of all shoulder girdle injuries. (Apley) -Children→ clavicle fractures easily, but it almost invariably unites rapidly & without complications. MOI mechanism of injury 1. Direct impact - Fall on the shoulder 2. FOOSH (Fall on the outstretched hand) anything similar Type ● Midshaft #→ lateral fragments pulled down by the weight of the arm & the inner, medial half is held up by the sternocleidomastoid muscle. ○ Medial costoclavicular ligament and lateral coracoclavicular Iman, Izzaty, Nisa, Lissa (3/3/21) Forti