KURSK STATE MEDICAL UNIVERSITY

DEPARTMENT OF TRAUMATOLOGY & EXTREME MEDICINE

Head of the Department : Prof. Dubrovin G.M.

Teacher in Charge: Dr. Samuel Raj

Patient’s name : Barizova Thathyana

Diagnosis : Close oblique fracture of the middle third diaphysis of clavicle(right
side). With displacement. Without complications'

T. Ashain Nilhan Fernando

Group no 03
5th year 1st semester

Kursk 2013
Name of the patient: Barizova Thathyana
Age : 61 years old
Sex : Female
Date of admission to hospital: 13.10.2013
History of accident :
Date and time of the accident : 13.10.2013
Location of accident : Home (Bathroom)
The mechanism of injury : Direct
First aid which was provided
to the patient before hospitalization:

• Anesthesia; non narcotic-analgin (i.m)

• Transport immobilization. Kramer's splint.
From the healthy left shoulder joint to right base
of metacarpal.
The patient's complaints on admission :
• Pain
• Swelling
• Redness
• Increase temperature
• Loss of function
• Pathological movement of fragments
• Crepitus
• Deformation
• Shortening of a clavicle
The results of patient’s physical examination on
admission to hospital

• The ability to walk : present. Without problem

• Consciousness : satisfactory
• Position of body : Forced posture
• Facial appearance :No Pathology
• Eyes: No Pathology
• Oral mucosa : Moist & Pink
• Condition of skin : Moist
• Results of lungs auscultation : Symmetry resonant
• Pulse (per min.) : 73 /min
• RR : 18
• BP : 110/80 mmhg
 The local status of patient on admission to
hospital
• The length of the damaged segment : 3cm

• Condition the axis of the damaged segment :

Deviation occurs

• The possibility of movement in joints of damaged

segment : Movement cause pain

• The temperature of the skin of damaged segment :

Increase temperature
• Sensitivity of the damaged segment
: Decrease sensitivity

• The presence of the arterial pulsation at the

damaged extremity : Present

• The presence of swelling of the damaged

segment : Present

• Description of wound (if it is presented)

location, configuration, size : Absent
 The preliminary diagnosis, which was
made on the admission

Close fracture of the middle third diaphysis of

clavicle(right side).
 Results of laboratory, radiology and another
(ultrasound, ECG, etc.)
Complete blood count

Hemoglobin : 117 g/dL

RBC : 3.85x 10*12 /l

WBC :
Neutrophil :
Bands :
Lymphocyte :
Monocytes :
Eosinophil
CI : 0.9
Urinalysis

pH : Acidic
Volume : 110ml
Specific gravity : 1.010
Protein : -absent
Urea : 4mmol/l
 X -ray
• Right shoulder region
• AP view
• Close oblique fracture of the
middle third diaphysis of
clavicle(right side). With
displacement. Without
complications
 Full clinical diagnosis

Close oblique fracture of the middle

third diaphysis of clavicle(right side).
With displacement. Without
complications…..
 Plan of treatment

• Diet : 15 (normal)
• Regime : Hospital region
• Anesthesia : Novocain block
• Immobilization : Smirnov – Vanshtein bandage
 01.Closed fracture of the clavicle
absent,

a .pathological movements.
b .deformation.
c .appearance of bone’s fragments.
d .crepitus
e. Shortening of a clavicle
 02.What are the basic method of
anesthesia ?
a .cold
b .local and regional anesthesia
c .narcotic and non narcotic analgesics
d .immobilization
e .all
03.What is the wrong answer of fracture of 1st
metacarpal bone?

a. Benet's fracture
b. Roland's fracture
c. transverse facture of shaft
d. oblique fracture of shaft
e. spiral fracture of shaft
04.What is the wrong answer of sequelae
of scaphoid fracture ?

a. malunion
b. Delayed union
c. non-union
d. Avascular necrosis
e. Scaphoid non-union advanced collapse
 05.What is the general sign ?

a .pathological movements.
b .deformation.
c .loss of function
d .crepitus
e. Shortening of a clavicle