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17 Cards in this Set

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Clavicle Fractures- mechanism?

direct blow to lateral aspect of shoulder

fall on an outstretched arm

direct trauma

In displaced fractures SCM and trapezius muscles pull the medial fragment _________, while pectoralis major and weight of arm pull the lateral fragment _______________.



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

AC Joint Stability

* provides anterior/posterior stability
* has superior, inferior, anterior, and posterior components

__________ ligament is strongest, followed by posterior. (Of the AC Ligaments)


coracoclavicular ligaments

trapezoid and conoid

What are 80-85% of clavicular fracture locations?

middle third of clavicle

What are 10-15% of clavicular fracture locations?

Lateral third

* Fracture occurs lateral to coracoclavicular ligaments (trapezoid, conoid) or interligamentous
* Usually minimally displaced
* Stable because conoid and trapezoid ligaments remain intact


Type I (Neer Classification)

What are 5-8% of clavicular fracture locations?

medial third

* Fracture occurs medial to intact conoid and trapezoid ligament
* Medial clavicle unstable
* Up to 56% nonunion rate with nonoperative management


Type IIA (Neer Classification)

* 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


Type IIB (Neer Classification)

* Intraarticular fracture extending into AC joint
* Conoid and trapezoid intact therefore stable injury
* Patients may develop posttraumatic AC arthritis

Type III (Neer Classification)

* 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


Type IV (Neer Classification)

* Comminuted fracture
* Conoid and trapezoid ligaments remain attached to comminuted fragment
* Medial clavicle unstable


Type V (Neer Classification)

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

What two nerves lied on the anterior side of the arm when the palm is facing outward?