Best time for clavicle fracture surgery

Every girl wants to have a perfect body, and some women like their clavicle very much, so they will try every means to exercise their clavicle. However, during the exercise, if the method is wrong, it is easy to cause a clavicle fracture. If the clavicle is injured, it will affect the movement of the entire upper part of the body, so you must undergo surgery in time and try to perform the surgery within 24 hours. Don't delay too long to avoid causing more pain.

The clavicle is S-shaped and located between the manubrium of the sternum and the acromion. It is the only bony support connecting the upper limbs to the trunk. The clavicle is located subcutaneously and superficially, and is easily fractured when subjected to external force. The incidence rate accounts for 5% to 10% of all fractures in the body. It mostly occurs in children and young adults.

The main manifestations are local swelling, subcutaneous congestion, tenderness or deformity. The displaced fracture ends can be felt at the deformity. If the fractures are displaced and overlap, the distance between the acromion and the manubrium of the sternum becomes shorter. The function of the injured limb is limited, the shoulder is drooping, the upper arm is pressed against the chest and dare not move, and the affected elbow is supported with the healthy hand to relieve the pain caused by the traction of the sternocleidomastoid muscle. The fracture site is tender to palpation, and bone crepitus and abnormal clavicle movement may be felt. The deformity of greenstick fractures in young children is often not obvious, and they are often unable to report the location of pain, but their heads are often tilted toward the affected side and their jaws are turned toward the healthy side. This feature is helpful for clinical diagnosis. Sometimes fractures caused by direct violence can puncture the pleura and cause pneumothorax, or damage the subclavian blood vessels and nerves, resulting in corresponding symptoms and signs.

1. X-ray examination

When a clavicle fracture is suspected, an X-ray is required to confirm the diagnosis. Generally, 1/3 clavicle fractures are imaged in the anteroposterior position and in the oblique position tilted 45° toward the head. The imaging range should include the entire length of the clavicle, the upper 1/3 of the humerus, the shoulder girdle and the upper lung field. If necessary, a chest X-ray should be taken. The anteroposterior image can show the superior and inferior displacement of the clavicle fracture, and the 45° oblique image can observe the anterior and posterior displacement of the fracture.

Non-displaced clavicle fractures or greenstick fractures in infants and young children are sometimes difficult to diagnose on the original X-ray images. Repeat X-rays 5 to 10 days after the injury can often reveal callus formation.

In the case of fractures of the outer third of the clavicle, the diagnosis can usually be made by X-rays in the anteroposterior position and at a 40° tilt toward the head. It is sometimes difficult to diagnose a fracture of the lateral articular surface of the clavicle using conventional X-rays, and sectional X-rays or CT scans are often required.

The anteroposterior X-ray image of the inner 1/3 of the clavicle overlaps with the mediastinum and vertebral body, making it difficult to show the fracture. Taking X-ray images tilted 40° to 45° toward the head can help find the fracture line. During the examination, one should not be satisfied with the diagnosis of soft tissue injury based on the absence of fracture on the frontal X-ray. A careful examination is required to determine whether there are signs of fracture of the medial end of the clavicle or of the local area in order to make a correct diagnosis.

2. CT examination

CT examination is often used for complex clavicle fractures, such as fractures involving the articular surface and acromion. It is especially better than X-ray examination for fractures of the articular surface.