The collarbones are tubular, curved bones approximately 15 cm long that connect the shoulder blades to the sternum and strengthen the shoulder girdle. Outside, they are shrouded in powerful muscle tissue (5 different muscles). The bone itself consists of the sternum, middle and acromial (near the shoulder) parts. The thicker parts at the ends are connected to the sternum and scapula. In addition to supporting and connecting functions, the clavicle also plays a protective role - the most important circulatory, lymphatic, and nervous structures are located nearby, and the artery and vein of the brachial plexus pass under it. The structure of the acromioclavicular joint is complex; a serious bruise of the collarbone can cause impairment of motor activity of the upper limb.
Causes
It is not difficult to get a bruised collarbone; the cause of this injury can be:
- unsuccessful falls on the shoulder, shoulder or elbow joint, or on the abducted arm,
- direct blows to the collarbone area.
The most common injuries are to the acromioclavicular joint (ACJ), the joint in the shoulder girdle that connects the collarbone to the shoulder blade.
Children, no less often than adults, receive collarbone injuries due to their activity, carelessness and skeletal immaturity.
Symptoms
When a collarbone is bruised, patients usually complain of the following symptoms that require treatment:
- aching pain, aggravated by movements of the limb,
- swelling of the bruised area, painful swelling as a result of the inflammatory process,
- shoulder drooping,
- bruise or severe hematoma - blood accumulates in the subcutaneous tissue due to damage to blood vessels,
- disorders of skin sensitivity if nerve structures are affected.
These symptoms are also typical for more serious injuries to the collarbone, but in the case of an uncomplicated bruise, the bone remains intact, usually only the skin, subcutaneous layer and muscle tissue are damaged. Blood vessels rupture, leading to bleeding and bruising. At the same time, the hand functions, and the painful sensations go away on their own over time. Cases of damage to the nerve structures, the bone itself and its joints lead to severe pain in the upper region of the shoulder and impaired functioning of the arm.
One of the common injuries to the clavicle during a bruise is a dislocation of its acromial end (often a consequence of the fact that the blow fell on the shoulder). In this case, the articular surface of the head of the humerus and the glenoid cavity of the scapula are damaged. A dislocation is characterized by severe pain, impaired movement in the shoulder joint, swelling, and asymmetry of the damaged area of the shoulder.
Contusion of soft tissues of the face
If there is mobility of the shoulder joint, there is no dislocation, or the second end has dislocated near the sternum. In this case, there is severe pain in the chest area, swelling occurs, and the bone may protrude towards the chest or back.
If a fracture occurs, the above symptoms may be supplemented by elongation of the arm, deformation of the collarbone, and a characteristic crunching sound when attempting to move.
In the event of a severe injury to a child’s collarbone and a bruise appears, it is recommended to immediately see a pediatric traumatologist, since children have a weak skeleton and fractures of the bone tissue of the collarbone are likely.
If any of these signs occur, it is better to contact a medical facility to clarify the diagnosis in order to neutralize all health risks.
Treatment
Treatment of scapula injury is carried out using two methods. The patient is prescribed conservative treatment or undergoes surgery according to indications. The doctor selects the therapy, taking into account the patient’s condition, his individual characteristics and the extent of the damage.
Conservative treatment
In most cases, surgery can be avoided. The doctor gives painkillers to the patient and performs manipulations. Fixing bandages are used after comparing bone fragments:
The drainage splint is installed for a period of 6 weeks. For minor injuries, the splint is worn for 4 weeks.
- Plaster cast Deso . With its help, not only the scapula is fixed, but also other bones in the shoulder area. A plaster cast reliably immobilizes the muscles. It is uncomfortable for a person to sleep, but bone deformation in this situation is completely excluded.
- Thoracobrachial bandage . A fixation method that is used more often for displaced fractures of the scapula. The bandage is applied for a month.
During the recovery period, the patient is recommended to use a fixation bandage. It is often used if the patient has a weakened bone skeleton or has been diagnosed with osteoporosis, which increases the risk of scapula injury.
If the bone tissue does not move, the plaster cast can be replaced with a regular restraint (orthosis).
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Surgical intervention
The operation is indicated for patients with complex bruises or fractures of the scapula:
- If there is a suspicion that the motor functions of the upper limb are impaired.
- If an injury to the left or right shoulder blade leads to damage to the shoulder region.
- Displacement of fragments requires surgical intervention.
- In case of intra-articular fracture.
- If the injury affected more than ¼ of the circumference of the glenoid cavity.
- Subluxation of the head of the shoulder joint requires surgical intervention.
The manipulations are carried out under local anesthesia. Metal parts (plates) are used to fix the bones. After surgery, it is important to go through a period of rehabilitation, restore the functions of the shoulder and prevent negative consequences.
Is it possible to do therapy at home?
You can treat a scapula injury at home, but only after consultation with a specialist. Complex bruises require surgical intervention. Mild damage can be treated with folk remedies, but therapy should be comprehensive:
- Mix vegetable oil, boiled water and vinegar in equal proportions. Dampen a small piece of cloth and apply it to the area where severe pain is felt.
- fresh burdock roots (70 g) and add vegetable oil (200 g). Leave for a day. Before use, heat the mixture over fire for 15 minutes and cool. The damaged area is lubricated with the medicine 3 times a day. It is recommended to store the ointment in a cool place using a dark glass container.
- Grind oak bark and daisy flowers . Mix the components in equal proportions, 1 tbsp. l. pour boiling water (1 tbsp) and leave for 30 minutes. Moisten gauze with infusion and apply to the damaged area.
