Traditional Chinese medicine diagnosis and treatment technology of clavicle fracture

China's traditional Chinese medicine reported

        There are two clavicle bent long bone, the position is shallow, bridge in the sternum and shoulder peak between, shoulder is with upper limbs and trunk of contact between osteoarthritis. Collarbone in a "~" form, the medial segment lordosis, and have the sternocleidomastoid muscle and chest big muscle attached after the period at a deltoid muscle and trapezius muscle attached. Clavicular fracture is relatively common, takes place in a third place, especially to young children more see.

        Conventional treatment

        Young children without shift fracture or green branches fractures of the triangle that available suspension upper limbs. Have displaced fracture, although can be managed to make its reduced, but actually don't have a very good method to maintain reset, and eventually will always remain a clavicle deformity. Although not tasteful appearance, but usually does not affect the function of the shoulder. Due to the strong ability of bone infant body, so certain deformity in development to correct. No need to get anatomical repositioning and repeated reduction, unfavorable at will by surgery. A shift in the following method treatment can be fractures.

        1. The reconstructive method

        The seat patients, hold out a bosom looked up, with his hands on his hips, performer in the middle of the back with his knee against the will, the hands hold its two shoulders the lateral, among the side slowly traction, make bosom shoulder, this time the fracture shift can reset or improve, if still have lateral shift, can be used according to mention technique correction.

        2. Fixed method

        In the MianDian buy two under your arm, with bandages of the shoulder from the alar, around the shoulder up front, across the back, after the side under your armpit and bypass the opposite shoulder up front, back to back to around of the arm and bag around 8 to 12 layer, namely "desert bandage fixing with triangle, word towel suspension limb the chest, and also can use double ring fixed law. General regular 4 weeks, can prolong the comminuted fractures fixed to 6 weeks. Most cases of fracture healing.

        3. Surgical treatment

        The fractures of clavicle open reduction and internal fixation should be very careful. If you need operation, should pay attention to reduce operation wounds and periosteum detachment range. Can use, kwire, steel plates or screws. To protect the triangle that 4 ~ 6 weeks.

        4. The drugs

        Should remove blood stasis, and promoting the early acetanilide detumescence, can invigorate the internal analgesic soup (angelica 12 grams, river xiong 6 g, frankincense, 6 grams sappanwood 5 g, safflower 5 g, myrrh 6 grams DeBie worm, 3 g, 3 g, rhiozma sanqi (panax notoginseng) 9 g, 5 g dried tangerine or orange peel, centella asiatica 6 grams, traversing cercis chinensis cane 9 g) or limb hurt a party (the "12 grams, red flowers, cortex phellodendri 6 grams 10 grams, which is 10 grams, wind 10 grams, rhiozma 12 grams, TongCao 10 grams, born dihuang 12 grams, the frankincense 5 g, liquorice 6 grams) to add and subtract. 3 as the external or double bogeys scattered.

        Should be reinforced, 3 middle renewal, internal and can choose a new injury for broken soup (1 ~ 2 g angelica tail, ze LAN leaves 6 grams, yuan hu 6 grams, the frankincense 3 g, danshen, 6 grams soil terrapin insect 6 grams of myrrh, 3 g, 3 g, natural sappanwood copper 1 ~ 2 gram, drynaria fortunei, 3 g to break 10 grams, SangZhi 12 grams, nut 6 grams), renewal bone huoxue soup, limbs injury two party, apply for cleidocranialdyspasia reinforcement of ointment.

        Middle age of the patients, easy for blood weak, blood does not honor muscle, and around the shoulder phlogistic, it should be a late on blood, filling kidney and liver, strong bones and muscles, can take orally bolus of 6 flavour glutinous rehmannia or limb injury three parties, attached with strong bone strong muscle cream. Children with fracture healing rapidly, such as no disease concurrently, later need not drug use.

        Appropriate technology

        Clamp the end ask swing gimmick reset percutaneous pin fixation retrograde wear (shandong province-the whole bone hospital)

        1. The treatment

        (1) equipment choice: according to patients with body shape and X-ray shows the proper choice of clavicle form of the clamp and ask clavicle, kwire.

        (2) patients take seat: the supine, shoulder surgery should be close to with the edge of the bed and high pad about 30 degrees, Oregon set with impending, so as to facilitate the gram side wear a needle from the shoulders.

