Treatment Undisplaced Simple slab/splint & sling for 1-2 days (for swelling to subside) Followed by Colles’ cast for 4-6 weeks Displaced Reduction under anesthesia (hematoma block, Bier’s block, sometimes G/A) Followed by Colles’ cast for 4-6 weeks If Reduction is Not Acceptable ORIF by k-wire, plate & screw or even external fixator Colles’ Cast It is a below elbow cast with palmar flexion and ulnar deviation with the following 4 criteria: ...
Treatment Non-operative Most clavicle fractures unite rapidly despite displacement. Mainstay of treatment is simple sling for 1-3 weeks or until pain subsides. Operative ORIF by plate & screw or intramedullary nail Indications of Surgery Open fracture Widely displaced fracture Displaced distal 3rd fracture Floating shoulder Cosmetic deformity Seizure disorder When earlier return to work is needed
Treatment Young Adult Closed Reduction and Internal Fixation with cannulated hip screws Elderly (>60y) Replacement hemiarthroplasty with femoral prosthesis
Treatment Antibiotics Debridement & tetanus prophylaxis Stabilization Soft-tissue cover Rehabilitation Antibiotics 1st/2nd generation cephalosporin or co-amoxiclav Started immediately Continued up to soft-tissue cover or a maximum of 72 hours, whichever is sooner Debridement All dead and foreign material is removed Washed with large quantities of normal saline Stabilization Locked intramedullary nailing (if definitive wound cover is possible at the time of debridement) Temporary stabilization with external fixator and later replaced with intramedullary nail (if definitive wound cover is not possible immediately)
Treatment Undisplaced Long arm back slab for 3 weeks with elbow at 90 degrees or less. Displaced Closed reduction under G/A with traction & counter-traction followed by long arm full plaster for 4-6 weeks: With elbow at 90 degrees or less (extension variety) With elbow in slightly extended position and then flexion is attained gradually, i.e., 10 degrees a week (flexion variety) Indications of ORIF Failed closed reduction Type III fracture (completely displaced extension variety) Open fracture Neurovascular damage