Madrid, June 21 (efesalud.com). Dr. Santiago Arauz de Robles, head of the Shoulder Unit of the CEMTRO Clinic in Madrid, explains in this videoblog that clavicle fractures, very prevalent in sports practice, although they are solved in most cases with immobilization without plaster nor surgery, require urgent surgical intervention with plate and screws in professions such as car mechanic or hairdresser.
The clavicle is a dense bone in the shape of "that" that joins the trunk with the arm from the top of the sternum to the acromion of the scapula, part of the scapula that is located on the shoulder of the human skeleton. Its main function is to give stability to this scapular waist and support the movement of the arm.
"When a fracture occurs in the clavicle, the displacement of the two fragments of the broken bone is usual: the part of the bone proximal or closest to the neck is directed upwards and the distal part or closest to the shoulder moves downwards, since either by the own traction of the muscles or by the weight of the arm, "he describes.
"And of all the broken bones that are diagnosed in the ER, almost 10% are clavicular," he adds, "80% of these fractures occur in the middle third of the bone, some towards the lateral part of the distal area and the prevalent in the proximal zone The average shortening between the two parts ranges between 1.5 and 3 centimeters, it is very rare for the bone to fracture and remain together.
The sport practice is usually behind a broken clavicle: falls from the bicycle, the motorcycle, the ski, the snowboard or stumbles in rugby, football or basketball. The patients also reflect a lot of pain.
"The two parts of the clavicle, which is very dense, usually stick together, but this does not happen so easily in adults, in fractures with much displacement of the two parts or in bones with minutes – more than two pieces. lack of consolidation is around 30% of cases, "says the orthopedic surgeon.
The recovery of a broken clavicle always generates doubts, since it takes about three or four months to heal by itself, with full guarantee; and surgery is only recommended in exceptional cases, both for the peculiarities of the fracture and for the profession of the injured. An office worker is not the same as a motorcyclist.
"The younger the patient is, the better the bones stick, a problem that diminishes after 20 or 30. The greater the displacement of the two parts of the bone, the worse it gets, the more pieces of bone that result from the fracture. , the more difficult it will be for its new union, and if the rupture is more distal, it will also be more complicated, "he explains.
Therefore, the treatment of each clavicle fracture is "a la carte".
"If the patient is an administrative worker or similar, he can wait for the bone to stick, and rescue surgery can always be performed if it does not stick well enough, whereas if the patient is a hairdresser, or a a mechanic in a workshop or an elite athlete, the operation will be almost immediate, they can not wait up to four months to return to work, "says Dr. Arauz.
In the surgical procedure, the bone is recomposed by joining the fractured parts "as if it were a puzzle" and placing an osteosynthesis, usually a plate adapted to the "ese" form of the clavicle.
"A few days after the surgery, the patient will stop feeling pain, even if he has temporary discomfort in the area of â€‹â€‹the scar and his personal beauty is affected for a lifetime by a more or less unsightly appearance," he says.
Another drawback is the pressure of the skin with the clavicle plate operated because of contact or friction with objects, such as the straps of a backpack or the safety belt of the car.
"We often have to remove the plaques from this type of pain, we always warn patients that they can undergo two clavicular operations, one to put the plaque and another to remove it a year," he warns.
Since most fractures of the clavicle are healed when the arm is immobilized with a bandage in eight or a sling, especially if the patient is a child, since the thorax can not be cast, "you do not have to obsess separation of the two parts of the bone during the recovery, we must have patience and let nature do its job ", concludes the head of the Traumatological Emergencies of the CEMTRO Clinic.
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