Post-Clavicle Fracture Care: Essential Tips for Recovery and Rehabilitation

Nursing Care After Clavicle Fracture

Hello Doctor, my father is 55 years old.
He had a motorcycle accident yesterday, and the emergency room diagnosed him with a distal left clavicle fracture, left chest and left knee contusions.
The emergency department said surgery is not necessary and only prescribed pain medication and advised him to use a triangular bandage for immobilization.
However, his friend told him that maintaining a single position after a fracture could lead to muscle adhesion, which might prevent him from lifting his arm straight in the future.
Considering the nature of his work, he removed the triangular bandage as soon as he got home from the hospital.

I would like to ask about the proper timing for using a triangular bandage.
Is it really necessary to keep it immobilized all day? Should he keep it on while sleeping? How long does he need to be immobilized, for a month or three months? How long will it take for him to heal? Will this lead to muscle adhesion as a complication? If there are concerns about complications, will he need rehabilitation?
Additionally, he has no visible external injuries on his left chest, but he reports significant pain.
His knee has only superficial injuries without swelling, but he also complains of pain and inability to fully extend it.
Does this indicate muscle tissue injury? The doctor only prescribed pain medication and topical ointment for the injuries, so does that mean muscle injuries will have to heal on their own?

Mr. Hsu, 50~59 year old female. Ask Date: 2020/08/02

Dr. Chen Bochen reply Orthopedics

Some fractures with minor displacement can be treated with a triangular bandage for stabilization, allowing the bone to heal on its own over a period of 2-3 months.
Removing the triangular bandage too early may lead to increased displacement, which could necessitate surgical intervention when it was initially avoidable.
The triangular bandage should be worn at all times except when lying down; some individuals may even choose to wear it while sleeping to prevent unconscious movements.
Generally, the bandage is applied for 4-6 weeks, with adjustments made based on the severity of the injury.

Clavicle fractures often occur in conjunction with rib fractures, and rib fractures can sometimes be difficult to detect on X-rays due to angling issues.
However, most rib fractures do not require surgery, although they can be painful for about a month.
If there is difficulty fully extending the knee, it may indicate joint effusion, and it is advisable to consult an orthopedic specialist.
If there is effusion, aspiration can significantly alleviate the condition.
Wishing you a smooth recovery.

Reply Date: 2020/08/02

More Info

Post-clavicle fracture care is crucial for ensuring proper healing and minimizing complications. Your father's situation, with a distal clavicle fracture and associated injuries, requires careful attention to both immobilization and rehabilitation. Here are some essential tips and insights regarding his recovery process.

Immobilization and Use of the Sling
1. Purpose of the Sling: The triangular sling is designed to immobilize the arm and shoulder, reducing movement that could disrupt the healing process. It helps alleviate pain and provides support to the injured area.

2. Duration of Use: Generally, a sling should be worn for at least 2 to 4 weeks, depending on the severity of the fracture and the doctor's recommendations. It's essential to follow the physician's advice regarding the duration of immobilization. While it's important to keep the arm supported, it is also crucial to avoid prolonged immobility to prevent stiffness and muscle atrophy.

3. Sleeping with the Sling: It is advisable to wear the sling while sleeping, especially in the initial weeks following the injury. This helps maintain the arm in a stable position and prevents accidental movements that could aggravate the fracture.

4. Gradual Movement: After a few weeks, and with the doctor's approval, gentle range-of-motion exercises can be introduced to prevent stiffness. However, these should be done cautiously and under the guidance of a healthcare professional.

Risk of Adhesions and Muscle Stiffness
1. Muscle Adhesions: Prolonged immobilization can lead to muscle adhesions, which may result in limited range of motion and discomfort. To mitigate this risk, it's important to follow a structured rehabilitation program that includes gradual movement and strengthening exercises once the initial healing phase is over.

2. Rehabilitation: After the immobilization period, physical therapy is often recommended to restore strength and flexibility. A physical therapist can design a personalized rehabilitation program that addresses your father's specific needs, focusing on regaining full function of the shoulder and arm.

Pain Management and Other Injuries
1. Chest and Knee Pain: The pain in your father's chest and knee may indicate soft tissue injuries, such as bruising or muscle strain. While these injuries can be painful, they typically heal with time and conservative management. Applying ice, taking prescribed pain medications, and resting the affected areas can help alleviate discomfort.

2. Monitoring Symptoms: It's essential to monitor any changes in pain levels or mobility. If the pain worsens or if there are signs of complications (such as swelling, redness, or fever), seeking medical attention is crucial.

Expected Recovery Time
1. Healing Timeline: Clavicle fractures generally heal within 6 to 12 weeks, but this can vary based on factors such as age, overall health, and the specific nature of the fracture. Regular follow-up appointments with the orthopedic doctor will help assess healing progress.

2. Follow-Up Care: Regular follow-ups are essential to monitor the healing process and make any necessary adjustments to the treatment plan. X-rays may be taken to ensure proper alignment and healing of the fracture.

Conclusion
In summary, your father's recovery from a clavicle fracture involves a balance between immobilization and gradual rehabilitation. Adhering to the use of the sling, engaging in appropriate exercises as advised by healthcare professionals, and managing pain effectively will contribute to a successful recovery. It's also important to address any concerns about other injuries, such as those to the chest and knee, with his healthcare provider. By following these guidelines and maintaining open communication with his medical team, your father can work towards a full recovery and return to his normal activities.

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