Restoring the clavicle after a fracture. Recovery after a clavicle fracture with exercise therapy and massage Non-displaced clavicle fracture recovery period

REHABILITATION - EURODOCTOR.RU - 2012

Three periods of rehabilitation treatment after a clavicle fracture

A collarbone fracture is by no means a rare type of injury, the mechanism of which can be indirect, that is, due to a fall on the hand, shoulder or elbow, which is much more common than the second option - a direct blow directly to the collarbone. The main therapeutic approach to this problem is the fixation method. For this purpose, a figure-of-eight type of Borchgrevink, Ombredan or an immobilizing Deso bandage, as well as Delbe cotton-gauze rings and a Kuzminsky splint are usually used.

As a rule, surgical intervention is resorted to quite rarely in such situations - when bone fragments compress and damage nearby vessels and nerve trunks, or if it is not possible to eliminate the existing displacement of the clavicle in any other way. In this kind of situation, the fragments are first exposed, then an open reduction is performed and finally fixed with the help of special plates, metal pins, tie bolts or long screws. This tactic ensures high-quality and reliable retention of clavicle fragments in the desired, correct position, eliminating the need to apply a cast during the postoperative period, which improves the patient’s quality of life and reduces the duration of his rehabilitation period.

Immobilization with bandages (including plaster) and splints lasts on average about three weeks. Therapeutic exercises are prescribed literally from the second or third day after the injury. First, these are various movements of the fingers, flexion-extension in the wrist and elbow joint, pronation-supination (inward-outward rotation) of the forearm, as well as small abductions of the limb in the shoulder joint when tilting in the direction where the collarbone is damaged. At first, the exercise is performed with outside help with the arm bent at the elbow; subsequently, the degree of abduction is increased, without exceeding an angle of 90° (during immobilization). Along with special exercises, they also do breathing and general developmental gymnastics at this time.

In the second period (at the end of immobilization), they perform flexion-extension and abduction-adduction in the shoulder joint using gymnastic sticks, in addition, they continue to work out all the other joints of both arms and legs, and do exercises for the core.

In the third period, in order to restore the full range of motion in the shoulder joint and increase muscle strength, additional exercises with resistance and weights are introduced, using expanders and dumbbells, a mace, and exercise machines, respectively.

In cases where, after a fracture of the clavicle, osteosynthesis of its fragments was performed, active movements in the shoulder joint are allowed after the sutures are removed, and arm movements exceeding 90° after about two weeks.

Massage and warm baths are also useful, but only with the permission of a doctor.

The upper limb belt allows for normal mobility of the arm in the shoulder joint. This component usually includes the collarbone and scapula. But if scapula fractures are a rather rare occurrence, then a collarbone fracture is one of the typical injuries after a direct blow to the shoulder girdle or after a fall. In order to determine this condition, you should not resort to a large number of diagnostic techniques, since the injury is accompanied by characteristic changes in appearance and symptoms.

The structure and position of the clavicle

This bone is visualized when examining a person of average or thin build. In obese people, the collarbone can be detected by palpation of the shoulder girdle area. It connects the acromial end of the scapula and the upper part of the sternum. The main function is to help the upper limb cope with physical activity and maintain the shoulder joint in the correct position. That is why, in the case of a clavicle fracture, the first sign is a displacement of the shoulder, which provokes the patient to constantly support it.

The clavicle consists of three parts:

diaphysis - the middle part of the clavicle;

two metaphyses - a section of the clavicle adjacent to the epiphysis and in direct contact with the articular capsule;

two epiphyses - the terminal parts of the clavicle, which fix the bone to the scapula and sternum with the help of joints (acromio-clavicular and sternoclavicular).

Directly behind the bone runs a system of some of the largest vessels in the body - the subclavian vein and artery. Damage to these vessels is one of the most dangerous complications of a fracture, which can cause death as a result of rapid blood loss. It is impossible to stop such bleeding without surgical intervention, so you need to quickly recognize the symptoms of this pathology to avoid a tragic outcome.

Also behind the clavicle bones are all the nerve fibers that control the sensitivity and muscles of the arm. This is important information, since if these structures are damaged by bone fragments, complete loss of sensation or partial/complete paralysis of the upper limb can occur. Timely surgical intervention in most cases allows you to completely restore the innervation of the hand and return the patient to his previous quality of life.

An additional danger lies in the location of the nearby apex of the lung, damage to which can lead to disruption of the breathing process and a general deterioration in the patient’s condition.

