Fracture Clavicle

Clinical Features:

• Blunt Trauma over (Site)
• H/0 fall from Height
• H/O Road Traffic Accident (RTA)
• H/O Physical Assault
• Swelling/ Pain/ Deformity of affected site.
• Associated (Abration/ Laceratio/ Bruise)

 Investigation:

• Blood Grouping & Rh Typing
• RB
• S. Creatinine
• X-ray of Affected site (B/) including adjacent joint.

 If Pain 0T: Add others investigation:

• Chest X-ray P/A view
• ECG
• Echocardiography (if abnormal ECG/old age)

Rx:(Indoor)

• Diet: Normal/ Liquid
• Bed Rest

1. Inf. H/S(2L)

• IV stat @20 d/min

2. Inj. Ceftron 2gm(Ceftriaxone)

• 1 vial IV stat & Daily

3.Inj. Rolac 30mg(Ketorolac)

• 1 amp /M stat & TDS

4. Inj. Esotid 40mg (esomeprazole)

• 1 vial /M stat & BD

5. Blood Transfusion (if Haemorrhage/ Anemia)

6. Please take inform written consent

7. Send the patient in OT table

8. Catheterization before OT

Post Operative Order:
1.Diet: NPO, TFO(Till further order)
2.Inf.Hartman ([post id="506" title="Hartmann"])(1L) +
Inf.5%DNS([post id="510" title="DNS"])(1L) +
Inf.5%DA ([post id="511" title="Dextrose "])(1L)

• ….I/V 30 drop/min.

3. Inj.Ceftron([post id="398" title="Ceftriaxone"])  (1gm)

• … 1 vial I/V ….BD 

4. Inj.Sergel ([post id="392" title="Esomeprazole"])((40mg)

• …1 vial I/V ….BD

5.Inj.Filmet([post id="406" title="Metronidazole"])(500mg/100ml)

• …1 bottle I/V….stat.& TDS

6.Inj.Rolac([post id="450" title="Ketorolac"]) (30mg)

• ….1 ample I/M OR I/V stat & TDS 

OR 
Inj.Anadol([post id="453" title="Tramadol"]) (100mg/2ml)

• ….1 ample I/M OR I/V stat & TDS

7.Nalbun-2([post id="453" title="Tramadol Hydrochloride"])

• …1 ample I/M stat 

OR 
Inj.G-Pethidine([post id="456" title="Pethidine"](100mg/2ml)

• …..1 ample I/M stat

With 
Inj.Vergon([post id="453" title="Tramadol"]) (12.5mg/ml)

• …1 ample …I/M stat 

8.Voltaline ([post id="448" title="Diclofenac"])suppository (50mg)

• ….1 stick Per rectal –SOS

9.Monitor all Vitals…any abnormality then call doctor

10. Elevated affected area

 Discharge Treatment:

1.Cap.Denver([post id="399" title="Cefixime"]) (200mg)

• 1+0+1……...7 days

2. Tab.Fimet ([post id="406" title="Metronidazole"]) (400mg)

• 1+1+1………..5 days

3.Cap.sergel ([post id="392" title="Esomeprazole"]) (20mg)

• 1+0+1………..14 days

4.Tab.Rolac([post id="450" title="Ketorolac"])  (10mg)

• 1+0+1(after meal) ….5 days

5.Tab.Rivotril([post id="474" title="Clonazepam"]) (0.5mg)

• 0+0+1……..15 days

6.Tab.CEEVIT([post id="466" title="Ascorbic"] Acid)(250mg)

• 1+0+1……...10 days

7.Tab.Xinc-OT([post id="470" title="Zinc"])

• 1+0+1…………1 month

 8. Tab.Calboral -D

• 1+0+1........................3 months

If Chance of Infection: change antibiotics

 Tab.Arlin (Linezolid) (600mg)

• 1+0+1............14 days 

Cap. Flux (Flucloxacillin)(500mg)

• 1+1+1+1.............14 days

Advice:

• নিয়মিত ঔষধ খাবেন।
• আক্রান্ত স্থান উচু করে রাখবেন।
• আঙ্গুল নাড়ানাের চেষ্টা করবেন।
• ১৪ তম দিনে সেলাই কাটাবেন।
• ৬ সপ্তাহ পায়ে ভর দিবেন না, বিশ্রামে থাকবেন।
• ৬ সপ্তাহ পর Backslab খুলবেন।
• কোন সমস্যা হলে ডা. পরামর্শণ নিবেন।
• ইনফেকশনের চান্স থাকলেঃ
• ৩ দিন পরপর ড্রেসিং করাবেন।