For fixation in case of a clavicle fracture, Delbe rings are often used - a simple, convenient and reliable device, named after the name of its inventor, a famous traumatologist.
A good idea always gets developed. Today, models of various designs for adults and children are used to immobilize the clavicle and shoulder girdle. Also, their pristine simple device has not lost its relevance, and it can be quickly built at home. The main thing is to know in what situations Delbe rings are needed and how to apply them correctly.
Author of the article / Site experts Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category
Total work experience over 25 years. In 1994 he graduated from the Moscow Institute of Medical and Social Rehabilitation, in 1997 he completed a residency in the specialty “Traumatology and Orthopedics” at the Central Research Institute of Traumatology and Orthopedics named after. N.N. Prifova.
Osteosynthesis for clavicle fracture
A clavicle fracture is an injury that is among the top 10 most common.
Such cases account for 3 to 20% of all calls for fractures. The reasons for bone vulnerability are its structural features and specific location. In addition, the clavicle itself is quite thin, which increases the likelihood of fracture under significant mechanical stress in the upper body. One of the treatment methods - installing a plate for a clavicle fracture (titanium implant) - can be used both immediately after the injury and during recovery after an old injury. A plate implant is often used when displacement occurs.
The operation to fix a plate for a clavicle in case of a fracture is performed only under general anesthesia.
Surgical treatment is possible in a trauma department. The patient should lie on his back.
Application technology, care
The method of using Delbe rings is quite simple, but you still need to follow certain recommendations:
- A ring of hard material is placed between the shoulder blades;
- Two belts or tourniquets are wrapped around the shoulders, they are threaded through the ring and fixed in the position required for therapy.
The product must be positioned in a special way so that it is in maximum contact with the body, otherwise the rings will move and rub the skin. The device is worn all day, but taken off when sleeping.
In this case, the doctor must independently determine the degree of back deflection. Also, you cannot independently determine for yourself the period of use of the rings, especially in case of a fracture.
In order for the device to work properly, it must be looked after in a certain way:
- Before washing, it is important to fasten all fastenings;
- Wash by hand or set the machine to manual mode (water temperature no more than +40 degrees);
- Do not wash the device with other clothes;
- For washing, use only detergent for delicate items;
- The rings must not be twisted or ironed; they must dry naturally.
Treatment with connection to the plate
Titanium plates for clavicle fractures are mainly used:
- With a diaphyseal fracture. It can be oblique and simple. Suggests extension of the fracture. It is treated conservatively or surgically. During surgical therapy, either plate or intramedullary fixation is used. The latter option is preferred for the recovery of young active people, when it is important to return full activity and mobility of the upper body and limbs as quickly as possible.
- For displaced injuries. Preference is given to an S-shaped plate for the clavicle (hook-shaped).
- For damage to bone tissue and joints. Here, too, a hook-shaped plate is used on the clavicle , especially when there is intra-articular damage with the formation of a large number of bone fragments. The main feature of such a plate is that after complete fusion of bone tissue, it must be removed.
Reviews
The effectiveness of the Delbe orthopedic fixator for problems with posture or collarbone fractures can be judged by consumer reviews.
Vyacheslav: “In winter I slipped on the ice and fell on my shoulder.
The result is damage to the collarbone (screw fracture). They connected it from two halves and put Delbe rings on me until the bones fused completely (about three weeks). When everything grew together, I took it off and was surprised to find that my back was almost straight. So I killed two birds with one stone! The question of price is 1200 rubles. for “Comf-Ort”, which is now always with me! It is also suitable for preventing the recurrence of posture problems.” Elena: “My son began to slouch, but the more he tried to straighten his back, the more his spine bent in the lumbar region. It became clear that the situation could not be changed for the better on our own. As prescribed by the doctor, I bought Delbe T-1730 rings for children. The cost of the product is 850 rubles. At first I was skeptical: how can you bend the “hump” in the opposite direction using these straps? And now both the doctor and I are happy. So I recommend it to anyone who has problems with posture!”
Indications and contraindications for clavicle osteosynthesis
Osteosynthesis of the clavicle - the connection of bone fragments in an anatomical position using a plate fixation structure - has indications for both fresh injuries and old ones.
- Indications for restoration ( plate osteosynthesis ) for fresh clavicle injuries are: open fracture;
- closed fracture in case of damage to the neurovascular tourniquet;
- a complex fracture in which interposition of soft tissue is observed (when it is sandwiched between bone fragments, which prevents comparison of fragments - reposition - in a closed way);
- high risk of skin injury from sharp bone edges;
- the vertical location of one of the fragments, which, when displaced for the purpose of reposition, can affect the nerves or choroid plexuses.
- delayed fusion;
Operations to connect bone fragments to a plate during a fracture (osteosynthesis) are carried out urgently if the injury is fresh and is accompanied by a risk of damage to blood vessels and nerve endings. In other cases, surgical treatment can be delayed and is carried out as planned after a comprehensive diagnosis.
Contraindications
Contraindications to functional restoration with the help of plates ( clavicle osteosynthesis ) are only relative (the decision is made by the doctor, the operation can be prescribed after the problems that make it impossible to carry out have been eliminated). These include:
- serious condition of the patient (multiple injuries);
- acute infectious diseases;
- severe inflammation and suppuration in the shoulder girdle area.
