Shovel fracture

Description:

Shovel fracture — pathological states, arising during disturbance of anatomic integrity of a shovel. Most often arise in, so-called, areas of "a surgical neck" of a shovel.

Shovel fracture reasons:

The mechanism of this injury consists in blow to the area of a shovel or falling on it. The indirect mechanism (falling on a brush or an elbow joint of the taken-away hand) involves changes of a joint hollow, a neck of a shovel, an akromion and a coracoid.

Shovel fracture symptoms:

The clinic of a fracture of shovel depends on damage localization. Usually, fractures of a body, an awn and corners of a shovel are followed by pain, a swelling owing to hemorrhage — a symptom of "a triangular pillow"; in certain cases it is palpatorno possible to reveal deformation, pathological mobility, crepitation. At a shovel fracture function of an extremity suffers moderately. The change of a joint hollow is characterized by emergence of pain, a hemarthrosis, sharp dysfunction of a shoulder joint. Shift of fragments owing to what is characteristic of a fracture of a neck of a shovel the shoulder joint as if slips kpered and from top to bottom. Contours of a joint change. Visually acromial shoot will excessively stand under skin, and the coracoid - as if leaves kzad. Under akromiony some retraction is formed. The movements in a shoulder joint are sharply limited because of pain, though are possible. Palpatorno morbidity, sometimes crepitation in a shovel neck zone, especially come to light if the attempt of passive movements is at the same time made. The place of damage at a fracture of a shovel is available to survey from front and back surfaces of an axillary hollow. The change of an akromion and a coracoid of a shovel involve emergence of a swelling in the place of an injury, existence of bruise which is better visualized on 2 — the 4th days, local morbidity, a bone crunch which are defined at a palpation of shoots. The fracture of a shovel is characterized by restriction of movements in a shoulder joint as the attempt of their performance causes pain in places of an injury.

Treatment of a fracture of shovel:

The fracture of a shovel provides preferential conservative method of treatment. Anesthesia is carried out by introduction to the place of damage of 10 — 40 ml of 1% of solution of novocaine. In the course of an injury fragments of a body, an awn and corners of a shovel are displaced slightly and do not need reposition. The main way of conservative treatment of a fracture of shovel is imposing of a bandage of Dezo with the roller in an axillary hollow for a period of 3 — 4 weeks. Working capacity is recovered in 4 — 5 weeks. In case of a fracture of a neck of a shovel or its shoots without shift, the extremity is fixed the taking-away tire or a plaster torakobrakhialny bandage. Assignment of a shoulder is made on 80 — 90 ° and reject kzad from an axis of nadplechiya on 10 — 15 °. The term of an immobilization makes from 4th to 6 weeks. Recovery of working capacity happens in 6 — 8 weeks. For treatment of a fracture of neck of a shovel with shift as reposition, apply a method of skeletal traction on the taking-away tire. The spoke is carried out through an elbow shoot. Position of an extremity the same, as at changes without shift. On skeletal traction the patient is 3 — 4 weeks, then apply a plaster torakobrakhialny bandage 3 weeks. Radiological control of standing of fragments in the course of extension is obligatory. In the period of an immobilization carry out functional and physiotherapeutic treatment, after its termination appoint a course of recovery therapy. Working capacity at shovel neck fractures with shift is recovered in 8 — 10 weeks. Extremely rare method of treatment of fractures of shovel is operational.