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FRACTURES AROUND SHOULDER

FRACTURES AROUND SHOULDER. Fractures around Shoulder. Fractures of Clavicle Fractures of Scapula Fractures of proximal Humerus. Fractures of Clavicle. Surgical Anatomy. FRACTURES OF THE CLAVICLE. FUNCTIONS OF THE CLAVICLE Power and Stability of the arm Motion of the shoulder girdle

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FRACTURES AROUND SHOULDER

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  1. FRACTURES AROUND SHOULDER

  2. Fractures around Shoulder • Fractures of Clavicle • Fractures of Scapula • Fractures of proximal Humerus

  3. Fractures of Clavicle

  4. Surgical Anatomy

  5. FRACTURES OF THE CLAVICLE • FUNCTIONS OF THE CLAVICLE • Power and Stability of the arm • Motion of the shoulder girdle • Muscle Attachments • Protection of the Neurovscular Structures • Respiratory Function • Cosmesis

  6. FRACTURES OF THE CLAVICLE • INCIDENCE OF INJURY: 4% • MECHANISM OF INJURY: - Direct - Indirect • CLASSIFICATION OF CLAVICLE FRACTURES: • Fractures of the Middle third of the clavicle - 76% • Fractures of the Lateral third of the clavicle- 21% • Fractures of the medial third of the clavicle – 3% • CLINICAL PRESENTATION : Pain, swelling, deformity, loss of function

  7. FRACTURES OF THE CLAVICLE • ASSOCIATED INJURIES • Associated Skeletal Injuries • Fractures of the clavicle and Scapula • (The Floating shoulder ) • Injuries to the Lungs and Pleura • Brachial plexus Injuries • Vascular Injuries • RADIOGRAPHIC FINDINGS • Shaft Fractures • Fractures of the lateral third • Fractures of the Medial third

  8. FRACTURES OF THE CLAVICLE • TREATMENT • Conservative: Broad arm sling for 3-4 weeks • Operative

  9. FRACTURES OF THE CLAVICLE • INDICATIONS OF OPERATIVE TREATMENT Open fractures Fractures with neurovascular compromise Polytrauma Floating shoulder (combined clavicle & scapula fractures) Symptomatic non-unions Cosmesis

  10. OPEN REDUCTION

  11. FRACTURES OF THE CLAVICLE • COMPLICATIONS • Nonunion • Mal-union • Neurovascular compromise

  12. FRACTURES OF SCAPULA

  13. Fractures of ScapulaSurgical Anatomy

  14. Fractures of Scapula • Incidence: 1% • Mechanism of Injury: Direct/Indirect RTA, Fall from height • Associated Injuries: Clavicle fractures 15 - 40% Rib fractures 25 - 50% Pulmonary injuries 15 - 55% Humeral fractures 12% Brachial Plexus 5-10% Skull fractures 25% Lower Limb fractures 11% Major Vascular injury 11% Splenic lacerations 8%

  15. Fractures of Scapula Classification: • Fractures of body of scapula • Fractures of neck of scapula • Fractures of glenoid cavity • Fractures of coracoid process • Fractures of acromion process

  16. Fractures of Scapula • Clinical Features: Pain, swelling, deformity, loss of function • Diagnosis: Plain X-rays, CT scan • Treatment: 90% treated conservatively- Broad arm sling for 4-6 weeks

  17. Fractures of Scapula Indications for Operative treatment: • unstable fractures • combined injuries

  18. FRACTURES OF THE PROXIMAL HUMEURS

  19. Fracture of the proximal Humeurs • Anatomy

  20. Fracture of the proximal Humeurs

  21. MECHANISM Of INJURY • Direct injury • Indirect injury • CLASSIFICATION OF FRACTURES OF THE PROXIMAL HUMEURS • Non displaced • Displaced • Neer four-part classification • AO Classification

  22. INVESTIGATIONS • X-rays (AP and Lateral views) • CT Scan

  23. Treatment • NON-OPERATIVE Cuff and collar sling • OPERATIVE ORIF with wires Sutures Plates Screws Replacement of humeral head with Prosthesis

  24. OPERATIVE TREATMENT

  25. REHABILITATION • Range of motion exercises • Muscles strengthing exercises

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