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Fractured clavicle healing time: Clavicle Fractures | Johns Hopkins Medicine

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Clavicle Fractures | Johns Hopkins Medicine

Where is the clavicle?

The clavicle is the bone that connects the breastplate (sternum) to the shoulder. It is a very solid bone that has a slight S-shape and can be easily seen in many people. It connects to the sternum at a joint with cartilage called the sternoclavicular joint. At the other end, the bone meets the shoulder area at a part of the shoulder blade (scapula) called the acromion. The joint at that end of the bone containing cartilage is called the acromioclavicular joint.

The collarbone acts as a strut to connect the sternum to the shoulder blade. Because of the critical location of the clavicle, any severe force on the shoulder, such as falling directly onto the shoulder or falling on an outstretched arm, transfers force to the clavicle. As a result, the collarbone is one of the most commonly broken bones in the body.

How do you know if you have a clavicle fracture?

When bones break, there is swelling due to bleeding from the blood vessels in and around the bone. There is also pain from the broken bone due to damage of microscopic nerve endings around the bone. Sometimes the bone is broken enough to create an angle between the broken ends, which causes a deformity along the bone. Usually with a broken collarbone the pain and swelling are severe and there may be a visible deformity. Often there is pain at the site of the fracture with any attempt to move the arm. The only way to verify if there is a fracture is to get an X-ray of the area.

What should be done if you think your clavicle is fractured?

If you think that the clavicle is broken, it is best to seek medical treatment right away. The best way to treat the injury until you can reach a physician or emergency facility is to immobilize the arm and shoulder by holding the arm close to the body with the other arm or in a sling. You should put ice on the injured area for 20 to 30 minutes at a time, making sure not to freeze the skin. Pain medication such as Tylenol or over-the-counter nonsteroidal agents such as ibuprofen or naproxen (Advil or Aleve, for example) are acceptable. The only time you should not take medication is if there is a break in the skin over the fracture, which indicates that the ends of the bones may have punctured the skin. In that case, the fracture may need surgery to clean out any dirt or debris. Other indications of more severe injury include tingling, numbness or weakness in the hand or arm. If the injury is near the sternum and you have shortness of breath or difficulty swallowing you should seek immediate medical attention.

What is the treatment for a clavicle fracture?

The first thing the physician will do is take an X-ray to determine if the clavicle is broken, where the fracture is located and how many pieces it is broken into. Clavicle fractures are basically divided into three types based upon location. Fractures near the sternum are the least common (less than 5 percent of all clavicle fractures). Fractures near the AC joint are the second most common and can come in many different patterns. The most common fractures of the clavicle are in the middle of the shaft of the bone, approximately halfway between the sternum and the AC joint.

The most common way to treat the fractures in the middle is with immobilization with either a sling or a special bandage called a figure-of-8 splint. Studies have shown that these fractures heal just as quickly and as well with a sling as with the figure-of-8 splint, so we recommend a sling in a majority of cases. The figure-of-8 splint is generally uncomfortable, difficult to wear nonstop for six or eight weeks and can result in skin problems and a smelly patient because it should not be removed to wash the armpit. Figure-of-8 splints are not indicated or useful in fractures of the clavicle near the AC joint. However, some orthopaedic doctors have strong opinions about the use of this figure-of-8 device, and it can produce an acceptable result.

The second thing that helps in the treatment of clavicle fractures is pain relief with cold therapy and pain medication. It is recommended that you ice the fractured area for 15 to 20 minutes every two hours for as long as necessary to decrease the pain and swelling. Heat is not recommended. Pain medication in the form of narcotics is the best for relief of pain from a fractured clavicle, and you may need it for several weeks, especially to help you sleep. Many patients with this injury have to sleep sitting up to be comfortable. Other pain-relieving medications such as acetaminophen or nonsteroidal medications may be used, but they generally will not be adequate by themselves until the pain and swelling start to subside.

How long does a clavicle fracture take to heal?

How long it takes the fracture to heal depends upon many factors, such as age, the location of the fracture and how many pieces it is broken into. Clavicle fractures in children (younger than 8 years old) may heal in four or five weeks, and clavicle fractures in adolescents may take six to eight weeks. However, fractures in adults or teenagers who have stopped growing take 10 to 12 weeks to heal and may take longer. Most clavicle fractures will heal completely by four months in an adult. There are some indications that clavicle fractures broken into more pieces take longer than ones with a fewer fragments.

What can be done while waiting for a clavicle fracture to heal?

Within a few days of the fracture you should be able to move your fingers, wrist and elbow without too much discomfort. As the pain in the clavicle area improves you should be able to begin moving the shoulder joint a little to prevent the joint from tightening up too much. If the shoulder joint gets stiff, it is a condition known as a frozen shoulder. Usually as the pain in the fracture begins to subside, it is acceptable to begin moving the shoulder. Your physician may show you the motions or send you to a physical therapist for instructions. Generally motion of the shoulder does not prevent clavicle fractures from healing once the fracture has begun to heal.

Once the fracture has healed, motion is generally not restricted. It may take months before the fracture has healed enough to withstand contact such as in sports. Strengthening of the shoulder and arm should wait until the fracture has healed. Exercises should not be done until directed by your physician. Also, individuals who want to stay aerobically fit can usually begin light exercise such as walking or exercise biking after a few weeks, with the permission of their physician.

What result can be expected once a clavicle fracture heals?

Usually there are no limitations once the fracture heals. Most patients have full range of motion and can return to activities with no limitations. Some fractures can take six to nine months to heal. If the fracture does not heal, surgery may be necessary. Some fractures of the clavicle that do not heal completely are not painful and may not need surgery. Many factors determine whether a clavicle fracture will need surgery, and they should be discussed with your doctor. Generally, if surgery is necessary it is done with an incision followed by implanting a plate and screws. Sometimes a bone graft may be needed to help stimulate healing. Treatment after surgery depends upon many factors, such as how fast the fracture heals. Fortunately surgery is needed in few cases and is successful in cases where it is needed. Surgery can reduce a visible deformity of the fracture but results in a scar. Occasionally surgery may be indicated in a high-caliber athlete but this too is controversial and studies are mixed on when exactly surgery should be done.

Are fractures near the AC joint any different?

Fractures near the AC joint also can usually be treated without surgery. If there are torn ligaments associated with the fracture, then surgery may be indicated, although it is controversial. The pluses and minuses of surgery should be discussed with your doctor. Fortunately fractures of the clavicle near the AC joint need surgery only a small percentage of the time (less than 10 percent overall).

Broken Collarbone (Clavicle Fracture): Symptoms, Treatment, Healing

Overview

What is a clavicle fracture?

A clavicle fracture is a break in the collarbone. You have two clavicles — long, slender, S-shaped bones connecting the shoulders to the upper chest. Broken collarbones are common, making up about 5% of all adult bone fractures.

Are there different kinds of clavicle fractures?

A collarbone can crack in one place or break into several pieces (comminuted fracture). The broken pieces may still line up or may end up out of place (displaced fracture).

Symptoms and Causes

How do people break their collarbones?

A clavicle breaks when force or pressure causes it to snap. Common causes are:

  • Collisions (trauma) when an arm is outstretched, like during skiing, hockey, football and other sports.
  • Direct hits to the clavicle, such as in a car accident.
  • Falls onto the clavicle or an extended arm.
  • Passing through the birth canal for a baby.

What are the symptoms of a broken collarbone?

If you break your collarbone, you may experience:

  • Snapping or grinding noise when the bone breaks.
  • Sharp pain, which gets worse when you move that area.
  • Shoulder slumping down or forward because the bone no longer supports it.
  • Difficulty moving or lifting the arm, with a possible grinding feeling when you do.
  • Bruising, swelling or tenderness in the area.
  • Bump that you can see through the skin.
  • Numbness or “pins and needles” (less often).
  • Bone poking through the skin, with bleeding (rarely).

Diagnosis and Tests

How is a clavicle fracture diagnosed?

If you think you’ve broken your clavicle, seek immediate medical attention. A healthcare provider will:

  • Ask you to describe what happened.
  • Examine the area.
  • Take X-rays of the injured area to confirm a broken bone. X-rays can also show exactly where the break is, how bad it is and whether any other bones broke.

If the healthcare provider thinks there’s damage to a joint or artery, you may get more tests:

  • Arteriography/arteriogram, which uses X-rays and dye to see inside the arteries.
  • CT scans, which provide more detailed pictures than X-rays.
  • Ultrasound, which uses sound waves to create pictures of what’s happening in the body.

Management and Treatment

What should I do if I break my clavicle?

If you think you broke your collarbone, take these steps immediately:

  • Put your arm in a sling to stop it from moving. You can create a sling from a piece of cloth like a towel or shirt. Wrap it around your arm and fasten it to the back of your neck to hold up your arm.
  • Apply ice to reduce pain and swelling.
  • Take over-the-counter pain medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include ibuprofen (Advil®, Motrin®), naproxen, (Aleve®) or acetaminophen (Tylenol®) if it doesn’t interfere with your other medications or health issues.
  • Call a healthcare provider or go to the emergency room.

