Clavicle Fractures - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational video describes describing the most important points in clavicle fractures. This is a very nice lecture , I WAS EXPERMINTING WITH power point but the content of the lecture is very good. it is like a rare stamp with errors which will get better with time, thank you

Examination of the patient
•Check for deformities and tenting of the skin. •May be impending open fracture. •Watch for distracted clavicle. •Check for possible neurovascular deficit (check for brachial plexus injury). •Be aware that the neurovascular bundle is very close to the clavicle (subclavian vessels are about 1 cm from the clavicle).
X-rays: get x-rays of both shoulders. In the x-rays, you are going to look for shortening, comminution and the z-type fracture.
Risk factors for nonunion, fracture displacement and comminution. shortening more than 2 cm .
Absolute indications for surgery: open fracture, vascular injury and fragment is tenting the skin.
Conservative treatment: most clavicle fractures can be treated without surgery. Patient with undisplaced clavicle fractures usually heals well. It is difficult to reduce and maintain reduction in clavicle fractures. Healing will occur in 85% of patients despite the degree of displacement. if the fracture is significantly displaced, then there is a higher incidence of nonunion and this displaced fracture can cause significant, persistent weakness and disability even if the fracture heals. sling is Used for minimally or nondisplaced fractures of the clavicle. The fracture will probably heel with a small bump (callus of healing). Movement of the shoulder and the arm is not a risk factor for nonunion.
Surgical treatment:
•Comminuted fracture (use buttress plate)•Segmented fracture •z-type fracture •fracture shortening more than 2 cm •fracture displacement more than 100%
nonoperative treatment in these cases will lead to decreased endurance and strength, but the range of motion will remain the same in operative or nonoperative cases.
What type of hardware or surgical implant should be used in fixation of clavicle fractures?
Reduction: 1- superior plate fixation, 2- anteroinferior plate fixation,surgery is usually not easy. Surgery begins by defining the location of the AC joint. Also surgery is dependant on getting good x-rays in the operating room.
Superior plate fixation: no dissection of the deltoid muscle from the clavicle. The superior plate has a mechanical advantage being on the tension surface of the clavicle.
Anteroinferior plate fixation: has the advantage of using longer screws with a safe screw trajectory and less hardware prominence. Has disadvantage of deltoid dissection from the clavicle. The anteroinferior plate may be better tolerated by the patient, especially those who carry loads on their shoulders such as backpacks.
It is better to use a contoured plate. About 30% of the clavicle fixation plates are removed after the fracture has completely healed.
Complications of clavicle fractures: nonunion, malunion.
Complications of clavicle fractures due to fixation
1-Symptomatic hardware (most common complication, will need reoperation)
2-Infraclavicular numbness: complication due to injury of the supraclavicular nerve. There are three supraclavicular branches span out to cover the entire clavicle subcutaneous surface, lateral ,medial & intermediate. Injury to these branches may cause chest wall numbness below the incision. Injury to those branches may occur due to the incision or from traction during surgery. treatment of nonunion of the clavicle is plate and bone graft

[almariourpiano]

It is a.very helpful and informative video to everyone. Lord Jesus bless you Doctor.❤

[miguelpereira]

I broke my clavicle in 4 peaces 10 days ago in a mtb accident. Despite several opinions i decided for surgery. 72h after i’m really happy of first results: no pain, almost no pain drugs, stability, small movements… nothing compare with before surgery situation : huge pain, drugs and at least 6 weeks time to may be have the clavicle somehow fixed again

[caroljones]

This video is so much more helpful that the Orthopaedic Doctor that I am seeing.

[joshharte]

This is the best video for information. thank You

[cubasestudent]

I appreciate your thorough explanation of collarbone fractures and treatment options.

[RKXY]

My mommy learned a lot from this video.

[chinitabam]

I experiencing it now ..my clavicle fracture occur way back 2013 and its 9 years ago, now i lways have pain in my back through my neck

[AlazarYZ]

I just fractured my clavicle and it socks. Keeping my fingers crossed that surgery will be approved.

[lucianosouza]

Broke my clavicle almost two months ago and the Doctor at A&E told me it will need surgery as I now understand from this video, it was a "Z" type fracture.
Being already at the same hospital twice afterwards and being told that the NHS (UK) guidelines are to wait to see how it goes 😢....
Going back tomorrow for the third time to see if they decide to help me in fixing it 🙏🏻

[Moinuddin]

Thanks Dr Nabil, it was really very helpful

[OrthoStrike]

Really a good and interesting video...

[toddolson]

Thank you for this detailed information. Always good to know what one is up against.

[vlogpat]

Thanks for the video very informative, a month ago i broke my clavicle bone in the middle in my left side of shoulder and it was completely displaced and i didn't go for surgery but now still functioning

[theshowtimefitnessboxing]

And thank you for this informative videos sir❤

[Raskolnikov]

May I ask, why the 1/3 lateral (distal) fracture is a problem fracture?

[edwardmichalczyksou]

Broke clavicle 3 times never set last time while sleeping on shoulder and gave out becoming non union finally having repaired properly after 30 years, finding out that shoulder was pulling on neck causing major problems, 2 months now and finally relieved can't imagine that any ortho would think that it would just heal, and you could live like that wasting littery years of life and living with pain and discomfort also I believe that after my first break with it being now out of place shoulder changes now and causing a torn labrum you would think that they would know about proper alignment????

[maryajones]

I was just sitting and I heard and felt my clavicle crack. It has been contracting by and by. Last night it really cramped in my neck and today it popped.

[ernestsanda]

Really helpful, broke my clavicle 6 days ago

[lucyblue]

How common is clavicle fracture due to shoulder dystocia in the uk?

[nusrathjahanjameel]

Assalamualaikum wa rahmatullah wa barakatuh wa maghfiratahu,
Last video and this both videos on clavicle helped me alot sir!
Jazakallahukhairan kaseera