Classification of clavicle fractures

It is extremely important to distinguish between different types of fractures, since the method and time of treatment, prognosis and recovery time depend on this. For damage to the collarbone, it is customary to use several classifications that allow an accurate assessment of the patient’s condition.

It is also imperative to determine the absence or presence of complications. These include damage to adjacent vessels (subclavian arteries and veins) and nerve trunks of the brachial plexus.

Causes of a clavicle fracture

In most cases, the cause of a fracture of a given bone is trauma - excessive exposure to a certain area of ​​force. The most dangerous among them are:

a fall from a height that is greater than or equal to the height of the victim. Support in such cases may come from a straightened arm, the outer part of the shoulder or the elbow;

a strong blow to the shoulder girdle or directly to the collarbone.

In addition to injuries, damage to the collarbone is possible as a result of disruption of the normal bone structure. In this case, a fracture appears even in the case of minimal impact on the bone (a push to the shoulder girdle, a sharp movement of the arm). Such an injury is called a pathological fracture and is possible in the following cases:

tuberculosis of the clavicle - this bone is quite rare, but can still be affected by the tuberculous process; in such cases, Koch’s bacillus can settle in the bone tissue. It gradually destroys the bone from the inside and provokes thinning of the walls of the clavicle;

malignant tumors and bone metastases - osteosarcoma, fibrosarcoma, giant cell tumor. These neoplasms provoke the destruction of normal bone tissue and the proliferation of atypical cells;

Osteomyelitis of the clavicle is a bone infection in which microbes penetrate the bone tissue. Risk factors are surgical interventions on the collarbone and adjacent tissues, the presence of foci of chronic infection in the body (sinusitis, cholecystitis, pyelonephritis), immunodeficiency conditions (oncological blood diseases, HIV).

Symptoms of clavicle damage appear almost identically with both pathological and ordinary fractures. The main difference is the severity of intoxication of the body and the presence of signs of damage to other organs, thanks to this it is possible to distinguish between these conditions during the diagnostic process.

Symptoms of a clavicular bone fracture

Damage to the collarbone is usually accompanied by characteristic symptoms, thanks to which it is quite easy to suspect this particular pathology. You need to pay attention to the following signs:

pain – high intensity, sharp and sharp. It persists at rest and intensifies when palpating the area of ​​the shoulder girdle or when performing movements in the shoulder joint;

characteristic position - when a collarbone is fractured, it is usually painful to hold the limb pressed to the body and bent at the elbow with the help of a healthy arm. In this position, the severity of pain may decrease slightly;

swelling – pronounced swelling appears in the area of ​​the shoulder girdle within the next hour after the injury. The skin over the site of injury becomes hot to the touch and hyperemic;

deformation of the clavicle (interrupted/uneven contour) - a symptom can only be detected in patients with a thin build and when bone fragments are displaced;

immobility of the shoulder - since any change in the position of the shoulder causes severe pain, the patient tries to fix the arm and prevent any movements.

Identifying bone damage is much easier than identifying complications. It is quite difficult to do this without special diagnostics, but the following signs may alert you during the initial examination:

with bleeding - rapidly growing swelling, redness of the skin in the area of ​​the shoulder girdle and pallor of other areas of the skin. The patient feels severe weakness, darkening of the eyes, dizziness;

When the nerve plexus is damaged, sensitivity in the arm area is usually lost. If one of the trunks of the plexus of nerve fibers is ruptured, partial paralysis develops. If the entire brachial plexus is damaged, the entire upper limb is paralyzed.

Signs of a clavicle fracture differ slightly among pathological types. It is necessary to pay attention to the prolonged presence of low-grade fever, constant weakness, unreasonable weight loss, the presence of discomfort and unpleasant sensations in the clavicle area before the development of a fracture.

Diagnosis of a clavicle fracture

To diagnose traumatic clavicle fractures, an X-ray examination of the upper chest area is sufficient. Using this method, you can accurately determine the nature of the fracture, the presence of displacements, and plan treatment tactics.

If the doctor suspects a pathological fracture, the number of diagnostic tests performed increases. To diagnose the cause, a series of laboratory tests are performed (biochemical analysis of venous blood, clinical general analysis of urine and blood) and a biopsy of the affected areas of the clavicle is performed - taking pieces of bone for further histological and cytological examination.

Detection of changes in the blood characteristic of the inflammatory process (a rise in the level of C-reactive protein above 5, an increase in the level of leukocytes above 10 * 10 9, an acceleration of ESR exceeding 20) in combination with the presence of characteristic bacteria in the collarbone is a reliable sign of the development of infection (tuberculosis or osteomyelitis). In the presence of atypical cells in biopaths, a thorough diagnosis of the tumor process is required.

