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17 Cards in this Set
- Front
- Back
Clavicle Fractures- mechanism? |
direct blow to lateral aspect of shoulder fall on an outstretched arm direct trauma |
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In displaced fractures SCM and trapezius muscles pull the medial fragment _________, while pectoralis major and weight of arm pull the lateral fragment _______________. |
posterosuperiorly
inferomedially |
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What are some associated sx's with clavicle fx's? |
* pneumothorax
* neurovascular injury * rib fracture * should be considered with significantly displaced fractures * ipsilateral scapula fracture |
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AC Joint Stability |
* provides anterior/posterior stability
* has superior, inferior, anterior, and posterior components |
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__________ ligament is strongest, followed by posterior. (Of the AC Ligaments) |
superior |
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coracoclavicular ligaments |
trapezoid and conoid |
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What are 80-85% of clavicular fracture locations? |
middle third of clavicle |
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What are 10-15% of clavicular fracture locations?
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Lateral third |
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* Fracture occurs lateral to coracoclavicular ligaments (trapezoid, conoid) or interligamentous * Usually minimally displaced * Stable because conoid and trapezoid ligaments remain intact Nonoperative |
Type I (Neer Classification) |
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What are 5-8% of clavicular fracture locations? |
medial third |
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* Fracture occurs medial to intact conoid and trapezoid ligament
* Medial clavicle unstable * Up to 56% nonunion rate with nonoperative management Operative |
Type IIA (Neer Classification) |
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* Fracture occurs either between ruptured conoid and intact trapezoid ligament or lateral to both ligaments torn
* Medial clavicle unstable * Up to 30-45% nonunion rate with nonoperative management Operative |
Type IIB (Neer Classification) |
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* Intraarticular fracture extending into AC joint
* Conoid and trapezoid intact therefore stable injury * Patients may develop posttraumatic AC arthritis |
Type III (Neer Classification) |
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* A physeal fracture that occurs in the skeletally immature
* Displacement of lateral clavicle occurs superiorly through a tear in the thick periosteum * Clavicle pulls out of periosteal sleeve * Conoid and trapezoid ligaments remain attached to periosteum and overall the fracture pattern is stable Nonoperative |
Type IV (Neer Classification) |
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* Comminuted fracture
* Conoid and trapezoid ligaments remain attached to comminuted fragment * Medial clavicle unstable Operative |
Type V (Neer Classification) |
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ORIF absolute indications requiring surgery |
* open fxs
* displaced fracture with skin tenting * subclavian artery or vein injury * floating shoulder (clavicle and scapula neck fx) * symptomatic nonunion * posteriorly displaced Group III fxs * displaced Group I (middle third) with >2cm shortening |
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What two nerves lied on the anterior side of the arm when the palm is facing outward? |
Median Ulnar |