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Basics of CT Scan Head and Trauma Radiographs
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Ujjwal Gorsi, Chirag Kamal Ahuja
Subcutaneous emphysema on chest radiographs creates radiolucent striations which outline fibres of the pectoralis major (Figure 29.12). Air can also spread to the head, neck and abdomen. Trauma to chest can cause various injuries to the skeleton. Injury to the brachial plexus and great vessels may be seen in association with upper rib trauma. Lower rib fractures may be associated with injuries to upper abdominal organs. Five or more contiguous single fractures or three adjacent segmental rib fractures will lead to flail chest. Respiration can be severely impacted as a result of paradoxical motion during respiration (Figure 29.13). Clavicle fractures are common and usually are not of much clinical significance (Figure 29.14). Sternoclavicular dislocations, scapular and sternal injuries may also be seen. Spinal fractures may cause neurologic and vascular damage.
Orthopaedics
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
MANAGEMENT Fractures of the middle third of the clavicle can be managed conservatively with a broad arm sling + rehabilitation; fractures of the distal or proximal clavicle often require open reduction + internal fixation (ORIF).
Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
Trauma: Fractures or dislocations of the shoulder.Clavicle fracture.
İpsilateral clavicle and humerus diaphysis fractures in newborn after vaginal delivery; a very rare case report
Published in Journal of Obstetrics and Gynaecology, 2022
Metin Celik, Emre Arikan, Sevil Eraslan, Songul Celik Tastan
The risk of clavicle fracture among all deliveries is 0.2–3.5% (Beall and Ross 2001). Neonatal clavicle fractures are mostly in the form of greenstick fracture. Generally, it is diagnosed as a result of x-rays taken due to palpable callus tissue within 7–10 days. Therefore, most diagnoses are recognised at discharge or at the first check-up (Joseph and Rosenfeld 1990). Clavicle fractures are difficult to diagnose as they are commonly confused with brachial plexus palsy, congenital clavicle pseudoarthrosis, and congenital torticollis (Tachdjian 2002). In the study by Lurie S. et al., There is no significant predictable risk factor to avoid clavicle fractures (Lurie et al. 2011). Both cavicular and humerus fractures often heal without any deformity after simple immobilisation (Sherr-Lurie et al. 2011).
Neonatal birth fractures: a retrospective tertiary maternity hospital review
Published in Journal of Obstetrics and Gynaecology, 2020
Andreas Rehm, Prakash Promod, Amanda Ogilvy-Stuart
We identified 66 neonates who sustained a fracture during delivery: 46 clavicle-, 13 humerus-, four skull-, one femoral-, one rib- and one tibial fracture. Five babies with fractures also had an Erb’s palsy; three with a humeral fracture (in 2 Erb’s palsy was on the side of the fracture, in 1, on the opposite side) and two patients with a clavicle fracture (both on the fracture side). All five made a full spontaneous recovery without the need for a referral to a specialist peripheral nerve injury unit. One neonate with a humeral fracture and one with a clavicle fracture also had shoulder dystocia. The patient who sustained a tibial fracture also presented with healed intrauterine fractures of other bones as a result of osteogenesis imperfecta type 3. The other neonates with a fracture had no known underlying metabolic disorders. The patient with the femoral fracture was delivered by emergency Caesarean section and the one with the tibial fracture by elective Caesarean section. Seven clavicle fractures were identified by the senior author which had not been reported by the reporting radiologists at the time of the imaging. The radiology department confirmed the senior author’s findings.
Sports-related sternoclavicular joint injuries
Published in The Physician and Sportsmedicine, 2019
Justin E. Hellwinkel, Eric C. McCarty, Morteza Khodaee
The most common mechanism of injury for SCJ injury is an impact to the shoulder directed anteriorly or posteriorly. The CCL is suspected to act a fulcrum, thus an anterior blow to the shoulder and lateral clavicle results in an anterior dislocation of the medial clavicle. Similarly, a posterolateral blow, or a direct anteromedial blow, would result in a posteriorly dislocated SCJ. Cadaveric biomechanic studies have demonstrated that direct protraction of the clavicle at the SC joint primarily results in rupture of the posterior sternoclavicular ligament in 41.7% of cases and secondary rupture of the CCL in 33.3% of cases [5]. The CCL is almost never the source of primary failure with this vector of load, so it likely acts as a fulcrum until it too fails. Retraction of the clavicle, however, does not predictably produce failure of one ligament more than others, demonstrating the contribution of multiple supporting structures in preventing this type of displacement. These types of injuries are common in collision sports during tackles, such as football and rugby. Given the complex movements of the SC joints in many planes and the variable vectors of force acting upon it during sporting events, it is difficult to predict patterns of ligamentous injury of this joint. SCJ dislocations from medial clavicle fractures can also present from similar mechanisms of injury. Ligamentous integrity can be compromised in fracture settings, as the CCL has a broad insertion and can be found as close as 13 mm from the SCJ and some authors suggest a low threshold for surgical intervention in this setting [11,12]. Although a rare injury, SC dislocation should be considered in the differential diagnosis for direct shoulder impact because of the potentially fatal outcome if missed.