First aid for a broken collarbone

If you suspect the development of this injury, you should immediately consult a doctor. The best option is to call an ambulance, which will take the victim to the nearest emergency room or surgery department. Before the doctors arrive, you can start providing first aid.

Pain relief with available painkillers

At home, you usually have access to some non-hormonal anti-inflammatory drugs or combination pain relievers. The most common representatives of these groups are: “Analgin”, “Citramon”, “Ibuprofen”, “Pentalgin”.

You should not use a large amount of drugs at once - one or a couple of tablets is enough. The first effect of taking the drug can be expected after 15-30 minutes, depending on the patient’s body and the drug. The emergency doctor must name the drug that was taken.

Fix the shoulder

Any movement in the injured shoulder joint will cause pain and can lead to displacement of bone fragments, so it is extremely important to immobilize this segment of the limb. Applying a bandage to the fracture site is quite simple - at home it is recommended to use a regular 8-shaped bandage.

How to apply it? They begin to wrap on the healthy side, several circular wraps are made through the armpit and shoulder girdle, after which the bandage is passed along the back and the affected side is wrapped in the same way. It is necessary to apply such a bandage quite tightly in order to prevent further displacement of the damaged clavicular bone.

If attempts to immobilize the affected arm fail, you should wait for the ambulance to arrive or use a scarf, which will allow you to temporarily fix the shoulder. To do this, you need to place your forearm on the middle part of the scarf and tie its ends around your neck. It is worth noting that it is important to place the outer end behind the back, since such manipulation will reduce the load on the neck muscles and the likelihood of displacement of bone fragments.

Cold on the affected area of ​​the shoulder girdle

This procedure must be performed within the next 5-10 minutes from the moment of injury. The cold will help relieve pain and swelling. Recommended application time is 30 minutes.

Upon arrival, the ambulance team must assess the quality of fixation of the limb and correct all shortcomings. If the bandage has not been applied, the doctor will independently immobilize the upper limb belt. The standard items in the first aid kit are rings for a clavicular bone fracture. Soft elastic rings are put on the healthy and affected shoulder girdles, which are then tightened on the back using a special locking mechanism. This approach to fixation allows us to simultaneously somewhat reduce pain and qualitatively prevent displacement of fragments. Currently, doctors have refused to use splints in case of a collarbone fracture.

After delivering the patient to the doctor, an adequate method of further treatment of the fracture is selected, and the question of whether hospitalization is advisable is decided. These points depend on the type of fracture and the presence of complications.

Treatment of traumatic fracture

The main goals of treatment are to achieve alignment of fragments and fix them in the correct anatomical position. If these conditions are fully met, the collarbone will heal without additional treatment within 1.5 months. Otherwise, recovery of the damaged bone may take a long time.

Currently, two special methods of treating traumatic fractures are used: surgical and conservative. Conservative involves the comparison of fragments using closed reduction, which should be performed only by a qualified and experienced traumatologist. Surgery in the presence of a fracture is carried out in case of complications, the presence of a rupture of the skin with bone fragments, or severe displacement of the bones.

Conservative treatment

First of all, the doctor should numb the patient before performing the closed reduction technique. For this purpose, an injection of novocaine into the fracture area is used. After the onset of anesthesia (the patient does not experience pain), you can begin the therapeutic procedures. The optimal position for the patient is sitting with the head tilted towards the injured side. This position ensures muscle relaxation and the return of the clavicular bone fragment to its original position. Closed reduction takes on average 10-15 minutes. If after 2-3 attempts it is not possible to restore the anatomical position of the bone, it is worth moving on to a surgical method of treating the fracture.

Plaster application

The second extremely important part of fracture treatment is the application of a plaster cast, which will fix the collarbone in its correct position. In most cases, a Vanstein bandage is used, which covers the forearm on the injured side, the upper arm and the chest. Despite the fact that such a bandage significantly restricts the patient’s movements, it is not worth removing it without X-ray confirmation of bone fusion.

On average, the rehabilitation period takes about one to one and a half months. During this time, it is worth monitoring the patient’s condition and monitoring the bone healing process. Signs that should alert you:

increased pain in the collarbone area;

local increase in temperature in the projection of the fracture;

prolonged redness of the skin in the area of ​​the shoulder girdle (over 5-6 hours);

increase or reappearance of edema.

If these signs occur, you should immediately consult a doctor - he will perform an examination and decide on further treatment tactics.

