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B. Clavicle fractures

B1. Clinical features

(1) ๋ชจ๋“  ์–ด๊นจ ์†์ƒ์˜ ๋ฐ˜์„ ์ฐจ์ง€ - ์–ด๊นจ ๋ถ€๋ถ„ ์†์ƒ ์‹œ ๋ฐ˜๋“œ์‹œ ํ™•์ธํ•ด์•ผ ํ•จ
(2) ๊ฐ€์žฅ ํ”ํ•œ ๊ธฐ์ „์€ ์–ด๊นจ๋กœ์˜ ์ง์ ‘์ ์ธ ๊ฐ€๊ฒฉ์ž„ (Buckling clavicle)
(3) ์ž„์ƒ์ฆ์ƒ์œผ๋กœ๋Š” swelling, deformity, tenderness๋ฅผ ๋ณด์ผ ์ˆ˜ ์žˆ์Œ.
(4) ๊ณจ์ ˆ์€ ์ข…์ข… ๋งŒ์ ธ์ง€๊ฑฐ๋‚˜ crepitus๊ฐ€ ์žˆ์„์ˆ˜ ์žˆ์Œ.
(5) ์†Œ์•„์˜ ๊ฒฝ์šฐ ์•ฝ 2์ฃผ, ์„ฑ์ธ์€ ์•ฝ 4~6์ฃผ ์ •๋„๋ฉด ์น˜์œ .

B2. Diagnosis

(1) ๋Œ€๋ถ€๋ถ„์˜ ์‡„๊ณจ๊ณจ์ ˆ์€ Standard shoulder & clavicle x-ray๋กœ ์ง„๋‹จ ๊ฐ€๋Šฅ
(2) X-ray : 45๋„ Cephalad tilt View๊ฐ€ ๋„์›€์ด ๋œ๋‹ค (Lordotic view)
(3) ํ™•์ง„์„ ์œ„ํ•ด์„œ๋Š” CT์ดฌ์˜

B3. Middle third clavicle fractures

(1) ์‡„๊ณจ ๊ณจ์ ˆ ์ค‘์—์„œ ๊ฐ€์žฅ ํ”ํ•จ.
(2) ์ผ๋ฐ˜์ ์œผ๋กœ๋Š” ๋ณด์กด์  ์น˜๋ฃŒํ•˜๋‚˜, ๊ธฐ๋Šฅ์  ๋˜๋Š” ๋ถˆ์œ ํ•ฉ์˜ ๊ฐ€๋Šฅ์„ฑ์„ ๋‚ฎ์ถ”๊ธฐ ์œ„ํ•ด ์ˆ˜์ˆ ์  ์น˜๋ฃŒ๋ฅผ ์‹œํ–‰.

(3) ๋ถ€์ •์œ ํ•ฉ์ด๋‚˜ ๋ถˆ์œ ํ•ฉ์˜ ์œ„ํ—˜์ธ์ž

โ€ข
์ดˆ๊ธฐ์— ๋‹จ์ถ•๋œ ๊ธธ์ด๊ฐ€ 2ใŽ ์ด์ƒ
โ€ข
Comminuted Fx
โ€ข
์ „์œ„๋œ ๊ณจ์ ˆ> 100%
โ€ข
์‹ฌํ•œ ์™ธ์ƒ
โ€ข
๊ณ ๋ น, ์—ฌ์„ฑ
(4) ์ดˆ๊ธฐ ์น˜๋ฃŒ๋กœ sling ๋˜๋Š” figure-of-eight brace๋ฅผ ์‚ฌ์šฉํ•˜์—ฌ ํ†ต์ฆ์ด ์—†์„ ๋•Œ๊ฐ€์ง€ ๋ณดํ†ต 4~8์ฃผ๊ฐ„ ๊ณ ์ •

B4. Distal clavicle fractures

(1) ํฌ๊ฒŒ type I, II, III ๋กœ ๋‚˜๋ˆ„์–ด์ง
(2) Type II : CC ligament์˜ ํŒŒ์—ด์™€ ๊ด€๋ จ์ด ์žˆ๊ณ , ๋ถˆ์œ ํ•ฉ์„ ๋ฐฉ์ง€ํ•˜๊ธฐ ์œ„ํ•ด ์ˆ˜์ˆ  ํ•„์š”ํ•  ์ˆ˜ ์žˆ์Œ
(3) Type I, III : sling์œผ๋กœ ๊ณ ์ •ํ•˜์—ฌ ๋ณด์กด์  ์น˜๋ฃŒ ์‹œํ–‰

B5. Proximal third clavicle fractures

(1) ํ‰๊ฐ• ๋‚ด์˜ ์†์ƒ๊ณผ ์ข…์ข… ๊ด€๋ จ์ด ์žˆ์„ ์ˆ˜ ์žˆ์Œ.
(2) ์ดˆ๊ธฐ ์น˜๋ฃŒ๋Š” sling์„ ํ†ตํ•œ ๊ณ ์ •์ž„.
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