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Fractured clavicle

The clavicular fractures are among the most common causes of bony lesions. The fracture is localised more frequently in the passage between third medial and lateral (80%) that is the weakest point. When the fracture is complete, the medial fragment shifts upwards due to the action of the sternocleidomastoid muscle, while the lateral fragment moves downwards due to the action of the deltoid muscle joined by the arm weight.
The traumatic mechanism occurs especially because of a fall on the arm in extension (fall from a horse, motorbike or bicycle).
Pain in the fracture seat might be so intense that moving the limb could be impossible.  The area is swelling and deformed at the level of the fracture edges, altering the normal profile of the shoulder. The injury is generally evaluated thanks to a standard radiography, but sometimes a musculotendinous ecography is sufficient. It is important, instead, to undergo a CT scan in more difficult fractures to diagnose, while a MRI will be suggested when the lesion of the rotators cuff is suspected.
The fracture recovery depends on the condition of alignment of fragments that which requires that the shoulder is kept backwards through the functional “8” bandage, necessary even if annoying.

The clavicle heals in three weeks on average, but if stubs are complexly compound, the immobilisation will be prolonged. When bandage will be removed, a bony callus will be easily perceivable and visible, as if it was a step. It is usually avoided the surgical treatment of the injury. Rehabilitation is extremely important: when the bandage is removed, it is necessary to start a set of rehabilitation therapies in the pool and in the gym to recover in the shortest time possible the range of motion of the shoulder, the strength of its muscles and the neuromotor control on the shoulder.

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