Skin care while wearing a cast

Quite often, patients are concerned about skin irritation that occurs after applying a plaster cast. How to prevent its development and alleviate the problem? To do this, it is worth remembering a number of simple rules:

Do not wet the plaster - moisture will soften its structure and negatively affect the skin. If moisture does get on or near a fixed limb, you should allow the liquid to evaporate naturally. You can speed up this process using a hairdryer.

Protect the cast from abrasions and impacts - you should wear loose clothing and try not to lean on the cast while sleeping.

If there is itching, do not try to comb the skin under the plaster cast using a knitting needle or ruler. Also, do not pour various lotions and other liquids onto the plaster. Such actions will only worsen the discomfort. To relieve unpleasant sensations, you should use the same hairdryer, but direct a stream of cold air into the plaster.

Antihistamines (Suprastin, Claritin, Cetrin, Cetrizin) also have antipruritic properties.

Surgery

Patients with a clavicle fracture may undergo surgery if one of the following circumstances exists:

concomitant fracture of the scapula;

damage to the brachial plexus nerves or subclavian vessels;

comminuted fracture or the presence of significant displacement of fragments;

the presence of a soft tissue rupture (open fracture);

intra-articular fracture;

impossibility of performing closed reduction.

The main goal of surgery is to connect bone fragments and eliminate complications that have arisen: suturing nerves and blood vessels, treating the wound to prevent infection. For these purposes, a special metal plate is placed on the surface of the collarbone and secured with screws. At the moment, intramedullary osteosynthesis is performed (insertion of a Kirschner wire into the clavicular bone), but this manipulation is recommended only if it is not possible to carry out the manipulations presented above.

Postoperative rehabilitation is faster than in the case of conservative therapy. The arm is fixed with a bandage for one and a half to two weeks. It is not necessary to use a bandage. A plaster cast is required only in cases of comminuted fractures or when the doctor is not confident in the effectiveness of osteosynthesis.

How long should such a fixation device remain in the bone? There are no precisely defined deadlines. Typically, the Kirschner wire is removed 6-8 months after surgery. The periosteal plates remain on the collarbone along with the screws for at least a year. In older patients (usually over 50 years of age), such structures may remain in the collarbone for life, since removal surgery poses an additional health risk.

What is better to choose conservative therapy or surgical intervention?

In some cases, the traumatologist may offer the patient a choice of treatment tactics - wait for bone fusion in a plaster cast or perform surgery. What is better to choose in this case? This usually does not affect the outcome of treatment - but the doctor may provide several treatment options. Surgery differs from conservative treatment in several key ways.

The first is the duration of treatment. After surgery, the patient can move his arm 2-3 days after the operation, and the bandage is removed after two weeks. The cast must be worn for at least a month, which can cause significant discomfort to the patient.

The second is the consequences of therapy. Wearing a cast is a safe method for healing fractures. Among the possible complications with this approach, in most cases, incorrect reposition of fragments and delayed fusion occur. Carrying out surgery with periosteal osteosynthesis or insertion of a Kirschner wire is a serious intervention in the functioning of the body. It is also extremely important to remember that young patients must undergo a second operation after the bone has healed to remove the bone-fixing devices, and this always implies an additional risk for the body.

Each method has its own pros and cons. If there is a choice, doctors prefer to choose a conservative method, but the decision still remains with the patient.

Features of treatment of clavicle fractures in children

This type of fracture is one of the most common injuries in children aged 12 to 17 years. When treating young patients, surgical tactics are preferred in most cases. If possible, open reposition of fragments is performed under local anesthesia - an anesthetic (Lidocaine, Novocaine) is injected near the brachial plexus, which eliminates sensitivity in the area of ​​intervention.

Unlike adult patients, children are much more likely to undergo intramedullary osteosynthesis - a small wire is inserted into the collarbone for a period determined by the traumatologist. Bone fusion occurs earlier because children have a more abundant blood supply to the tissues. After surgery, it is recommended to wear a fixing bandage for a period of one to one and a half weeks, which will prevent re-displacement of the fragments.

What should you not do after a collarbone fracture?

The end of therapy does not mean complete restoration of the collarbone. The resumption of loads on the injured limb and forearm should occur gradually so as not to lead to the development of re-injury.

Immediately after removing the cast, it is prohibited to engage in sports or significantly load the upper limb. It is also not recommended to carry a briefcase or bag on the injured side, stretch your arm for a long time, or lean on your shoulder. During this period, you should gradually strengthen the muscles and develop the arm, which has weakened after therapy. To do this, you can perform the following exercises:

Slowly raise your arm above your head and slowly lower it. If there is pain, do not be afraid. The doctor would not allow the bandage or plaster to be removed if there was no confidence in the fusion of the bones. As a rule, the presence of unpleasant sensations is associated with contractures - temporary restrictions on movement in the joints as a result of changes in tendons and muscles. It is necessary to overcome painful sensations with extreme caution, gradually increasing the range of movements.

