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Fracture clavicle.pptx
- 1. Pre-graduate Xray Dr. Ahmed Saleh Assistant Lecturer Orthopedic department
- 2. Bony Anatomy
- 3. Muscles
- 6. Types of clavicular fracture
- 7. Mechanism of injury • Fall onto lateral aspect of shoulder (85%) • Direct impact to clavicle
- 8. Displacement • Medial fragment pulled posterosuperiorly by sternocleidomastoid muscle • lateral fragment pulled inferomedially by pectoralis major and and weight of arm
- 9. Complications • Neurovascular injury • subclavian artery or vein • brachial plexus • Skin Tenting • Nonunion • Smoking • Malunion • Pneumothorax
- 10. How to Manage • ABCD • Skin • Neurovascular • Fracture specific TTT
- 11. Fracture specific treatment • Conservative • Arm Sling • Operative • Open reduction Internal fixation (ORIF) • displaced fracture with skin tenting • open fractures • subclavian artery or vein injury • floating shoulder (clavicle and scapular neck fracture) • 100 % Displacement or 2cm Shortening?!!
- 12. Review Fracture clavicle Then 5 minutes break
- 13. Types of clavicular fracture
- 14. Mechanism of injury • Fall onto lateral aspect of shoulder (85%) • Direct impact to clavicle
- 15. Displacement • Medial fragment pulled posterosuperiorly by sternocleidomastoid muscle • lateral fragment pulled inferomedially by pectoralis major and and weight of arm
- 16. Complications • Neurovascular injury • subclavian artery or vein • brachial plexus • Skin Tenting • Nonunion • Smoking • Malunion • Pneumothorax
- 17. How to Manage • ABCD • Skin • Neurovascular • Fracture specific TTT
- 18. Fracture specific treatment • Conservative • Arm Sling • Operative • Open reduction Internal fixation (ORIF) • displaced fracture with skin tenting • open fractures • subclavian artery or vein injury • floating shoulder (clavicle and scapular neck fracture) • 100 % Displacement or 2cm Shortening?!!
- 20. •Comment on the following X rays
- 21. 1
- 22. • Comment • Diagnosis • Nerve to be affected • Treatment
- 23. 2
- 24. • Comment • Diagnosis • Nerve to be affected
- 25. 3
- 26. • Comment • Diagnosis • Nerves to be affected • Artery to be injured
- 27. 4
- 28. • Comment • Diagnosis • Nerves to be affected • Artery to be injured
- 29. 5
- 30. • Comment • Diagnosis • Possible Complication • Treatment Cannulated screws Bipolar hemiarthroplasty Avascular necrosis
- 31. 6
- 32. • Comment • Diagnosis • Definitive treatment Dynamic hip screw DHS
- 33. 7
- 34. • Comment • Diagnosis • Primary care • Definitive treatment