For children
Only a specialist in a specialized medical institution has the right to apply Delbe rings for children. Local anesthesia is mandatory. This is due to the fact that children are very active and are afraid of medical procedures.
It is better for infants to apply a Deso bandage. Displacements in young children are rare. The periosteum in babies is elastic. Therefore, there is no need to use Delbo rings. In addition, their use creates great discomfort for an active baby.
Children's reclinators are most often used as a corset-orthosis. It supports the spinal column during various diseases and deformities. The retainer is removed at night and put on again in the morning.
How is clavicle osteosynthesis performed?
The main recommendation for restoration with plates for osteosynthesis : sufficient length of the lateral fragment. If it is insufficient, the structure may become loose after fixation. Since the metal “holder” is located in the external subcutaneous sections, this can lead to skin injuries during rehabilitation (plaster cast) and subsequently (clothing, straps).
The osteosynthesis of the clavicle itself is carried out using various plate instruments (depending on the nature of the injury). The choice of their type also determines the cost of the plate for a clavicle fracture , so it should be given sufficient attention.
Features of the procedure for connecting (osteosynthesis) the clavicle with metal plates for fractures :
- general anesthesia;
- position of the patient lying on his back:
- a small cushion is placed under the shoulder blade;
- the incision is made longitudinally, above the clavicular bone (the recovery zone is opened, blood clots are removed, fragments are compared);
- osteosynthesis of the clavicle is carried out in 3 stages - first, a titanium plate on the clavicle is modeled according to the curvature of the bone, then the model is applied to its surface (from above or in front) and fixed with screws to the bone fragments;
- The last manipulations are layer-by-layer fixation of sutures, installation of drainage (rubber drains) and application of an aseptic dressing.
Figure-of-eight bandage
The method is recommended for fixing an injured collarbone without displacement. This bandage got its name due to its characteristic shape in the form of the number 8. You will need a wide bandage, which is applied in the area between the shoulder blades, bringing the end to the forearm and under the arm and then again to the starting point between the shoulder blades. The second end of the bandage is drawn in a similar way, only in a different direction, forming a “figure eight”. At the end of application, the edges of the bandage are securely tied with a knot.
The quality of the figure-eight bandage is directly determined by the tight winding. Otherwise, it will not be possible to ensure traction and immobility of the damaged collarbone and transport the patient to a medical facility without unpleasant consequences.
The advantages of the method are reliable bilateral fixation and guarantee of immobility of the damaged clavicular joint. The period of wearing the bandage is usually about 2-3 weeks. This method is practically not used for first aid; its application is possible only by a specialist after reduction of a clavicular fracture.
Types of implants
The choice of implant determines not only the price of the plate for clavicle fractures, but also the effectiveness of treatment. Current practice uses tubular and semi-tubular titanium plates for clavicle fractures . They are selected according to the nature of the injury.
- For a fracture in the middle third of the clavicular bone, the following is used for osteosynthesis: a reconstructive plate with a number of holes from 6 to 8;
- narrow dynamic compression plate up to 3.5 mm wide;
- Kun-cheru rod.
- tightening wire loop (2 knitting needles);
How to put on Delbe rings and how long to wear them
Many patients ask these questions. There are a number of rules and recommendations for using a bandage:
- It is recommended to wear an orthopedic bandage while standing or sitting on a flat surface.
- In case of damage to the upper extremities, a fracture of the collarbone, dislocation or other injury, putting on the product cannot be done without outside help. Otherwise, you risk making the situation worse.
- The fixing bandage should be worn on a T-shirt or thin cotton T-shirt. Especially if there is damage to the skin or if it is highly sensitive. If you are allergic to synthetics, be sure to consult your doctor about the advisability of using this medical device.
- After putting on the Delbe rings, they are fixed with Velcro. Do this carefully, adjusting the degree of tension and the angle of shoulder extension, with particular caution in the case of bone fractures. In order not to create additional stress on the body and not to spoil the posture, these parameters are determined by the doctor.
- Doctors recommend removing the medical retainer at night. At this time, the product is stored flattened.
- The bandage is worn for a long time, until complete recovery.
How long exactly should Delbe rings be worn? Rehabilitation time will vary depending on goals and reasons. Only the attending physician can accurately answer this question.
Reclinator care
When the product becomes dirty, wash it. Only hand wash is acceptable. Do not rub or squeeze the reclinator vigorously with your hands. Dry only naturally, spreading the product - for example, on the back of a chair. Avoid exposing it to direct sunlight.
Order plates for a clavicle fracture
You should find out how much a clavicle plate of the desired type, shape and class costs only from trusted suppliers of medical instruments for surgical treatment. There is a large selection of such implants - our specialists know everything about the products and, if necessary, will answer any questions.
In the company's catalog you can choose and buy a clavicle plate made of high-quality purified titanium for osteosynthesis for all types of fractures. All products are made on modern equipment using advanced technologies and taking into account the latest developments in the global traumatology industry.
find out the price of a clavicle plate by going to the page of the desired product. Here you can place an order, request a catalog of analogues for comparison, or professional advice. Get the necessary information in one touch (especially for your convenience, there is an “Ask a question” button on the page).