Move your arm away from your body and then slowly bring it back. During the exercise, you should strain your muscles to restore their tone and train to their previous strength.

Try performing circular movements in the shoulder joint with a gradual increase in arm span.

No earlier than one and a half to two months from the moment the cast is removed, you should start adding load to the collarbone and arm. For these purposes, you can use light dumbbells or simply carry a shopping bag on the injured side. Doctors also recommend the use of shoulder expanders and some groups of exercise machines (boat, butterfly) with light weight (no more than 5 kg), the load should gradually increase.

Active sports can begin within 5-6 months from the moment the plaster or bandage is removed. It is by this time that the collarbone begins to regain its former strength and structure, and the muscles acquire the necessary tone.

Features of clavicle fractures in newborns

One of the obstetric complications is a clavicle fracture in a newborn. This condition can occur due to 4 main reasons:

large fruit – if the child weighs more than 4 kg;

weakness of labor - if the fetus spontaneously stops moving through the birth canal, doctors use obstetric forceps or a vacuum extractor to extract the baby. In this case, there is a possibility of injury to the collarbone;

anatomically narrow pelvis in a woman - if the size of the bone walls is insufficient for the unhindered passage of the child through the birth canal, a cesarean section is required. If you choose a different delivery tactic, the baby may be injured;

formed labor is the active period of labor, which normally lasts from 12 to 14 hours. But there are options to speed up this process up to 4-6 hours, which can lead to injury to the baby during rapid movement through the birth canal.

According to statistics, a fracture of the right clavicle is observed somewhat more often than the left. Recognizing the presence of this injury is quite simple - in children under one year of age, bone damage is determined visually during the examination, and redness and pronounced swelling occur in the area of ​​the shoulder girdle. The child suffers from constant pain, which is expressed by hysterical crying. The limb on the injured side does not move in the shoulder joint, since such movements cause pain.

In most cases, the fracture occurs like a green branch, which significantly accelerates the process of healing and tissue regeneration. The treatment tactics are predominantly conservative - the newborn is subjected to a bandage for 6-7 days, rest and regular feeding (ideally breastfeeding) are ensured. The consequences of a fracture in newborns are extremely rare.

How to care for a baby with a broken collarbone?

Despite the fact that such fractures in children heal quite quickly, the child should be provided with competent care during the recovery period. First of all, it is forbidden to re-injure the collarbone. Because fragments that are connected only by a thin layer of periosteum can tear it quite easily. Within a week from the moment the bandage is applied, it is prohibited to:

press on the collarbone area;

injure the baby’s shoulder girdle or shoulder in any way;

pull the hand from the side of the injury.

You need to swaddle your baby in the same way as before, without applying additional effort and without pulling the diaper too tightly. When rocking, it is recommended to place the baby on the healthy side, gently holding the sore arm. During sleep, the child should lie on his back.

For any baby, the presence of milk from the mother is extremely important, since this is the optimal food product for the baby, which is created by the mother’s body. In the presence of a clavicle fracture, breastfeeding is especially important, since milk is the best source of building material for bone regeneration. You need to feed your baby on demand, which is expressed in the form of hungry crying.

A clavicle fracture is a fairly common injury, especially among young people. It is quite easy to suspect based on the characteristic symptoms. If you have such symptoms, you should immediately call an ambulance or take the victim yourself to the nearest trauma department. Rehabilitation after a fracture takes a short period of time - on average, one and a half months is enough. Complications from such a fracture occur extremely rarely, so the patient has the opportunity to restore his previous quality of life.

Frequently asked questions from patients and their parents

Is it necessary to remove the pin after surgery to treat a clavicle fracture in a child?

Yes, it is necessary, since it will interfere with normal skeletal growth. The optimal timing of removal is determined by the traumatologist in each specific case, but usually the Kirschner wire is removed after several months.

Is there an alternative to plaster in the case of a conservative approach to the treatment of a clavicle fracture?

In the absence of displacement and the patient is young, cotton-gauze Delbe rings or a figure-of-eight bandage can be applied for a period of 4-6 weeks, but plaster is traditionally considered the optimal method of conservative therapy.

Is it possible to apply a Deso bandage for a broken collarbone?