What does a healthcare provider do to treat a broken collarbone?

Most clavicle fractures don’t need surgery. If the broken parts of the bone are in a good position to heal, healthcare providers may recommend:

  • Arm support: A sling can help you feel more comfortable as you heal. It can also prevent broken parts of bone from moving around.
  • Medication: Over-the-counter medications can relieve pain as the bone heals. Some healthcare providers may prescribe stronger drugs, such as opioids, for a very short period of time. Those come with risk of drug addiction, though, and should be used only if really necessary
  • Physical therapy: A physical therapist can teach you special exercises. These exercises can improve motion in your arm, strengthen your shoulder and prevent stiffness. You may do the exercises in a physical therapist’s office, at home or both.

What if I need surgery?

Sometimes you need surgery to treat a broken collarbone, like when:

  • Blood vessels or nerves get injured.
  • Fractures break through the skin.
  • Pieces of broken collarbone are not in a good position to heal.

Surgery to treat a clavicle fracture is called open reduction and internal fixation. The operation puts broken pieces of collarbone back where they belong (reduction). It then uses metal devices to keep the pieces in place (fixation). An orthopaedic surgeon (specialist in bone and muscle injuries) may perform the procedure using:

  • Plates and screws attached to the outer surfaces of the bone. The hardware usually isn’t removed after the bone heals, unless it causes discomfort (this usually happens a year or more after the surgery).
  • Pins or screws through the bone. They are usually removed once the fracture has healed.

Prevention

How can I prevent a clavicle fracture?

Clavicle fractures happen suddenly and are difficult to prevent. But certain things can help keep your bones safer:

  • Drive safely and wear a seatbelt when riding in a vehicle.
  • Eat a well-balanced diet with plenty of calcium to keep your bones strong.
  • Use good technique and body positioning for any sports you play or activities you do (such as bike riding).
  • Wear protective gear when playing sports or participating in hobbies.

Outlook / Prognosis

What is the outlook for a broken clavicle without surgery?

Most collarbone fractures heal in six to eight weeks, without surgery or complications. Most people are able to start getting back to normal activities by three months or so, but full recovery may take up to six to 12 months.

You may feel a bump where the fracture healed. The bump may get smaller on its own over time, but it might never go away completely. You may also have less strength in your shoulder and arm. But unless you have other injuries, you can often return to normal activities within a few weeks.

What is the outlook for a broken clavicle with surgery?

If you have surgery, you may feel the plate or other hardware inside your body. You’ll also have limited use of your arm for six to eight weeks. After that, you can start using it for normal daily activities such as bathing, dressing and eating. You should wait for your healthcare provider’s permission before doing things that involve lifting, pulling or pushing. You should also wait to play sports. In general, recovery is similar to treating a broken clavicle without surgery with return to normal activity around three months or so and full recovery up to six to 12 months after surgery.

While your break heals, you should follow-up with your surgeon or other healthcare provider to make sure you don’t have complications. Complications after surgery may include:

  • Malunion: If the pieces of bone move out of place and heal in the wrong position, healthcare providers call it a malunion. It may need surgery.
  • Pain and stiffness: Sometimes the shoulder can get very stiff or painful after surgery. Your healthcare provider may recommend physical therapy or remove any irritating pieces of hardware.
  • Wound problems: The place where the surgeon cut your skin may have trouble healing, get infected or bleed.

Living With

What can I do to make sure I heal after a broken collarbone?

Whether you have surgery or not, you should go to all your follow-up appointments. At those checkups, your healthcare provider will:

  • Check the motion in your shoulder.
  • Talk to you about how you feel and whether you still have pain.
  • Take more X-rays if needed.

You should also follow all exercise advice from your healthcare provider and physical therapist. Physical therapy can be slow and uncomfortable, but it’s important if you want to return to your normal activities.

In the first few weeks of physical therapy, you will do gentle exercises to help prevent stiffness and pain. You will eventually start exercises with light weights and stretchy bands. Once the bone fragments rejoin, you will do more aggressive strength training.

A note from Cleveland Clinic

A clavicle fracture is a break in the collarbone that’s often painful. Most people don’t need surgery, but some require an operation to put the pieces of bone back in place. Physical therapy is important to get you back to daily activities. Talk to your healthcare provider about exercises to reduce pain and stiffness and regain strength.

Broken Collarbone (Clavicle Fracture): Symptoms, Treatment, Healing

Overview

What is a clavicle fracture?

A clavicle fracture is a break in the collarbone. You have two clavicles — long, slender, S-shaped bones connecting the shoulders to the upper chest. Broken collarbones are common, making up about 5% of all adult bone fractures.

Are there different kinds of clavicle fractures?

A collarbone can crack in one place or break into several pieces (comminuted fracture). The broken pieces may still line up or may end up out of place (displaced fracture).

Symptoms and Causes

How do people break their collarbones?

A clavicle breaks when force or pressure causes it to snap. Common causes are:

  • Collisions (trauma) when an arm is outstretched, like during skiing, hockey, football and other sports.
  • Direct hits to the clavicle, such as in a car accident.
  • Falls onto the clavicle or an extended arm.
  • Passing through the birth canal for a baby.

What are the symptoms of a broken collarbone?

If you break your collarbone, you may experience:

  • Snapping or grinding noise when the bone breaks.
  • Sharp pain, which gets worse when you move that area.
  • Shoulder slumping down or forward because the bone no longer supports it.
  • Difficulty moving or lifting the arm, with a possible grinding feeling when you do.
  • Bruising, swelling or tenderness in the area.
  • Bump that you can see through the skin.
  • Numbness or “pins and needles” (less often).
  • Bone poking through the skin, with bleeding (rarely).

Diagnosis and Tests

How is a clavicle fracture diagnosed?

If you think you’ve broken your clavicle, seek immediate medical attention. A healthcare provider will:

  • Ask you to describe what happened.
  • Examine the area.
  • Take X-rays of the injured area to confirm a broken bone. X-rays can also show exactly where the break is, how bad it is and whether any other bones broke.

If the healthcare provider thinks there’s damage to a joint or artery, you may get more tests:

  • Arteriography/arteriogram, which uses X-rays and dye to see inside the arteries.
  • CT scans, which provide more detailed pictures than X-rays.
  • Ultrasound, which uses sound waves to create pictures of what’s happening in the body.

Management and Treatment

What should I do if I break my clavicle?

If you think you broke your collarbone, take these steps immediately:

  • Put your arm in a sling to stop it from moving. You can create a sling from a piece of cloth like a towel or shirt. Wrap it around your arm and fasten it to the back of your neck to hold up your arm.
  • Apply ice to reduce pain and swelling.
  • Take over-the-counter pain medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include ibuprofen (Advil®, Motrin®), naproxen, (Aleve®) or acetaminophen (Tylenol®) if it doesn’t interfere with your other medications or health issues.
  • Call a healthcare provider or go to the emergency room.

What does a healthcare provider do to treat a broken collarbone?

Most clavicle fractures don’t need surgery. If the broken parts of the bone are in a good position to heal, healthcare providers may recommend:

  • Arm support: A sling can help you feel more comfortable as you heal. It can also prevent broken parts of bone from moving around.
  • Medication: Over-the-counter medications can relieve pain as the bone heals. Some healthcare providers may prescribe stronger drugs, such as opioids, for a very short period of time. Those come with risk of drug addiction, though, and should be used only if really necessary
  • Physical therapy: A physical therapist can teach you special exercises. These exercises can improve motion in your arm, strengthen your shoulder and prevent stiffness. You may do the exercises in a physical therapist’s office, at home or both.

What if I need surgery?

Sometimes you need surgery to treat a broken collarbone, like when:

  • Blood vessels or nerves get injured.
  • Fractures break through the skin.
  • Pieces of broken collarbone are not in a good position to heal.

Surgery to treat a clavicle fracture is called open reduction and internal fixation. The operation puts broken pieces of collarbone back where they belong (reduction). It then uses metal devices to keep the pieces in place (fixation). An orthopaedic surgeon (specialist in bone and muscle injuries) may perform the procedure using:

  • Plates and screws attached to the outer surfaces of the bone. The hardware usually isn’t removed after the bone heals, unless it causes discomfort (this usually happens a year or more after the surgery).
  • Pins or screws through the bone. They are usually removed once the fracture has healed.

Prevention

How can I prevent a clavicle fracture?

Clavicle fractures happen suddenly and are difficult to prevent. But certain things can help keep your bones safer:

  • Drive safely and wear a seatbelt when riding in a vehicle.
  • Eat a well-balanced diet with plenty of calcium to keep your bones strong.
  • Use good technique and body positioning for any sports you play or activities you do (such as bike riding).
  • Wear protective gear when playing sports or participating in hobbies.

Outlook / Prognosis

What is the outlook for a broken clavicle without surgery?

Most collarbone fractures heal in six to eight weeks, without surgery or complications. Most people are able to start getting back to normal activities by three months or so, but full recovery may take up to six to 12 months.