Before using any folk remedy, you should consult a doctor to avoid an allergic reaction and complications.
Find out which ointments help with joint pain.
First aid
First aid for a bruised collarbone is as follows:
- immobilize the injured arm after an injury - a fixing bandage is required in case of a fracture (you can hang the arm bent at the elbow on a cloth bandage or attach it to the body),
- apply something cold to the skin at the site of injury (a container of cold water or ice, items from the freezer) to prevent swelling and hematoma, as well as to reduce pain,
- If the pain is unbearable, take a painkiller (orally or intramuscularly).
After these steps, it is recommended to contact a traumatologist or surgeon as soon as possible. Self-medication can only cause harm.
First aid for bruises with damage to only soft tissues includes only measures to cool the bruise, relieve pain and treat the wound.
Clavicle fracture
Therapeutic tactics are determined by the presence and nature of the displacement. Children and adults with uncomplicated, well-reduced clavicle fractures without the threat of damage to nerve trunks or blood vessels do not require hospital treatment. If there is a threat of complications, hospitalization in the trauma department is indicated. In most cases, conservative treatment is highly effective; operations are rarely performed.
First aid
First aid consists of hanging the limb on a scarf, bending it at the elbow joint and bandaging it to the body. You should not try to eliminate the displacement yourself by sharp jerks or movements of the affected limb - this can cause secondary displacement of the fragments and increase the risk of complications.
Conservative treatment
The main treatment method is immobilization. The fixation period for children is 2-3 weeks, for adults – 1 month. In childhood, Delbe rings are usually sufficient to hold fragments. In adults, the Chizhin frame and other special dressings are used.
- For greenstick fractures and non-displaced injuries, a fixation bandage is applied.
- In case of a clavicle fracture with displaced fragments, local anesthesia is performed, followed by reposition and fixation with a soft or plaster cast.
After reposition, a control photograph is taken and UHF is prescribed. For severe pain in the first days after injury, it is recommended to take analgesics. After cessation of immobilization, the patient is referred for massage and exercise therapy.
Surgery
Indications for emergency surgical treatment are all open fractures of the clavicle and closed injuries with the development of complications or the threat of damage to nerves, pleura and blood vessels from unstable bone fragments. Planned operations are performed when there is irreparable displacement of fragments and significant external deformation of the shoulder girdle. The following options for clavicle osteosynthesis are possible:
- Intraosseous
. Indicated for comminuted fractures, a special pin or Bogdanov nail is used. - Nakostny
. Recommended for multi-fragmented injuries, performed using a curved plate. - Spoke
. Fixation is performed with knitting needles, which are passed through fragments of the clavicle. The ends of the spokes are brought outside the bone and fastened.
In the postoperative period, antibiotics, analgesics, and physiotherapy are prescribed. Discharge is carried out after the sutures are removed (on 8-10 days).
Diagnosis and treatment
What to do if your collarbone hurts after a bruise? A clavicle contusion is considered a closed soft tissue injury in the clavicle area. An X-ray for such an injury will not show any abnormalities.
If you have a severe bruise of the collarbone, it is better not to self-medicate at home, but be sure to consult an experienced traumatologist who can determine whether it is a bruise, a dislocation, a sprain of the clavicle articular apparatus, or a fracture. The doctor will examine and palpate. An x-ray is needed to check the integrity of the bones and confirm the diagnosis. For serious bruises, an MRI is prescribed. This research method reveals ruptures of nerves, blood vessels, and ligaments. Additional examination methods may also be prescribed:
- CT scan,
- ultrasonography,
- angiography (check vascular patency),
- arthrography (check the integrity of the capsule of the bruised clavicle joint),
- arthroscopy (using a probe with a video camera, the acromioclavicular and sternoclavicular joints are examined for damage),
- laboratory tests (blood and synovial fluid tests).
Clavicle fracture
Based on the results of the examination and examination of the victim, the attending physician prescribes a treatment regimen. The diagnosis of a clavicle bruise is often based on examination and x-ray data only, excluding all of the above examinations.
How to quickly cure a bruised collarbone? Minor bruises usually go away within a couple of weeks. In case of complications, it may take a couple of months.
It is necessary to ensure rest and immobility of the clavicular joints for at least a week - wear an orthopedic bandage. During the first days, it would be a good idea to apply cold for up to 15 minutes every couple of hours. Exposure to cold helps the vessels contract and thereby reduces the amount of hemorrhage. There will be less hematoma and swelling, which means recovery will be closer.
If necessary, you can use drugs to relieve inflammation (Movalis, Nise, Celebrex) and externally gels, creams, ointments (Diclofenac, Voltaren, Denebol, Febrofid, Heparin ointment, Lyoton).
In case of severe injury (dislocation or fracture), operations are often performed: the position of the bone is restored, the ligaments are sutured. Then a tight bandage is applied to immobilize the arm.
After medications, physiotherapy is recommended: UHF, electrophoresis, magnetic therapy. With their help, the pain and swelling of a bruise go away more quickly. To improve blood circulation, you can also do treatment at home - warm up the bruised area using a heating pad or warm compresses.
Diagnostic methods
A doctor can make an accurate diagnosis based on a medical examination. If necessary, the patient will need to undergo additional examination. You can determine a scapula injury using:
- x-ray,
- computed tomography (CT).
It is necessary to undergo a thorough examination to exclude intra-articular fracture and damage to other organs. In most cases, the cause of a severe bruise of the shoulder blade is an accident (road traffic accident) or a bad fall.