Aftercare of a clavicula fracture
For the follow-up treatment of a clavicula fracture there is a fixed follow-up treatment scheme. Wearing a Ruck or Gilchrist dressing is indicated in all cases. The further procedure can be based on the wound healing phases.
Up to the 5th day one speaks of an inflammatory phase. Here, pain reduction, manual lymphatic drainage and maintaining the mobility of the elbow and wrist on the affected side play a major role. From day 5 onwards, the healing process changes into the proliferation phase.
The focus is now on the careful mobilisation of the shoulder with the help of various measures. It is important that affected persons perform these exercises correctly under guidance, as this is the only way to positively support the healing process. After about 4 weeks, now called the remodelling phase, the mobilisation of the shoulder can be increased to over 90° movements.
2 weeks later, another X-ray check should be carried out. The return to a specific sport must be discussed individually, taking into account the progress of healing and the type of sport. The rucksack bandage is an integral part of the post-treatment scheme for a medial/medium clavicula fracture.
In the case of fractures on the outside, wearing a backpack bandage is not indicated; in this case a Gilchrist or Dessault bandage is applied. The primary goal of the application of the rucksack bandage is to immobilize the clavicle and thus relieve pain. It also serves the purpose of stabilising the shoulder.
The backpack bandage consists of padded loops that run like the straps of a backpack – hence the name. The loops converge on the back in an intermediate piece. This intermediate piece varies according to manufacturer or model, but is often shaped like a ring to thread the loops.
The narrowness can also be adjusted on this intermediate piece. By wearing the backpack bandage, a straight back posture is achieved as well as a pulling of the shoulder down and back. The tightness has to be checked regularly in order to be able to make possible corrections in the form of loosening or tension.
On the one hand, it is essential that the clavicle has an optimal position by the right amount of pull and on the other hand, that a malposition of the shoulder blade can be avoided. In general, care must be taken to ensure that the backpack bandage is applied correctly, otherwise it will have a negative effect on the healing process. The total wearing time for adults is 3-4 weeks, but only 10 days for children.
Physiotherapeutic treatment after a clavicula fracture is necessary in any case. Physiotherapy usually starts after about 4 weeks. The exact start varies of course individually depending on the healing process.
At the time of the first physiotherapy sessions, affected patients must occasionally still wear the Gilchrist or rucksack bandage. This can be taken off for the exercises without hesitation and then put on again. The aim of physiotherapy is to carefully mobilise the shoulder and to restore its full strength and functionality.
At the beginning, the focus of physiotherapy is on pain reduction, lymph drainage and heat and/or cold therapy. In the further course of the treatment, the focus is on exercises for mobility, stretching, agility and strength building of the shoulder. It is important that patients perform and learn the exercises under the precise guidance of a physiotherapist so that they can later perform them independently.