You may feel a bump where the fracture healed. The bump may get smaller on its own over time, but it might never go away completely. You may also have less strength in your shoulder and arm. But unless you have other injuries, you can often return to normal activities within a few weeks.

What is the outlook for a broken clavicle with surgery?

If you have surgery, you may feel the plate or other hardware inside your body. You’ll also have limited use of your arm for six to eight weeks. After that, you can start using it for normal daily activities such as bathing, dressing and eating. You should wait for your healthcare provider’s permission before doing things that involve lifting, pulling or pushing. You should also wait to play sports. In general, recovery is similar to treating a broken clavicle without surgery with return to normal activity around three months or so and full recovery up to six to 12 months after surgery.

While your break heals, you should follow-up with your surgeon or other healthcare provider to make sure you don’t have complications. Complications after surgery may include:

  • Malunion: If the pieces of bone move out of place and heal in the wrong position, healthcare providers call it a malunion. It may need surgery.
  • Pain and stiffness: Sometimes the shoulder can get very stiff or painful after surgery. Your healthcare provider may recommend physical therapy or remove any irritating pieces of hardware.
  • Wound problems: The place where the surgeon cut your skin may have trouble healing, get infected or bleed.

Living With

What can I do to make sure I heal after a broken collarbone?

Whether you have surgery or not, you should go to all your follow-up appointments. At those checkups, your healthcare provider will:

  • Check the motion in your shoulder.
  • Talk to you about how you feel and whether you still have pain.
  • Take more X-rays if needed.

You should also follow all exercise advice from your healthcare provider and physical therapist. Physical therapy can be slow and uncomfortable, but it’s important if you want to return to your normal activities.

In the first few weeks of physical therapy, you will do gentle exercises to help prevent stiffness and pain. You will eventually start exercises with light weights and stretchy bands. Once the bone fragments rejoin, you will do more aggressive strength training.

A note from Cleveland Clinic

A clavicle fracture is a break in the collarbone that’s often painful. Most people don’t need surgery, but some require an operation to put the pieces of bone back in place. Physical therapy is important to get you back to daily activities. Talk to your healthcare provider about exercises to reduce pain and stiffness and regain strength.

Rehabilitation and Recovery After Clavicle Fracture Surgery

Surgery for a clavicle fracture (broken collarbone) is typically done on an outpatient basis, so patients will go home the same day as surgery and will need to arrange for someone to take them home.

See Clavicle Fractures: Types and Symptoms

A sling is worn for 2 to 3 weeks after surgery for comfort and to help patients avoid movements that may impede healing. After surgery there are some movement restrictions—particularly for weight-bearing activities—but patients will be encouraged to continue to move the elbow, wrist and hand to prevent stiffness.

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Patients will also be encouraged to do an exercise known as the pendulum exercise, which is done as follows:

Save

Pendulum exercise.

  • Remove the arm sling and stand beside a table.
  • Lean forward and rest the hand of the non-affected arm on the table.
  • Allow the affected arm to straighten and dangle freely.
  • Gently swing the affected arm forward, backward, and in a circle for 2 to 3 minutes.

In This Article:

Once physicians confirm during follow-up visits that the bone is healing properly, the sling can be discontinued and normal range-of-motion activity can be resumed. Patients will also begin a course of physical therapy, which is a critical part of the recovery process to help regain strength and stability.

Removing surgical hardware
Depending on the type of surgery used to fix the bone in place, patients may also need a follow-up procedure to remove hardware.

Plate fixations usually stay in place, with intramedullary fixations sometimes involving removal of the pin once the bone is healed.

Typically patients are placed into a sling for a week or two to allow for healing of the incision, and then allowed gradual activity.

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Return to normal activities
Most clavicle fractures heal after about 6 to 12 weeks. Generally, normal activity can be resumed after 6 weeks, and participation in contact sports being permitted after healing is observed. Athletes can work with their physicians to confirm when they are cleared to resume play.

What to Expect When Recovering from Broken Collarbone

A broken collarbone is a common injury. Your doctor might call it a fractured clavicle. Recovery from this broken bone can take up to 12 weeks. During recovery, you might need to wear a sling or a brace. You may also need physical therapy to learn strengthening and mobility exercises. Your recovery will be slightly different if surgery is part of your treatment.

Having a good recovery period is important. It can keep you from having a weak or stiff shoulder. It also can help you get back to full activity more quickly. Here is what you can expect.

Recovery When You Don’t Need Surgery

Your collarbone connects your arm to your body. It extends from top of your breastbone, or sternum, to your shoulder blade. Usually, the collarbone breaks in the middle and the ends do not separate too far apart. You don’t normally need surgery for this type of break. Instead, you will need to wear a sling for about six weeks. The sling helps reduce pain and swelling. It keeps the ends of the broken bone in the right position for your bone to heal correctly.

You will have some pain during recovery. In most cases, an over-the-counter pain reliever can control the pain. An ice pack may also help reduce pain and swelling.

You will start physical therapy during the first three weeks, while you are still using the sling. The first exercises may involve moving your wrist and elbow. As your physical therapy progresses and you have less pain and stiffness, you will start to do strengthening exercises, too.

The length of recovery varies from person to person. After about three weeks, your doctor may take an X-ray to see how your break is healing. If the X-ray looks good, you may start gentle range-of-motion exercises for your shoulder. After about six weeks, you may have another X-ray. If you’re healing well, you may be able to stop using the sling. Then, your exercises will include more active range of motion.

Your doctor will let you return to normal activities gradually. Timing will depend on your progress. Most people can return to full activity in about 12 weeks.

You may need surgery if your collarbone breaks in several pieces or if the pieces move too far out of place. The surgeon may use plates or screws to bring the bone ends or pieces together so they heal properly.

Recovery after surgery usually takes longer and involves more pain. There is a higher risk for complications, too. You will still need physical therapy.

After surgery, you will need to wear a sling or a brace for 6 to 8 weeks. Also, you probably will need to take a strong pain medication called an opioid. Carefully follow your doctor’s instructions for taking this medicine. After a few days, your doctor may switch you to an over-the-counter pain reliever. You also can use an ice pack to reduce pain and swelling. You may start range-of-motion exercise for your elbow and wrist during the first week after surgery.

How long recovery takes varies from person to person. When an X-ray shows it is safe, you can remove your brace or sling while you do gentle range-of-motion exercise for your shoulder. This often occurs after about four weeks. Then, when a follow-up X-ray shows even more healing, you may be able to get out of your brace or sling for good and start full range-of-motion exercises. After about 6 to 8 weeks, you may add strengthening exercises. Full recovery may take 3 to 4 months.

Complications after surgery can include bleeding, blood vessel damage, nerve damage, infection, lung injury, and blood clots. Most of these problems occur soon after surgery. Let your doctor know if you experience any of the following:

Kids Health Information : Fracture care: clavicle (collar bone)

If your child has a fractured clavicle (collar bone), they will usually heal well with rest and time. A cast is not needed. Clavicle fractures usually occur in the middle of the bone. 

Most clavicle fractures have no displacement or only mild displacement, which means there is still some contact between the two ends of the bone at the site of the break. 

This fact sheet provides information on what to do once your child has been treated in hospital for a clavicle fracture. If you think your child has a fracture and you are looking for first aid advice, see our fact sheet Fractures (broken bones).

Care at home 

Your child should wear a sling for the first two to three weeks, including while they are in bed. This will help them feel more comfortable and help the fracture heal. Your child’s fingers should be higher than their elbow. Encourage your child to keep moving their hands and fingers while they
are wearing their sling.

During the first few days it is important for your child to rest as much as possible.

Fractures are painful. Although immobilising the arm with the sling will help to reduce the pain, additional pain relief (e.g. paracetamol) is often needed. Give the medication regularly for the first few days, following the directions on the packet, or as directed by the doctor.
Giving pain medications before bedtime will help your child have a better sleep, as lying down with a clavicle fracture will cause pain.

Your child can stop wearing the sling when the fracture site is no longer tender and your child can move the arm fully with little or no discomfort. In children, this is usually after three weeks, but can take as long as six weeks.

Follow-up

Children aged under 11 with an undisplaced fracture (ie there is some contact between the two broken ends of the bone) go on to heal very well, and do not need to have a follow-up appointment. Any angle formed by the two ends of the bone will remodel with time as it grows.

Children aged over 11 or in whom there is no contact between the two fractured ends of the bone should be reviewed by their GP or local hospital approximately two weeks after the injury to check healing.

 A few children aged 14 or over may be referred directly to the Orthopaedic Department if there is no contact between the two ends.

After the sling is removed

Gentle shoulder movement can begin when the sling is removed. Your child may return to sports such as swimming as soon as it is comfortable to do so and pain-free. However, contact sports should be avoided for six weeks after the sling comes off, as they are at greater risk of it breaking again.

A lump at the fracture site is quite normal and may take about a year to disappear. In older children, a small bump may remain. This is no cause for concern.

