The emergency medicine management of clavicle fractures
| Autor: | Mark R. Serpico, Spencer Tomberg |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Urgent referral Adolescent Referral Sling (weapon) Fractures Bone 03 medical and health sciences 0302 clinical medicine Pain control medicine Humans Displacement (orthopedic surgery) Child business.industry General surgery Disease Management Infant 030208 emergency & critical care medicine General Medicine Emergency department Clavicle medicine.anatomical_structure Child Preschool Orthopedic surgery Emergency Medicine Female Emergency Service Hospital business |
| Zdroj: | The American Journal of Emergency Medicine. 49:315-325 |
| ISSN: | 0735-6757 |
| Popis: | Background Clavicle fractures are common. An emergency physician needs to understand the diagnostic classifications of clavicle fractures, have a plan for immobilization, identify associated injuries, understand the difference between treating pediatric and adult patients, and have an approach to multimodal pain control. It is also important to understand when expert orthopedic consultation or referral is indicated. Objective of the Review To provide an evidence-based review of clavicle fracture management in the emergency department. Discussion Clavicle fractures account for up to 4% of all fractures evaluated in the emergency department. They can be separated into midshaft, distal, and proximal fractures. They are also classified in terms of their degree of displacement, comminution and shortening. Emergent referral is indicated for open fractures, posteriorly displaced proximal fractures, and those with emergent associated injuries. Urgent referral is warranted for fractures with greater than 100% displacement, fractures with >2 cm of shortening, comminuted fractures, unstable distal fractures, and floating shoulder. Nondisplaced or minimally displaced fractures with no instability or associated neurovascular injury are managed non-operatively with a sling. Pediatric fractures are generally managed conservatively, with adolescents older than 9 years-old for girls and 12 years-old for boys being treated using algorithms that are similar to adults. Conclusions When encountering a patient with a clavicle fracture in the emergency department the fracture pattern will help determine whether emergent consultation or urgent referral is indicated. Most patients can be discharged safely with sling immobilization and appropriate outpatient follow-up. |
| Databáze: | OpenAIRE |
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