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Closed Comminuted

Fracture 1/3 Middle Right


Clavicle
Meyke Liechandra (C11109130)
Advisor:
dr. Prori Fatwa Noor
dr. Wendelin Widia Madhin
Supervisor:
dr. Henri Yurianto, M.Phil, Ph.D, SpOT
Department of Orthopedic and Traumatology
Medical Faculty of Hasanuddin University
2014

Patient Identity
Name
: RF
Age
: 29 years old
Sex
: Male
Date of admission : May 15th 2014
RM
: 663655

History Taking
Chief complaint: Pain at the right shoulder

General State
Well nourished / Compos mentis

Local State
Right shoulder region
I

Clinical Pictures

Laboratory Finding
May 15th 2014
WBC : 11x103/mm3
RBC : 5,66 x106/mm6
HGB : 14,5 g/dl
HCT : 43, 9%
PLT

: 190 x103/mm3

HbSAg : Non Reactive


CT

: 700

BT

: 300

Radiological Finding

Chest X-Ray AP view


Result : Comminutived fracture 1/3 middle right clavicle

Resume
A

male, 29 years old, admitted to


the hospital with chief complaint
pain at the right shoulder since 3 days
ago.
On physical examination at the right
shoulder region : deformity (+),
tenderness (+), active and passive
motion are limited due to pain.
On radiological finding: comminuted
fracture 1/3 middle right clavicle

Diagnosis
Closed Comminuted Fracture 1/3 Middle Right
Clavicle

Therapy
IVFD
Analgetic
Apply

mitella
Plan: Open Reduction and
Internal Fixation (ORIF)

Discussion

Introduction
Fracture

is a break in continuity
of a bone.
Fracture of the clavicle is one of
the commonest fractures in
childhood and early adult life,
and is usually caused by a fall
onto the shoulder or the
outstretched hand.
Duckworth P, Blundell CM. Fractures and healing. In: Duckworth P, Blundell CM. Lecture Notes:
Orthopaedics and fractures. 4th edition. Hoboken: Wiley-Blackwell; 2010.

Epidemiology
80
5
1

Koval KJ, Zuckerman JD, eds. Clavicle fractures. In: Koval KJ, Zuckerman JD. Handbook of fractures.
Third Edition. Philadelphia: Lippincott Williams & Wilkins; 2006

Mechanism of Trauma
Direct trauma
Indirect
trauma

Lazarus MD, Seon C. Fractures of the clavicle. In: Bucholz RW, Heckman JD, Court-Brown CM.
Rockwood and greens fracture in adults. Sixth edition. Philadelphia: Lippincott Williams &
Wilkins; 2006

Anatomy

Thompson JC. NETTER's Concise Atlas of Orthopaedic. 2nd Edition.

Thompson JC. NETTER's Concise Atlas of Orthopaedic. 2 nd Edition.

Classification
Allmans Classification
Group I: fracture of the middle
third
Group II: fracture of the distal third
Group III: fracture of the proximal
third

Koval KJ, Zuckerman JD, eds. Clavicle fractures. In: Koval KJ, Zuckerman JD. Handbook of
fractures. Third Edition. Philadelphia: Lippincott Williams & Wilkins; 2006.

Lazarus MD, Seon C. Fractures of the clavicle. In: Bucholz RW, Heckman JD, Court-Brown CM.
Rockwood and greens fracture in adults. Sixth edition. Philadelphia: Lippincott Williams & Wilkins;
2006

Diagnosis
History Taking

Lazarus MD, Seon C. Fractures of the clavicle. In: Bucholz RW, Heckman JD, Court-Brown CM.
Rockwood and greens fracture in adults. Sixth edition. Philadelphia: Lippincott Williams & Wilkins;
2006.

Management

Duckworth P, Blundell CM. Fractures and healing. In: Duckworth P, Blundell CM. Lecture Notes:
Orthopaedics and fractures. 4th edition. Hoboken: Wiley-Blackwell; 2010.

Complication
Neurovascular

compromise

Malunion
Nonunion
Posttraumatic

arthritis

Infection
Hypertrophic

scar

Refracture
Koval KJ, Zuckerman JD, eds. Clavicle fractures. In: Koval KJ, Zuckerman JD. Handbook of fractures. Third
Edition. Philadelphia: Lippincott Williams & Wilkins; 2006.
Lazarus MD, Seon C. Fractures of the clavicle. In: Bucholz RW, Heckman JD, Court-Brown CM. Rockwood and
greens fracture in adults. Sixth edition. Philadelphia: Lippincott Williams & Wilkins; 2006.

Prognosis
Clavicular

fractures heal well.


It gives excellent function.
After remodelling are
cosmetically satisfactory.

Duckworth P, Blundell CM. The shoulder and upper arm. In: Duckworth P, Blundell CM. Lecture
Notes: Orthopaedics and fractures. 4th edition. Hoboken: Wiley-Blackwell; 2010.

Thank You