Take your child to your GP if you are concerned about:
• pain at the site of the fracture which is not improving by three weeks
• persistent tingling or altered sensation in the arm or hand.
• shoulder or elbow stiffness that does not resolve 

Key points to remember

  • A fractured clavicle (collar bone) will usually heal well with rest and time.
  • Your child should wear a sling until there is no tenderness over the fracture and they can move their shoulder without pain or discomfort (usually two to three weeks).
  • Children older than 11 years or those who have a displaced fracture will need a follow-up appointment one to two weeks after their injury.
  • Avoid contact sports for six weeks after removal of the sling.

For more information

Common questions our doctors are asked

Why doesn’t my child need a follow-up appointment?

We recommend that children aged over 11 have follow up at one to two weeks to check that healing is occurring normally.  This is because some children in this age develop a condition where healing does not occur properly, particularly where the two ends of the bone do not come into any contact with one another. Some children over 14 may be referred directly to the Orthopaedic Department by the treating health professional.  

Why do child children over 11 need a follow-up appointment?

If your child is older than 11 years, they should see their
GP for a follow-up appointment. This is because the majority of clavicle
fractures in this age group are displaced. 

If my child has a lump at the fracture site that doesn’t go
away, can anything be done about this?



Usually
these lumps will eventually go away in a few years. If the lump does not get
smaller after this time, you can have it reviewed. See your GP for a referral.
Surgery may be an option, but most people do not elect to have the surgery
because the lump will not cause problems. Also, surgery will leave a scar that
is often more noticeable than the original lump.

Developed by The Royal Children’s Hospital and the Victorian Paediatric Orthopaedic Network. We acknowledge the input of RCH consumers and carers.

Reviewed May 2021 

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
www.rchfoundation.org.au.

Does a Broken Collarbone Require Surgery?

Ask A Sports Doc: Does a Broken Collarbone Require Surgery?

November 07, 2016

Dr. Rick Cunningham is a knee and shoulder sports medicine specialist with Vail-Summit Orthopaedics and a physician for the U.S. Ski Team. For more information about Vail-Summit Orthopaedics visit www.vsortho.com.

Question: I broke my collarbone mountain biking. Will I need surgery?

Answer: Broken collarbones or fractured clavicles are common injuries accounting for about 3 percent of all fractures seen in adults. Eighty percent of these fractures take place in the middle part of the clavicle and are called mid-shaft fractures. In ski or bike injuries these fractures are typically have multiple fractured fragments.

Traditionally clavicle fractures were treated without surgery. Patients were placed in a sling for comfort and orthopedic surgeons advised patients that the bone should heal. However as orthopedists looked more critically at outcomes a number of studies showed that in high energy fractures where the bone ends are separated or overlap significantly the results are not always excellent.

The clavicle has an important function. It serves as a strut connecting your arm to your chest wall. The motion of your shoulder blade is dependent on normal alignment. As you lift your arm the clavicle elevates rotates and retracts. Thus if your clavicle fractures and heals shortened it can cause abnormal scapula motion and possibly shoulder pain and weakness. The clavicle also protects lung tissue and nerves. The clavicle is the last bone in our body to stop growing with its growth plate fusing around age 23.

Ninety percent of the time people break their clavicle as a result of a fall onto their shoulder or a direct blow to it. Rarely do we fracture our clavicle by landing on an outstretched hand. Fractured ends of the clavicle rarely break through the skin. Patients experience immediate pain swelling and bruising. Clavicle fractures are very painful as it is difficult to immobilize them. Thus little movements such as coughing cause severe pain. Unlike some fractures there is no way to “set” or reduce the fracture. Thus I don’t manipulate the arm or shoulder as the bones will not stay aligned. X-rays tell me how displaced the fracture is. There is no reason to get additional studies such as a CT scan or MRI unless other injuries are suspected.

For instance last week I was called to see a man in the ER who had a clavicle fracture but was also short of breath. His x-rays and a subsequent CT showed that he also had multiple rib fractures and a punctured lung.

How do I currently treat clavicle fractures in adults? I obtain different x-ray views and assess several things. First I measure how displaced the broken ends are. Secondly I measure whether the fractured ends are overlapped or shortened. If a clavicle fracture is displaced more than 15 mm (in kids more displacement can be accepted as they are still growing) then I recommend the fracture be treated surgically as the clinical results are better than allowing the fracture to heal in a displaced position. In surgery the clavicle fragments are put back together like a puzzle and the bone fragments are held in this position with hardware designed to fit the normal curvature of the clavicle. After surgery the patient is placed in a sling for 4 to 6 weeks at which time the bone is healed enough that the sling can then be discontinued and physical therapy started. If the fracture is minimally displaced then no surgery is required and the fracture should heal in a sling. I don’t put patients in a figure eight bandage as there is no difference in overall healing with these and most patients report more discomfort.

If a patient chooses not to have surgery for a significantly displaced fracture I counsel them that there is an increased risk of a nonunion (the bone does not heal and is then harder to correct down the road) or malunion (the bone heals crooked which can lead to pain and weakness). The main benefit of fixing a clavicle fraction with surgery is that the patient has shorter healing time. In a recent study of more than 100 patients with displaced midshaft clavicle fractures the nonsurgical group healed at an average of 28 weeks while the surgical group healed at an average of 16 weeks.

90,000 Treatment after fracture of the clavicle

Fracture of the clavicle is an injury that most often occurs in children and young people. Fracture is usually caused by a direct blow to the clavicle, its strong squeezing or falling on its side on an outstretched arm, and the first place among the causes of fracture is taken by sports injuries and road accidents.

Clavicle fractures can be divided into groups depending on the location and the presence of fragments and displacement; further treatment depends on these factors.Complex fractures with splinters and displacements require surgery, while relatively simple closed fractures can be treated conservatively with fixation followed by physiotherapy. It is important to understand that the decision on the type of treatment and the choice of a fixation bandage is made only by a doctor after a thorough examination and X-ray.

For the treatment of most clavicle fractures, complete or partial immobilization (immobilization) of the damaged area is sufficient. In children, the elderly, as well as in the case of a simple fracture, softer options are used instead of plaster: a bandage, orthosis or a fixing bandage.Their task is to reliably limit the mobility of the shoulder girdle and ensure the correct position of the hand during the recovery period, without injuring the skin and soft tissues. A properly fitted and applied bandage helps relieve pain – the muscles in the shoulder relax and the fragments of bone do not move or press anywhere.

Clavicle fracture in older people is less common than in younger people, but it has more serious consequences. Due to the peculiarities of regeneration after 50 years, doctors usually refuse traditional plaster, as such a rigid fixation can cause arthrosis, as well as irritate the surrounding tissues.

Fracture of the clavicle in children is sometimes called “fracture of the green twig” – that is, the bone fragments are held by the periosteum and therefore grow together much faster, and fixation with such a fracture may not be absolute. For young children, a bandage or reclinator is also indicated instead of plaster.

Bandages and bandages are supporting and fixing .

Support “kerchief” or kerchief dressing is usually used for first aid, as well as an addition to the classic plaster.It relieves the muscles and ligaments of the shoulder apparatus, relieves stress from the shoulder joint and scapula, keeps the hand in the optimal position for recovery. However, the fixation when using such a bandage is not complete, therefore, for better healing during the rehabilitation period, other types of bandages are usually used – fixing.

For small and simple fractures, the Dezo dressing is most often used. Its prototype back in the 18th century was invented by the French physician Pierre Desot, and the principle of operation has hardly changed over the past centuries.The Dezo bandage firmly fixes the shoulder and forearm to the body and is used not only during fracture treatment, but also during the rehabilitation and postoperative period.

In the case of a more complex fracture, an eight-shaped bandage or Delba rings is used. Delbe’s rings (orthopedic reclinators) are 2 belts crossed between the shoulder blades and threaded through one or more rings. This design allows you to adjust the size and tension of the belts.The reclinator fixes the shoulders in a dilated state, opens the shoulder blades, ensuring the correct position of the clavicle. The hand in this type of bandage is not fixed. Delbe’s rings can be worn under clothes, they are usually made of breathable material, and thanks to the soft linings, they are comfortable to wear around the clock.

Modern versions of the Dezo bandage and Delbe rings have several options for fixing and pulling forces and, in general, are a fairly simple design that does not require special knowledge and skill when putting on.However, it is very important that the first time the bandage is worn by the doctor (who will also determine the time of wearing the bandage).

If the treatment is started on time, and the patient follows all the doctor’s recommendations, the healing time after a clavicle fracture usually does not exceed 10 weeks for adults and 3 weeks for children. With a simple fracture, already on day 2, you can begin to gradually develop the hand, returning activity and blood circulation to the injured hand: bend and unbend the fingers, make light circular movements with the fingers and a hand – no more than 2 minutes a day.In this case, you can not strain the damaged area of ​​the shoulder girdle and engage in pain.

After the initial stage of rehabilitation, according to the doctor’s indications, the patient can be assigned physiotherapy . Usually these are procedures for magnetic, ultrasound and high-frequency therapy. It is also important to support your body with proper nutrition: there is more calcium (it is found in dairy products), vitamin D and C (fresh herbs, legumes, berries). In rehabilitation, you need to do everything gradually, listening to yourself, your feelings and, of course, to your treating specialist.