No, because such a bandage is meaningless for such damage. This type of bandage usually immobilizes the shoulder, but does not fix the collarbone, which is especially important for proper bone fusion.

Is it possible to leave a metal plate on the collarbone after bone fusion?

The bone plate does not need to be removed, provided that it is made of titanium alloy and the victim is over 50 years of age. In this case, the plate will not have any effect on the skeleton, but repeated surgery may cause an additional threat to health.

The picture clearly shows that the bone fragments have fused together at an angle. Is this normal and is additional treatment required?

If the angle is very pronounced (over 20 degrees), there is an incorrect selection of treatment tactics or neglect of the doctor’s recommendations during the regeneration period. Additional treatment in terms of surgery in such cases is usually not prescribed, but the cosmetic defect will remain forever.

Are there rules for preventing fracture malunion?

Does a cosmetic defect remain after a clavicle fracture?

It all depends on the nature of the fusion. If the collarbone has been repaired correctly, there may only be a small bump at the fracture site. Otherwise, there may be a visual curvature of the bone contour.

Is it possible to play sports after a clavicular bone fracture?

Yes, but not earlier than 5-6 months from the moment the bandage is removed. Only the attending physician can give a final answer, based on the specifics of a particular case.

One of the most common injuries is a collarbone fracture. In newborns, a fracture occurs due to rapid passage of the birth canal or incorrect actions of obstetricians. In adults and older children, a clavicle fracture occurs when falling on the shoulder or as a result of a strong blow to the collarbone area.

The rehabilitation period depends on how quickly medical care was provided and what methods were used. The rehabilitation period is the final and important stage, because the functions of the bone and shoulder in the future largely depend on it.

The bones of the collarbone fuse within a month, and a thickening forms at this place. Motor function is impaired. Its restoration is possible only after a set of therapeutic and physical exercises.

Treatment for a clavicle fracture rarely requires surgery. The operation is performed in case of a complex fracture with displacement.

A traumatologist treats the fracture.

Initially, the doctor must:

• give the bone the correct position by moving the shoulder up and back;
• then a special plaster cast is applied to the fracture site;
• Then the fracture site is bandaged.

At the same time, the bandage is not rigid, which allows the hand to perform some actions that are necessary for rehabilitation. It takes place in three stages and allows you to completely restore motor activity. If treatment and rehabilitation are carried out correctly, then the fracture will never remind you of itself in the future.

What recovery methods are indicated?

For a non-displaced clavicle fracture, the rehabilitation period begins long before the bandage is removed. This is necessary for rapid bone fusion and to avoid stagnation of fluid and blood.

During the recovery period, the doctor prescribes a special set of procedures.

You can speed up physical activity using the following methods:

• physiotherapeutic procedures;
• massage;
• treatment and prophylactic complex;
• special diet.

The recovery period should be under the supervision of the attending physician.

Physiotherapy is indicated at the earliest possible stage. To achieve a positive effect, it must be read a week after the fracture.

The following procedures apply:

1. UHF therapy allows you to reduce tissue swelling and relieve pain in a short period of time.
2. Magnetotherapy. During therapy, the lesion site is exposed to a constant and alternating magnetic field. Special devices are used to carry out the procedure. This improves the fusion of bone tissue, while significantly reducing the risk of complications. The procedure can be carried out even through a plaster cast.
3. Interference currents allow you to speed up the process of resorption of edema and relieve pain. The procedure is carried out in the following way. 4 electrodes are attached to the area of ​​the body where there is no plaster cast. If it is necessary to attach them specifically to the plaster area, then special holes are cut in the bandage.
4. Electrophoresis is used to accelerate the process of bone tissue formation. During the procedure, areas of tissue are exposed to current. The procedure takes no more than 20 minutes. The positive effect is visible after the 10th procedure.
5. Paraffin baths and mud therapy are effective.

The presented list of procedures allows you to improve blood circulation and thereby speed up the fusion process.

If the clavicle fracture is without complications, then massage treatments are prescribed. They are prescribed on the 10th day after the fracture. The massage therapist massages healthy tissue near the fracture, which has a beneficial effect on the entire upper limb.

At the first stage, the massage therapist’s movements should be light and calm, so as not to cause additional discomfort to the patient. To carry out the procedure, use a special oil or cream. After removing the bandage, you can gradually move on to increasing the intensity of the massage.

During the rehabilitation period, a person must adhere to a diet rich in calcium. For better absorption, vitamin D is necessary. Silicon will allow the body to synthesize its own calcium.

It is necessary to give preference to the following products:

• milk;
• cottage cheese;
• fish;
• aspic;
• jelly;
• currant.

