Fractures and dislocations of clavicle

master's thesis

• Title (croatian): Prijelomi i iščašenja ključne kosti
• Author: Marko Belamarić
• Mentor: Ivan Dobrić (mentor)
• Committee member: Ivan Dobrić (predsjednik povjerenstva)
• Committee member: Davor Mijatović (član povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2021-10-20, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics

Abstract

Clavicle fractures are relatively common injuries. They are usually seen in young, active people. The mechanism is commonly direct trauma to the shoulder or fall on outstreched hand. According to the Allman classification, they can be divided into three major subgroups- fractures of middle third (being the most common one), distal third and, the least commmon, proximal third fractures. The patients can present with pain, tenderness, limited range of motion of affected arm and sometimes even ecchymoses on the affected area. The most common complications of clavicle fractures are brachial plexus injury and subclavian vessel injury, but they can also include life threatening conditions , such as hemo/pneumothorax. The diagnostic imaging modality of choice is anteroposterior radiograph. Treatment options can be divided into conservative and operative.
The two basic types of clavicle dislocations are acromioclavicular and sternoclavicular. They share a similar mechanism of injury- they can be a result of direct trauma to the shoulder (contact sport, motor vehicle accident) or indirect force. Acromioclavicular dislocations are classified according to Rockwood classification. The patient presents with pain around the acromioclavicular joint which can sometimes be reffered to the trapezius muscle. Complication which most commonly occurs is accelarated arthritis. Imaging modality used is special radiograph (Zanca). Treatment strategy follows Rockwood classification. Sternoclavicular dislocations are usuallly divided into anterior and posterior, with anterior being more common. Posterior dislocations can compress mediastinal structures and cause dysphagia and dyspnea and are the main cause of complications, namely neurovascular compromise. Computerized tomography (CT) is the golden standard of imaging. Treatment options are divided into conservative and operative, of course, depending on the patient status.

Abstract (croatian)

Prijelomi ključne kosti su relativno česte ozlijede. Obično ih nalazimo u mladih, fizički aktivnih ljudi. Mehanizam ozlijede je najčešće direktni udarac u rame ili pad na ispruženu ruku. Prema Allmanovoj klasifikaciji, možemo ih podijeliti u 3 grupe: prijelomi srednje trećine (ujedno i najčešći), distalne i, najrjeđe, proksimalne trećine. Pacijenti mogu imati bol, osjetljivost na dodir te smanjen opseg kretnji zahvaćene ruke, ponekad i ehimoze na zahvaćenoj strani. Najčešće komplikacije prijeloma ključne kosti su ozljeda brahijalnog pleksusa, ozljede arterije i vene subklavije, no mogu i uključivati po život opasne komplikacije, kao što su hemo/pneumotoraks. Prikladna dijagnostička metoda je rentgenski anterioposteriorni film. Terapijski pristup može biti konzervativni i operativni.
Dva osnovna tipa iščašenja ključne kosti su akromioklavikularno i sternoklavikularno. Oni dijele slični mehanizam ozlijede- mogu biti rezultat direktne traume (kontaktni sport, prometna nesreća) ili indirektne sile. Akromioklavikularna iščašenja su klasificirana prema Rockwood-ovom sistemu. Pacijenti se žale na bol oko akromioklavikularnog zgloba te se ponekada ta bol referira u trapeziusu. Komplikacija koja se najčešće javlja je ubrzani artritis akromioklavikularnog zgloba. Dijagnostička metoda koja se koristi je specijalni rentgenski film( Zanca). Terapijski pristup se ravna po Rockwood-ovoj klasifikaciji. Sternoklavikularna iščašenja se obično dijele na anteriorna i posteriorna. Posteriorna iščašenja mogu komprimirati medijastinalne strukture i uzrokovati disfagiju i dispneju te su glavni uzrok komplikacija, poglavito neurovaskularnih. Računalna tomografija (CT) je zlatni standard u dijagnostickom postupku. Opcije liječenja su podijeljene u konzervativne i operativne, naravno ovisno o statusu pacijenta.

• Keywords: clavicle; fracture; dislocation
• Keywords (croatian): ključna kost; prijelom; iščašenje
• Language: english
• URN:NBN: urn:nbn:hr:105:344301
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-12-19 08:19:13