Treatment of a fracture of the clavicle in St. Petersburg

The clavicle is a small S-shaped bone that connects the sternum and scapula. It is one of the most prone to fractures of human bones (up to 12% of all cases).

You can get this injury when you fall on your shoulder or outstretched straight arm. A strong blow to the shoulder area can damage the collarbone. In rare cases, the bone may crack due to seizures (for example, during an epileptic seizure).

Clavicle fracture symptoms

Signs of collarbone injury are well understood, so the traumatologist rarely has difficulty in making a diagnosis.If after the blow you notice that the shoulder is deformed, and the arm has lost its mobility, then these are sure signs of a fracture.

Frequent fracture symptoms:

  • swelling and hematoma in the shoulder area;
  • Sharp pain when moving the arm;
  • numbness of the hand;
  • shoulder shifted forward or downward.

The final confirmation of the diagnosis should be an X-ray.

Fracture of the clavicle with displacement

Allocate fractures of the inner, outer and middle third of the bone; they can be both closed and open with damage to blood vessels, pleura and nerves.

Displaced open fractures are considered the most severe. Such an injury is dangerous in that the bone fragments are strongly displaced from their normal position and damage the nearby soft tissues. There are several types of offsets: length, axis and angle. To accurately determine the nature of the damage, it is necessary to undergo additional examinations (CT, MRI).

Methods for treating a fracture of the clavicle

First aid is given to the patient first. The hand on the side of the fracture is fixed with a kerchief bandage.To avoid complications, the person must be taken to the emergency room as soon as possible.

Simple fracture without displacement is the easiest to treat. Enough immobilization of the shoulder, and the bone will grow together in 1-2 months. For children, recovery takes even less than a month.

Displaced fracture requires a special procedure – bone reduction. The broken parts of the bone must be returned to their original position and fixed. The reduction is performed under local anesthesia, and general anesthesia may be necessary in severe fractures.Delbe’s rings are used to fix the clavicle.

Complex fractures with displacement or splitting of the bone require long-term surgery and are restored under general anesthesia. These are severe injuries in which nerves and blood vessels are damaged.

As additional measures, analgesics, vitamins and mineral complexes with calcium are prescribed. After a while, when the bone begins to grow together, to speed up the treatment, the patient is offered to undergo a course of physiotherapy and physiotherapy exercises.

The emergency room at the Medicenter works without interruption. Fracture treatment is one of our main areas of focus.


Our clinics in St. Petersburg

You can get detailed information and make an appointment by calling
+7 (812) 640-55-25

90,000 Rehabilitation after a fracture of the clavicle in Moscow – prices for services in the center Wellbeing

Fracture of the clavicle is a common injury from falls or strong impact.The duration of recovery with proper rehabilitation is about 10 weeks.

Stages of recovery after a clavicle fracture

Rehabilitation is the final stage of treatment. Its task is to restore the functions of the shoulder and collarbone, to ensure their correct work in the future. At the same time, rehabilitation itself is also divided into stages.

  1. The shoulder and collarbone are stationary. This is a necessary step – otherwise the bones may not heal or heal with displacement.For fixation, doctors use special bandages (Ombredana, Dezo, etc.) and gauze rings. The period lasts an average of 3 weeks.
  2. The patient begins to develop the collarbone. The doctor removes the bandage and the patient begins to perform simple arm movements.
  3. The patient increases the load on the arm and returns it to its usual mobility. The main role at this stage is played by physiotherapy exercises.

Rehabilitation methods

Rapid recovery is impossible without special procedures.The most effective methods of rehabilitation are exercise therapy, massage and physiotherapy – baths, magnetotherapy, electrophoresis, heat therapy using paraffin, sand, vapors, ozokerite, therapeutic mud, etc. The procedures prevent stagnation of blood and lymph, restore sensitivity, reduce swelling, and promote rapid healing of injury.

It is equally important to eat right, add foods high in calcium, vitamin D and C to the diet. And if the patient feels helpless and depressed, a psychotherapist talks to him.

Massage and exercise therapy for clavicle fracture

Massage

The procedure can be started within a few days after the fracture. At the first stage of rehabilitation, the specialist massages the healthy area of ​​the shoulder girdle, back and part of the chest, and at the second and third stages, he gently strokes, pinches and kneads the collarbone and shoulder itself.

The main rule of massage is complete comfort. All unpleasant sensations must be reported to the doctor. And in no case should you do the massage yourself or trust it to a non-professional.This approach will fail at best and lead to disability at worst.

Physiotherapy

Like massage, exercise therapy classes can be started as early as 2-3 days after the injury. Physical exercises at this stage are very simple: you need to bend and unbend your fingers, perform circular movements with your hands. It is impossible to load directly the damaged area, it is also forbidden to make sudden movements, and if some exercises cause pain or discomfort, they should be canceled.The duration of classes should not exceed two minutes, the optimal number of workouts is about 5-6 per day.

At the second and third stages of treatment, the number, duration and complexity of exercises increase, the patient begins to use dumbbells, resistance bands, gymnastic sticks and balls. The load under the supervision of a specialist allows you to quickly develop the damaged limb and shorten the period of complete recovery.

Clavicle injury: rehabilitation after surgery

The patient may need surgery if the specialist diagnoses a complex fracture with bone fragments or displacement.Rehabilitation in this case differs little from the classical one, but the doctor can additionally prescribe medications to the patient to relieve pain, prevent the development of thrombosis and improve the restoration of bone and cartilage tissue.

Rehabilitation therapy in the Wellbeing Center

Extensive work experience, competent staff, thought-out infrastructure (from ramps and handrails to wide doorways), a multidisciplinary team of doctors and an attentive attitude to each patient – all this allows us to achieve great success in rehabilitation.

We are located not far from the capital and are always ready to receive patients from Moscow and the region or from other regions.

Surgical versus conservative interventions for fractured clavicle in adolescents and adults

This summary presents what we know from research about the effects of surgery versus non-surgical (conservative) treatments such as wearing a sling or a figure-of-eight for two to six weeks to treat a collarbone fracture.

Relevance

The clavicle acts as a bridge across the front of the chest to connect the arm and chest. It (the collarbone) helps stabilize the shoulder while allowing the arm to move freely and provides an attachment area for the muscles, while also functioning as part of the musculoskeletal system used in the act of breathing. The collarbone also protects the nerves and blood vessels and plays an important aesthetic role in a person’s appearance. The most common site for a clavicle fracture is the middle third of the clavicle.Trauma usually occurs in young adults and the elderly. This usually occurs when falling directly onto the outside of the shoulder. Most clavicle fractures in the middle third are treated conservatively (not surgically). However, the result may be unsatisfactory with more serious fractures. Surgical treatment consists in placing the bone back in its place and, as a rule, in performing internal fixation using a plate and screws or a metal rod that is inserted into the inner cavity of the clavicle bone.

Search results

We searched medical databases up to December 2017 and included 14 studies involving 1469 people with displaced or comminuted clavicle fractures in the middle third. All participants were adults, between the ages of 17 and 70, and there were more males than females. Ten studies compared plate fixation with conservative interventions (sling and / or figure-of-eight), and four studies compared internal fixation with wearing either a sling or figure-of-eight.

Highlights

A review found that surgery, compared to conservative treatment, may not improve shoulder function, pain, and quality of life one year later. However, surgery can reduce the risk of treatment failure when secondary surgery is required for fractures that have not healed or did not heal properly. We are not sure if the surgery provides the best cosmetic result overall. Although surgery reduces shoulder deformity, it can lead to unsightly scars and visible metal structures.We also have certainty if there is a difference between surgical and conservative treatment in terms of the risk of complications. However, the nature of these complications often differs depending on the treatment. Complications of surgery, such as wound infection and opening of the wound, or hardware irritation requiring additional surgery, must be weighed against complications that are more likely to occur with the use of a sling, such as stiffness (stiffness) in the shoulder and failure to heal properly.

Quality of evidence

All 14 studies had weaknesses that could affect the reliability of their results. We considered the quality of the evidence for all outcomes to be either low or very low.

Conclusions

Low-quality evidence suggests that surgery may not be beneficial over conservative treatment, or cause greater complications. However, we are uncertain about these effects, and further research may change these findings.

recovery after injuries and fractures of the clavicle

The Dr. Bloom Center uses the author’s method of postoperative recovery of the problem area. The operation restores its integrity, and the goal of correct rehabilitation of a clavicle fracture is to restore physiological functions.

Rehabilitation technology is aimed at restoring anatomical integrity (in case the operation was not performed), restoring the structure and eliminating the consequences of damage, with a simultaneous effect on the entire body as a whole, through the launch of internal processes of regeneration and self-healing.

A comprehensive step-by-step approach to the rehabilitation of a clavicle fracture with or without displacement allows you to return to your usual life much faster, in addition, the program is aimed at strengthening the whole body and significantly improving overall well-being.