        (3) the regular disinfection shoulder operation.

        (4) reset and fixed (to sit up a treatment of clavicle fracture right as an example).

        (1) clamped far fold end: with the collarbone in the fold put clamp is far away from the edge before and after nearly fold about a centimeter or so by Pierce the skin on down, and then fold along the far before and after the margin to deep sliding, until the clamp tooth depth of far fold period pointed up and down size l / 2 ~ two-thirds, fasten clamp tooth, make clamp tooth clamping live far fold section.

        (2) the cyclotron fracture end: the performer puts his left knee with the light up the top of your right elbow patients (or make a assistant raise), left hand carry end ask clamp drive the first period of clavicle fold gently pull back, and then pulling up, at the same time right thumb knead fold down near the front pressure, make the discount around nearly fold far the block to nearly the fold up front.

        (3) retrograde wear needle: determine the position of the medullary cavity, gram the acupuncture intramedullary, with bone hammer the injections tail, resistance to increased obviously, to switch to bone drilling drive, kwire penetration, the side into the needle edge adjustment direction, from the bend of clavicle back breakthrough, and from the shoulders locked inside 3 cm joint within set, on a hill in the margin of the skin. Since the drilling with bone with gripping and drive, kwire backward, until the needle smooth outside the folding tail section.

        (4) the fracture end resets with fixed: the end ask clamp mention far fold back around nearly discount for the end, when the far end of nearly fold the fold after beneath the left hand holding the discount period ask clamp drive up at the same time the pull to shuthelah, and correct the lateral displacement and overlapping shift and reset after accurate, an assistant with bones hammer strike from inside extroversion, kwire make it into the fold line near the medullary cavity period.

        (5) after the success of the fixed and reset, check the fracture technique stability, and will cut short the needle bending, smooth the buried with subcutaneous. Straighten out the rotating around technique fracture displacement of bone, the skin grain direction knead crowded pinhole make its natural closed, disinfection, sterile dressing. Check the radial pulse, the neck bracelets suspension forearm. End the operation.

        1. The key technology link

        (1) the mention of clavicle holding clamp clavicle far fold segment, the clamps point should as far as possible is located in thick long beak lock ligaments inside, so as to facilitate the cyclotron mention far fold section; Mention far paragraph should fold the discount will be far from below the fold after nearly whirly on carry, and with the other hand in thumb and forefinger downward pressure on the front nearly fold is far from broken section near section of the block swing mention fold the subcutaneous fat.

        (2) the gram far into the fold the acupuncture, application, kwire in the top of the bone slip method, as well the medullary cavity wall of touch week are resistance when feeling, under a clear sense of SeZhi before needle, needle into the direction should try to adjust, kwire shoulder joint direction along the locked from inside to outside wear out to tip from shoulder joints lock in party within 3 cm, shoulder blade with wear a Vatican skin advisable, he will further, kwire into nearly fold period of the medullary cavity.

        (3) reset, according to disruption type and shifting direction reset, attention should be paid to the end to clamp the clavicle lift to drag the collarbone far to the fold fixed overlapping shift.

        (4) the reset judgment method is: hand touch clavicle crest bone continuous, anything Angle deformity, prove that reset is good, can will do, kwire the strike into the fold or dived into nearly the medullary cavity period.

        2. Features

        This technique treating clavicular fracture, little pain, fracture restoration, healing fast, less complications, and in the course of treatment, patients can provide for oneself do not affect life completely general work.

        3. The matters needing attention

        (1) inside fixed gram choice, should according to the X-ray shows the marrow cavity thickness and lock choice of 2-2.5 mm in diameter, kwire, is too thick needle into the difficulties, and rules of stress is poor, is prone to generate Angle and a rotating shift.

        (2) in the operation of the subclavian carry clamps should be gripping collarbone far fold up and down before and after the diameter of the margin for l / 2 to 2/3 advisable, deep easy injury and subclavian blood vessels, nerve, a shallow weak is gripping. Gram acupuncture into the skin, should strictly control the depth, prevent accidents.

        (3) technique comminuted fracture to straighten out a little, and do not push hard on, in order to avoid damage the subclavian important organization. (excerpt from "formulary disease treatment technology, traditional Chinese and western medicine")