It is worth limiting the intake of smoked and pickled foods, and also completely avoiding coffee, black tea and alcohol.

If you follow all the doctor's instructions, you can completely develop your arm in a short period of time.

Physical therapy exercises

The treatment and prophylactic complex is prescribed even before the bandage is removed. The first exercises involve working with your fingers and hand. It is forbidden to raise your arm and develop the shoulder joint.

Movements should be light and smooth, with few repetitions. The ideal option is a few minutes a day.

If the patient experiences discomfort while performing the exercises, it is necessary to stop and postpone them until a later time.

In case of a displaced clavicle fracture, rehabilitation after surgery begins only after all sutures are removed.

Exercises are selected individually, taking into account the nature and degree of damage, as well as the general well-being of the patient.

Most often, exercise therapy is carried out in three stages. Let's take a closer look at each of them.

The first stage of restorative medicine begins immediately after the cast is applied and continues until the bandage is removed. During the day, the patient must perform at least 5 approaches, performing each exercise 10 times. After completion, a short break is required.

List of exercises at the first stage:

1. Bringing and spreading the fingers on the injured hand.
2. Flexion and extension of the arm into a fist. In this case, the thumb must be bent alternately to the inner and then to the outer surface.
3. Click with each finger.
4. Each finger must make rotational movements in a circle.
5. Movements of the hand up and down, to the sides.
6. Circular rotations with the hand.

After removing the bandage, the exercises are aimed at flexing and extending the injured arm at the elbow joint.

Rehabilitation after a displaced clavicle fracture is carried out under the supervision of a doctor.

Exercises in the second stage:

1. Place your palms on your shoulders and lift and lower your elbows.
2. Circular movements with your elbows at least 10 times.
3. The well-known exercise is the mill, only swinging movements are performed forward and backward.
4. Raising and lowering straightened arms up and down with a gymnastic stick.
5. Swing cross movements with your arms, slightly tilting your body forward.

The duration of this stage depends on the degree of the fracture and the age of the patient. Basically it is 20 days.

The third stage involves the development of the limbs until motor function is completely restored.

Rehabilitation after a clavicle fracture includes exercises:

1. The patient holds a special gymnastic ball above his head. Leaning forward, he pushes the ball between his legs.
2. Tossing and catching a special ball.
3. Holding dumbbells in his hands, the patient alternately raises his arms above his head.

conclusions

Today, many rehabilitation complexes have been developed that include rehabilitation exercises after a displaced clavicle fracture, a video of which can be found here. For complete recovery, systematic exercise therapy is important.

A clavicle fracture is a fairly common injury that can occur at any age. Since the collarbone is a long and thin bone, a fracture most often occurs in the middle. Rehabilitation after a clavicle fracture consists of a set of exercises and physiotherapeutic procedures aimed at restoring the function of the injured arm.

Causes of fracture and symptoms that indicate it

The cause of a collarbone fracture can be a direct blow to the shoulder, for example, during a car accident, or a fall from a height onto the arm.

Symptoms of this type of damage include:

• pain in the area of ​​injury;
• inability to raise your hand;
• the shoulder on the side of the fracture is lowered and moved slightly forward;
• Possible swelling and bruising around the collarbone.

Most often, a collarbone fracture occurs as a result of a fall on an arm or shoulder. Also, clavicle injury occurs in newborns directly during childbirth.

Features of rehabilitation in case of non-displaced fracture

If the collarbone is broken without displacement of its ends, then such damage is treated with a conservative method: a fixing bandage is applied, which gives the collarbone the most correct position.

Before fixation, the patient's shoulder is retracted upward and backward. The bandage allows the victim to perform some movements with the injured arm, which allows for recovery exercises during the period of immobilization of the limb.

Types of fixing bandages

To immobilize the injured arm, a plaster cast, a Deso bandage, Delbe cotton-gauze rings, or a figure-of-eight bandage are used. You can also use a dense round pillow. It is placed in the alar cavity and secured with a special bandage over the healthy shoulder. The arm itself is bent 45 degrees and secured with a scarf tied around the neck. In this case, the arm is slightly moved away from the body.

Recovery in case of a displaced fracture

If the injury occurs with displacement of the fragments, then surgical intervention is required. During surgery, the fragments are connected and secured with internal plates, bone implants or screws. Rehabilitation after a displaced clavicle fracture consists of three stages:

• immobilization;
• restoration of function of the shoulder joint;
• development of the damaged limb until its functions are fully restored.