The rehabilitation program after a fracture of the clavicle and other types of injuries to the sternocleidomastoid-acromial region includes:

  • Primary diagnostics with biomechanical testing – assessment of the complexity, severity and consequences of the treatment;
  • Development of an individual recovery program, taking into account the identified violations and the general state of the body’s energy resource;
  • Preparation of the necessary training equipment and personal instructor for the program;
  • Individual lessons in the most effective mode in this case;
  • Dynamic monitoring of the state and progress, correction of the individual program depending on the biomechanical changes in the injured area;
  • Development of a set of recommendations and exercises for performing at home;
  • Determination of the timetable for the next course, if necessary;

A personalized program is prepared for each patient, precise parameters and amplitudes of movement are set.The author’s system of methods and techniques of Dr. Blum allows you to activate deep muscle layers, turn on regeneration processes, restore normal spatial relationships and anatomical unity of the spinal column, the musculoskeletal system as a whole, restore the function – supporting and motor, eliminate muscle and osteoarticular imbalance.

  • accelerated recovery of the body at the expense of its own reserves;
  • individual approach and step-by-step problem solving;
  • low energy consumption of the body to obtain meaningful results;
  • feeling of cheerfulness and a surge of energy after classes;
  • lack of drug therapy and surgery;

The Dr. Bloom Center is equipped with unique patented training complexes.To solve rehabilitation problems of varying complexity, 800 training devices are used, which make it possible to set an accurate dosed load on the target segments of the musculoskeletal system. An integrated interdisciplinary approach allows you to solve complex problems that lie at the junction of narrow medical specialties.

Thanks to the targeted impact on the affected area, rehabilitation is as complete as possible, the rehabilitation period after a collarbone fracture is reduced, all conditions are created for returning to a full life.

Fractures and nonunion of the clavicle

I want to express my gratitude to the medical specialists of the 3 emergency trauma department, for their treatment, attention, good attitude and understanding. For telling me about each stage of treatment and our further joint actions to restore my health. Thank you so much for your attention, care, understanding. They will always support you with a kind word, and tell you what to do and how, with all the professionalism they do their job and at the same time they will always cheer you up and cheer! Head of the department, Artur Arslanovich Kerimov, traumatologist Boris Vladimirovich Tyulkevich, I would like to express special gratitude to the attending physician, traumatologist Evgeny Anatolyevich Kukushko for the excellent operation.As well as medical brothers: Lapin Oleg Igorevich, Yumashev Nikita Vladimirovich; to nurses Marina Vasilievna fornication, Oksana Mukha. Junior staff: Elena Anatolyevna Balashova, Elena Leonidovna Sablina. Sister hostess Ishutina Nadezhda Leonidovna, senior nurse Shushpannikova Oksana Sergeevna, dressing honey. brother Shelikhov Daniil Dmitrievich. Thank you very much for returning us to normal life. Health to you!

Was in the 3rd trauma emergency department.I want to express my deep gratitude for the treatment, attention, good attitude and understanding, sensitivity, professionalism, humanity in relation to patients. For the fact that they talked about each stage of treatment and further joint actions to restore my health. I would like to express my special gratitude to the department staff: head of the department Kerimov Artur Apslanovich, traumatologist Tyulkevich Boris Vladimirovich, medical brothers: Lapin Oleg Igorevich, Yumashev Nikita Vladimirovich, med. sisters: The Prodigal Marina Vasilievna, Musa Oksana.Junior staff: Balashova Elena Anatolyevna, Sablina Elena Leonidovna, sister owner: Ishutina Nadezhda Leonidovna, senior honey. sister Shushpannikova Oksana Sergeevna, dressing honey. brother Shelikhov Daniil Dmitrievich. I would especially like to express my gratitude to the attending physician Evgeny Anatolyevich Kukushko. On July 15, 2021, I once again ended up in the 3rd department of the Burdenko hospital. Evgeny Anatolyevich was my attending physician. From the first meeting with him, I felt trust in him. He listened to me very attentively, carefully studied the materials, and approached the preparation of the operation professionally.On July 22, he underwent a complex operation to REMOVE METAL STRUCTURES FROM THE LEFT HIM BONE, EXCUTE SCARS, CORRECTING OSTEOTOMY AT THE HEIGHT OF DEFORMATION. The operation took about six hours. After the operation period went well. Now I’m on the mend. Remembering and strictly adhering to the advice of Evgeny Anatolyevich. Dear honey. staff of 3 departments! Thank you very much for your work in bringing us back to normal life.

Good afternoon. On September 9, 2020, I underwent surgery on my right shoulder joint. I want to express my deep gratitude to the entire team of the 3 traumatology department (emergency). You are real professionals, God grant you health and long life so that you can help people and return them to a normal, full life. Thanks to you, I feel great, I am fully engaged in sports, my hand works in full force.Words cannot convey what you feel. Very, very grateful to everyone.

Thank you very much for your help. A very good and helpful doctor. I am very pleased with the performed operation. I hope that with the second joint I will get to your hospital.

Was consulted by Darya Alexandrovna and then operated on with her for a chronic injury.Everything went great, I didn’t even expect it! The doctor, not formally, but scrupulously and thoroughly studied my problem, proposed a treatment plan, performed the operation with high quality and continues to advise me throughout the rehabilitation period. Along with modern medical equipment, I was impressed by the professionalism and well-coordinated work of the entire medical team of the traumatology department. Low bow to everyone who heals people!

Was consulted by Daria Alexandrovna Naida and then operated on with her for a chronic injury.Everything went fine, I didn’t even expect it. The doctor did not formally, but scrupulously and thoroughly studied my problem, suggested a treatment plan, performed a high-quality operation, and consulted at the stage of rehabilitation. I was impressed by the professionalism and coordination of the work of the entire medical team of the Department of Traumatology. Low bow!

I express my deep gratitude to the attending physician Daria Alexandrovna Nayda and the entire team of the center of traumatology and orthopedics for their high professionalism, responsibility and dedication to their work.I myself am a doctor, I came for treatment from Yekaterinburg. On the very first day, a diagnosis was made (different from the guided one), the next day I successfully operated on, at all stages I felt the attention, care and well-done work of the whole team. Low bow to you, be healthy and happy!

Twice operated in the hospital with the attending physician Boris Vladimirovich Tyulkevich. Thank you so much for your professionalism, sensitivity and responsiveness.I would also like to express my gratitude to all the medical staff of the 3rd trauma department.

Warm and sincere words of gratitude to the 64th Department of Spinal Neurosurgery, GVKG them. N.N.Burdenko. For a long time there were problems with the lumbar spine. Was observed in a military clinic. Treatment (injections, physiotherapy, acupuncture, etc.) did not reduce the pain, the problems grew. I consulted the 64th department with the results of MRI and CT of the spine.The head of the department looked at G. N. Kozlov, promptly made a diagnosis, suggested a treatment regimen. After hospitalization, the department underwent radiofrequency nucleoplasty of the intervertebral discs by the attending physician IV Artyushin. On the second day I felt an improvement, the pain was gone. I would like to mention the medical staff of the department. Starting with the detour and the whole day you are surrounded by kind and caring people, the room is always clean and comfortable. The attending physician Artyushin I.V. always supported and tuned in for recovery. He closely followed the postoperative state, gave all the recommendations for the subsequent recovery period.Many thanks to the doctors Kozlov G.N., Artyushin I.V., all the staff of the department. Now I have a new life without problems and in a good mood. We all really need your work and care! Respectfully yours, reserve colonel Maltsev Eduard.

I would like to express my gratitude to the team headed by Dr. ARBUZOV Yu.V., and personally to Yuri Viktorovich, for the professionally performed work to restore the combat readiness of an active serviceman of the RF Armed Forces in the shortest possible time, brilliantly performed, using the author’s technique, a surgical operation to unite the achilles tendon and competent organization of the process of its further restoration.Many thanks to military surgeons and all medical personnel for their professionalism, sensitive attitude towards patients and high responsibility for the work performed.

90,000 Open and closed displaced clavicle fracture, symptoms

Clavicle fracture is a change in the physiological structure of the bone. The patient, during or after injury of the clavicle, experiences painful sensations in the supraclavicular and subclavian regions, with disruption of the usual previously available active movements in the upper limb on the injured side.In addition, a person notes swelling and a change in the shape of the clavicle.

When examining a bone injury, a traumatologist or surgeon relies on the patient’s complaints, anamnesis data, general examination, and the results of instrumental studies. X-ray examination has a high diagnostic value. Depending on the type of fracture, the doctor will determine the tactics of treatment. For example, in case of a green branch injury (in this case, the integrity of the periosteum is preserved), a soft fixation bandage should be applied to the child.If the fracture of the clavicle is accompanied by displacement of the fragments, then the tactics change: reduction is used with further fixation with a plaster cast. Finally, if there is a possibility of damage to nearby nerve trunks or vascular formations, the patient needs immediate surgical treatment.

Therefore, if your collarbone hurts , you should definitely contact a traumatologist! The doctor will conduct a qualitative examination and determine the causes of the pain syndrome.

