Therapy
A collarbone fracture can be treated conservatively or by surgery. If one wants to operate, the indication for this must be made clear. The most important criterion for surgery for a collarbone fracture is an open fracture in which the bone pierces the skin.
Even severely dislocated fracture ends, i.e. fracture ends that are shifted against each other, must be operated on. Other indications for surgery for clavicle fractures are concomitant injuries to nerves or vessels. The operation of a collarbone fracture is performed under general anesthesia, which is initiated by an anesthesiologist.
A sedative tablet is often administered before the operation to spare the patient unnecessary stress. After the anaesthesia is induced with intravenous drugs or anaesthetic gas, the surgeon begins to expose the fracture. Special care is taken not to injure any nerves or vessels.
During the operation, the bones involved are rejoined in an anatomically correct way and then fixed in place. Depending on the surgeon and the case at hand, a collarbone fracture is treated with metal plates or wires. The plates are fixed to the bone above the fracture gap with screws, thus ensuring absolute stability.
The bones can then grow together again. Wires are available as an alternative. After the operation, a so-called Gilchrist or backpack bandage is applied to immobilize the arm for a few days, followed by a sling for a few weeks.
Once the collarbone fracture has healed, the plates are removed again after 6-12 months. A new procedure is the use of a titanium nail, which is inserted minimally invasively into the medullary cavity of the bone and thus splints it from the inside.Which procedure is chosen depends mainly on the extent of the fracture and the surgeon. The duration of the operation itself can be given as 1-2 hours, depending on various factors, in complicated cases the duration may be longer.
The rucksack bandage is a very popular conservative method of treatment of clavicle fracture. It is applied around the shoulders like a very tightly pulled backpack. It pulls the shoulders backwards, straightens the upper body and restricts movement in the upper body, stabilizing the shoulders and the collarbone fracture.
The fracture is also pulled slightly apart, which prevents the fracture from growing together too short. Immobilization also includes pain therapy at the same time, as it prevents movement in the shoulder. In some cases, a collarbone fracture is also treated on an outpatient basis, i.e. without an inpatient stay in hospital.
In most cases, surgery requires at least two days of inpatient treatment. However, especially for young and athletic patients, it may be considered to perform the surgery on an outpatient basis. Until the anesthesia wears off, the patient is monitored for a few hours and then discharged home.
Nevertheless, the patient must pay attention to some measures after the operation. After an outpatient operation, even in the case of a collarbone fracture, there is usually a 24-hour ban on driving and operating machines. A person of trust must pick up the patient from the hospital, important decisions or duties should be avoided for the following day.
Whether a collarbone fracture is treated on an outpatient basis depends primarily on the extent of the fracture and the patient’s fitness. For example, an open fracture or fractures in older people should not be operated on as an outpatient. Ultimately, the decision lies with the treating medical staff.