First stage of rehabilitation

The first stage of recovery after a collarbone fracture lasts approximately three weeks. It begins on the second day after the injury and ends with the removal of the fixing bandage.
At this stage the following set of exercises is shown:

• The patient spreads and closes the fingers of the injured hand.
• Flexion and extension of the hand into a fist.
• The tips of each finger should touch the thumb. Repeat 10 times.
• Click each finger in turn 6-8 times.
• Move each finger in a circle in different directions.
• Flexion of the phalanges of the fingers.
• Lowering and raising the injured arm 4 times.
• Rotate the brush in a circle.

Seven days after the fracture, you can begin exercises to restore the elbow joint. The patient performs flexion and extension of the injured arm at the elbow

Second stage of rehabilitation

The second period of rehabilitation after a clavicle fracture begins after the bandage is removed. Its duration depends on the patient’s age, physical fitness, and characteristics of the fracture. This period usually takes about 15 days until the basic movements of the injured arm in different directions are restored.

Exercises for rehabilitation after a clavicle fracture at this stage aim to restore the function of the shoulder joint. Therapeutic exercise is performed simultaneously with the injured and healthy hands. Each action is repeated 8-10 times.

Set of exercises:

• The patient holds his palms on his shoulders and raises and lowers his elbows.
• The patient makes circular rotations with his elbows in different directions.
• Hands are lowered along the body. Raising and lowering straight arms with slow movements is performed.
• The patient raises his arms straight, then takes them back and lowers them.
• The patient, with straight arms, performs swing movements with one arm back, and the other forward, and then vice versa.
• The patient raises his arms up and then lowers them, holding a gymnastic stick in his hands.
• With a stick in bent arms, movements of the arms are performed in a circle in different directions.
• The patient alternately raises his hands up, holding the stick by its ends.
• The patient raises the stick above his head, then lowers it alternately on his head and behind his head.
• The victim leans forward and makes swinging cross movements with straight arms.

Third stage of rehabilitation

The main task of the third and final period of rehabilitation is the complete restoration of the function of the injured limb. The duration of this period is not limited.

A set of exercises at the third stage (movements must be repeated 8-10 times):

• The patient holds a ball weighing 3 kg with straight arms above his head, then he bends forward and, lowering his arms, pushes the ball between his legs.
• The patient makes movements in a circle in different directions with his arms extended upward with the ball.
• The patient throws and catches the ball.
• Raising your arms up and down with dumbbells of 2-3 kg.
• The patient performs circular movements in different directions, holding dumbbells in his hands.

Physiotherapeutic procedures during the recovery period

A week after a collarbone fracture, the doctor prescribes physiotherapeutic procedures. The damaged limb is exposed to a magnetic field, electrophoresis or ultraviolet irradiation.

These methods increase blood circulation in the injured area, which promotes faster bone healing. Physiotherapeutic procedures will be more effective if they are combined with exercises and massage.

Massage after a clavicle fracture

The doctor prescribes a course of massage depending on the degree of complexity of the injury. The early course begins ten days after the fracture. First, the undamaged areas near the fracture site are massaged.

After removing the fixing bandage, the massage becomes more intense, which restores the sensitivity of the skin in the area of ​​the fracture and improves blood circulation.

Possible complications after a collarbone injury

• If the fixation bandage is not worn correctly, the pearl may be complicated by the displacement of fragments of the broken bone. To prevent this from happening, the patient must strictly follow the recommendations for wearing a fixing bandage and visit a doctor from time to time to check the condition of the injured collarbone.
• A large lump may form at the site of the fracture. Over time it decreases, but a small bump may remain.
• After surgery, you may experience numbness in the skin just below the surgical incision. After some time, this numbness goes away completely or decreases.
• Infection of the surgical incision.
• Bleeding from the wound.
• Severe pain after surgery.
• Formation of blood clots in the legs.
• Damage to blood vessels or nerves near the broken collarbone.
• Lung injury.
• Nausea after anesthesia.
• Implant rejection.

Features of a clavicle fracture in children

A clavicle fracture in children is one of the most common injuries. Children can get injured during active play or falls.

At two to three years of age, children often experience incomplete greenstick fractures. In this case, the periosteum remains intact and holds the bone fragments together. Parents may think that this is an ordinary bruise, since there is no displacement and the pain is minimal.

A non-displaced fracture of the clavicle in children two to three years old requires only an ordinary bandage made from wide bandages to fix the shoulder. For displaced fractures, a Deso bandage can be used for children over the age of one year. For older children who have several displaced bone fragments, a figure-eight plaster cast is recommended.