Causes of clavicle fractures

Often, a clavicle fracture occurs in a domestic environment, and when symptoms of a clavicle fracture appear, you should immediately consult a traumatologist. Clavicle injury can occur for the following reasons:

  1. Direct mechanical action on the bone. Direct trauma (such as a sharp or violent blow) to the clavicle can cause severe collarbone pain, a characteristic symptom of collarbone injury.Direct trauma causes oblique, transverse and comminuted fractures of the clavicle. Situations in which a direct injury to the collarbone occurs are quite varied: the fall of a heavy object, a collision with a protruding part of a structure in production, a fight with the use of bits, large metal objects.
  2. Indirect bone injury. A broken collarbone can result from a fall on an outstretched arm, shoulder, or elbow. According to this mechanism, oblique and oblique fractures are formed.Often, indirect injuries occur during difficult weather conditions (ice), as well as when a person is under the influence of drugs or under the influence of alcohol.

In addition, sudden muscle contraction can be a rare cause of a collarbone fracture. Such situations are observed in patients with epilepsy: after a generalized convulsive seizure, the patient notes pain under the collarbone or above it, as well as symptoms of limitation of the motor functions of the arm.

Clavicle fracture symptoms

Closed fracture of the clavicle is accompanied by the following characteristic symptoms:

  • intense pain syndrome in the bone, while the intensity of pain in the clavicle does not decrease when taking any position;
  • restriction of available movements on the side of the bone injury, severe pain when performing previously habitual actions;
  • the occurrence of puffiness in the shoulder girdle, its shortening;
  • change in the standard shape of the clavicle;
  • Shoulder ptosis, displacement inward and slightly anteriorly.

Often, the doctor can suspect a fracture of the clavicle by the characteristic posture of the patient. So, a person often holds a limb that has been injured with a healthy hand. The patient can also press the injured limb to the trunk, explaining this by a decrease in pain syndrome when using this position.

As a rule, in the first seconds of injury to the clavicle, a person feels a sharp and severe pain in the supraclavicular or subclavian region. The pain syndrome intensifies when the limb hangs freely, which explains the forced position – pressing the injured limb to the body.The free position of the injured side leads to the fact that the fragments of the clavicle are displaced in different directions, change their position in the wound, giving the person additional discomfort. Thus, a person needs to make the minimum number of movements so as not to provoke displacement in the event of a fracture of clavicle of bone fragments.

Over time, there is a physiological response of the body to a fracture of the clavicle. Edema, hyperemia (redness of the damaged area), hyperthermia (increase in temperature in the area of ​​damage) are formed.This is a typical inflammatory response of the body to trauma to the bone base and soft tissues. Then there is an increase in pain and progression of hand dysfunction. Above the area of ​​the broken clavicle, a significant swelling is visually visible, corresponding to the site of displacement of the clavicle under the tension of the sternum-clavicular-mastoid muscle.

During an objective examination, the doctor draws attention to the following symptoms of a clavicle fracture:

  • the presence of areas of hemorrhage in the damaged area;
  • formation of pathological mobility in the supraclavicular or subclavian region, while any movement brings pain to the patient;
  • crepitus (crunch) of bone fragments.

In addition, open fractures are accompanied by the formation of a wound, from where a part of the clavicle protrudes, depending on the area of ​​the fracture. If an injury to the clavicle has led to a violation of the anatomical integrity of any neurovascular bundle located in the neck, then the patient complains of severe limb weakness, numbness, crawling creeps.

Often, dizziness and general weakness are added to the list of symptoms of a clavicle fracture, which can be explained by internal bleeding.In severe situations, shortness of breath and shortness of breath are added to the typical signs of collarbone injury, which are caused by damage to fragments of the clavicle of the pleura covering the lungs. This leads to the formation of pneumothorax in a person, and is accompanied by symptoms characteristic of such a complication.

Complications

Like any disease, a bone injury can be complicated by many pathological conditions, if the treatment of a clavicle fracture is not started in time.Fortunately, complications of trauma are rare because patients often seek immediate medical attention. However, it is impossible to exclude possible complications in case of poor-quality or untimely medical care:

  1. Injury of a vascular or nerve formation. A displaced clavicle fracture can damage a large vascular trunk or a nerve formation, resulting in characteristic symptoms. In the case of damage to a nerve fiber, disorders of the motor or sensory sphere in the injured area are observed as long-term consequences of damage.The severity of neurological symptoms depends on the nature and extent of nerve damage, however, do not forget about the likelihood of injury to nerve fibers. Damage to the vessel often leads to serious bleeding, especially if a sharp fragment of bone injures a large magistral vessel, resulting in severe blood loss.
  2. Damage to the pleura . A formidable condition for human life – pneumothorax, is formed when displacement with a fracture of the clavicle causes damage to the parietal pleura.Air enters the pleural cavity, which is accompanied by a characteristic clinical picture (shortness of breath, lack of air, lagging of one of the halves of the chest during breathing). Pneumothorax requires prompt action by healthcare professionals and immediate treatment.

In most cases, complications of the fracture can be prevented thanks to competent and correct assistance with a fracture of the clavicle.

Diagnosis of clavicle fracture

Diagnosis of a clavicle fracture with or without displacement is carried out by a traumatologist.As a rule, the doctor performs the entire list of diagnostic measures in the admission department of a hospital or in a trauma center. The main methods used by the doctor are as follows:

  1. Objective research data . The traumatologist conducts a thorough examination of the injury site. For a clavicle injury, a pronounced deformation of the site is characteristic, a strong swelling of the damaged area, in some cases, especially with a displaced clavicle fracture, crepitus (crunch) of bone fragments is observed.In the course of an objective examination, the doctor necessarily checks for the presence of neurological damage: he determines the sensitivity of the hand on the side of the injury, the presence or absence of active movements. In addition, the doctor needs to assess the possible complications. So, during the examination, the traumatologist determines the presence of symptoms of blood loss due to damage to large vascular bundles or difficulty breathing, shortness of breath as symptoms of the formation of pneumothorax.
  2. X-ray diagnostics. Radiography is the standard test for suspected collarbone injury. With its help, the doctor determines the site of the fracture, the displacement of the clavicle. A fractured collarbone in a child is often accompanied by an angular injury. In this case, the displacement of bone fragments occurs, however, the integrity of the periosteum is preserved. X-ray is traditionally performed in frontal projection, but in difficult cases, if the traumatologist is unable to determine the localization of all fragments of the clavicle, the diagnosis is carried out additionally in the lateral projection.
  3. An additional research method, with insufficient information content of X-ray diagnostics, is computed tomography . Three-dimensional reconstruction allows you to fully see the picture of the trauma of the clavicle, to determine the degree of displacement in the fracture of the clavicle of bone fragments.

Finally, if the traumatologist suspects complications in the form of trauma to large neurovascular bundles, he refers the patient to a consultation with a neurologist and a vascular surgeon.

Treatment

The therapeutic tactics that the doctor chooses depends on many parameters. For example, the degree of clavicle fracture matters , whether the clavicle fracture occurred in a child or in an adult, whether there is a displacement of bone fragments. In addition, when deciding on the tactics of treatment, the doctor assesses the presence of complications that have developed. If there is no threat of damage to large nerve or vascular formations, a well-reparable collarbone fracture has occurred in a person, then the patient does not need to be in hospital for a long time.

If there is a high risk of developing complications or exacerbation of the clinical situation , then the treatment of the clavicle should be carried out in the trauma department. According to statistics, in a significant number of cases, patients do not require surgical intervention, just ordinary therapeutic treatment is enough.

First aid for fracture

At the first stage, it is necessary to be sure to call an ambulance .Within a few minutes after the injury of the clavicle, active edema begins to form in the damaged area, which subsequently creates difficulties in performing closed reduction of the fragments. The more time elapses, the more likely it becomes that the patient will undergo an open reduction. Treatment of a broken collarbone by a traumatologist consists in a surgical operation, during which a special access to the injury site is performed, and then the bone fragments are compared. Of course, if closed reduction is not possible, then an open method is used to treat the clavicle.However, when performing an open surgical operation, the risk of infectious agents, pathogenic microorganisms entering the wound naturally increases, as well as the occurrence of purulent complications (abscess, phlegmon, secondary osteomyelitis). An ambulance transports the victim to the emergency department of a trauma hospital, and during the first aid, medical workers will provide high-quality pain relief, as well as immobilization of the fracture site. So, “Ambulance” performs primary actions aimed at reducing the likelihood of complications in the long-term period, as well as transporting the patient as accurately as possible.It is important to remember that a certain time will pass before the ambulance arrives, which can be properly used to alleviate the patient’s condition.

The main rule that must be remembered when assisting with a fracture of the clavicle is that you cannot independently try to carry out medical manipulations to eliminate the displacement of the clavicle by performing sudden movements or jerks. It is imperative to limit the mobility of the injured limb : due to sudden movements, secondary displacement of fragments or complications may occur.Competent first aid consists in immobilizing a limb (reducing its mobility by fixing it to the body) using a kerchief bandage. In this case, the hand must be fixed in a special way: press the humerus to the body, and only then bandage with the help of a kerchief bandage. However, there is a rule: if a person talks about an increase in pain during shoulder adduction, then it is necessary to leave the injured limb in a position that provides minimal pain.

Immobilization is considered an important aspect in the provision of first aid. Initial immobilization prior to the arrival of the ambulance team will reduce the severity of pain in the patient, because the injured area will be firmly fixed and immobilized with a bandage. Secondly, immobilization will help to avoid the development of complications in the form of trauma by bone fragments of vascular or nerve formations during transportation of an injured person to the emergency department of a trauma hospital. For immobilization, a kerchief bandage on the arm is actively used, during which the limb is bent at the elbow joint, pressed to the body.It should be remembered that during long-term transport of the patient to the hospital, the supporting function of the dressing is weakened over time. Therefore, it may be necessary to rewind the dressing to maintain sufficient retention force. Often for immobilization, in addition to the scarf dressing, the following types of dressings are used:

  • Velpo;
  • Deso;
  • 8-shaped bandage;
  • Delbe Rings.

Don’t forget about pain relievers .Pain in a broken collarbone is a strong irritant to which a person can react unexpectedly. This, in turn, can complicate the provision of first aid to the victim: he can resist, refuse any action. Besides. Intense pain syndrome during the arrival of the ambulance team will complicate the diagnosis of the condition and the collection of anamnesis, because the person will not be able to correctly and clearly answer the doctor’s questions. Non-steroidal anti-inflammatory drugs are actively used as pain relievers at home.Ketanov, Ibuprofen, Spazmalgon, Paracetamol are actively used. However, before using these products, you need to be sure that the person is not allergic to one or more of the components of the drug. In addition, non-steroidal anti-inflammatory drugs should be used very carefully in patients with gastric ulcer or duodenal ulcer. The drug will begin to act in 15-30 minutes with oral administration, 5-10 minutes after intramuscular administration. If the effect of the drug is not observed, it is impossible to increase the dosage or introduce a new dose of the drug, because the possibility of an overdose of the drug is possible, which requires special assistance for intoxication.

If you do not have the opportunity to use pain relievers to relieve pain, then you can use the proven and effective method – applying cold to the damaged area. Cold has a local effect without affecting other tissues and systems of the human body. Also, applying cold is the only option if you don’t know if the person has allergic reactions to the pain relievers available to you. The mechanism of action of cold is very simple: in the area of ​​the clavicle fracture, a cold object lowers the temperature of soft tissues, where many nerve endings are located.When the tissue reaches a temperature of 4-5 degrees, the intensity of transmission of pain impulses decreases in it, which means that irritation does not enter the brain. Thus, there is a temporary decrease in the severity of pain in humans. However, a broken collarbone requires a special approach to the application of cold. It is not necessary to apply a whole piece of ice to the damaged area, but crushed ice. The specificity is explained by the anatomical structure of the site: in the region of the clavicle there is a supraclavicular and subclavian fossa, which forms an uneven relief.Crushed ice will work much better on the damaged area than a solid block of ice. In addition, ice should be applied exclusively over the fracture site: if you move the ice pack to the neck area, the body may react in the form of a sharp drop in blood pressure and heart rate. The fact is that in the neck area there is a carotid sinus plexus, and careless influence on this formation can lead to serious consequences.

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Treatment in children

The main method of therapy is firm fixation, that is, immobilization of the limb.In children, the immobilization time is 2-3 weeks. To firmly hold fragments of a broken bone, special Delbe rings are often used. Children’s clavicle fractures often occur as a “green branch”, that is, while maintaining the integrity of the periosteum. In this case, a clavicle fixation bandage is used. A fixation bandage is sufficient even if the collarbone injury is not accompanied by displacement.

In cases where the fracture is characterized by displacement of fragments, reduction is performed.

Treatment in adults

Immobilization of the limb is carried out within 1 month, using the Chizhin frame or other bandages. If there is a displacement of fragments, then reduction is required (return of fragments to a normal physiological position) with the implementation of local anesthesia. Then fixation takes place with a soft or plaster cast.

The reposition is followed by a recovery period, and after some time, a control image is taken.It is actively used during the rehabilitation period of UHF, in the presence of severe pain syndrome, the doctor prescribes anesthetic drugs. As soon as the need for immobilization disappears, the doctor directs the patient to massage and physiotherapy exercises.

Conservative treatment consists in the use of soft or plaster bandages, as well as fixation of the limb. This type of therapy is used for uncomplicated fractures in both adults and children. Immobilization is carried out by a traumatologist, who actively monitors the restoration of the patient’s bone integrity.

The main goal of conservative therapy is to ensure the correct position of the bone, and rigid fixation of the clavicle in this position for a certain period of time. If the displacement of the fragments did not occur, then the immobilization of the shoulder girdle is sufficient for quality healing to occur. In cases where a displacement occurred with a fracture of the clavicle, a preliminary reduction is required, at the next stage immobilization occurs. In traumatology, two types of reposition are distinguished – closed and open methods.

Closed reduction is non-invasive, that is, the doctor does not perform open surgical access. With the help of non-invasive medical techniques, the traumatologist performs temporary immobilization, and then X-rays are taken. If the bone fragments were matched correctly, then the temporary immobilization is changed to permanent plaster fixation. In the case when the bone fragments could not be matched as accurately as possible, a repeated closed reduction or open reduction is performed at the decision of the traumatologist.

Open reduction has a number of strict indications, because during its use, open surgical access to the fracture area is performed. Then the doctor compares the bone fragments in the wound, fixes them, which is called intraosseous osteosynthesis and refers to the surgical treatment of a clavicle fracture.

Surgical treatment

Surgical treatment urgently is necessary if the patient has an open fracture of the clavicle or a closed injury, however, complicated by acute conditions.For example, a bone fragment damaged a large nerve trunk, which caused a violation of the innervation on the side of the injury or the great vessel, which caused bleeding. In some cases, bone fragments damage the parietal layer of the pleura, which threatens the development of an emergency condition – pneumothorax.

In a planned manner, surgical interventions are performed in case of a clavicle fracture, if the patient has a significant displacement of bone fragments or the girdle area is outwardly significantly deformed.Surgical treatment consists in performing osteosynthesis of the clavicle using one of the following techniques:

  1. Intraosseous method. Used for comminuted fractures. During the operation, a special pin or Bogdanov’s nail is used.
  2. Injection technique. A curved plate is used during the operation. This method is used for injuries with many fragments in the wound.
  3. Spoke method .Rigid fixation is performed using pins that literally pass through the fragments of the bone base. The ends of the needles are fastened, and they are first brought out of the clavicle.

In the postoperative period, antibiotics are used to prevent the development of infectious complications, pain relievers are used to relieve pain. Faster and more complete restoration of the functions of the injured limb is provided by physiotherapy procedures. Discharge from the hospital becomes possible after the removal of stitches, which occurs on the 8-10th day of hospital stay.

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Recovery

Physiotherapy is widely used in medicine for more active recovery.

Physiotherapeutic methods of rehabilitation after a fracture of the clavicle are actively used in medicine to accelerate the healing of trauma, as well as reduce pain and discomfort of the patient. In addition, physiotherapy has an anti-inflammatory, anti-edema effect, stimulates metabolism in the area of ​​damage and tissue regeneration.

The classification of physiotherapy procedures is based on the timing of the procedure. So, there are physiotherapy methods that are used only during the period of plaster immobilization, after removing the plaster, and also regardless of whether the patient has a plaster cast.

During plaster immobilization, SUF — irradiation in erythemal doses are actively used. At the local level, the procedure provides relaxation of muscle tissue in the damaged area, expansion of the capillary network, which stimulates blood flow in the irradiated tissue.Finally, tissue edema is reduced, as well as the severity of pain syndrome due to a decrease in the sensitivity of pain receptors. The general effect of SUF-irradiation in erythemal doses is manifested in the stimulation of the formation of vitamin D, which accelerates the formation of callus. The second procedure – e Electrophoresis of painkillers ensures the accumulation of painkillers in the subcutaneous fatty tissue and muscle tissue, which long-term reduce the intensity of the patient’s pain syndrome.

After the moment when the plaster cast was removed, it is possible to use new physiotherapy procedures. If the traumatologist removed the plaster cast, then the callus has already formed quite well, which means that it is possible to apply small loads to the bone to increase its strength. For this purpose, therapeutic massage, high-frequency magnetotherapy, amplipulse therapy, UHF-therapy, ultrasound therapy, remote shock-wave therapy are used.

Therapeutic massage provides active and persistent vasodilation in the injured area.The active blood flow accelerates the transformation of the formed callus into healthy, functioning bone tissue. Therapeutic massage has a significant general effect through a reflex effect on the vasomotor center located in the brain. Thanks to therapeutic massage, blood pressure in patients is normalized.

High-frequency magnetotherapy provides an analgesic effect by influencing the nervous tissue. In addition, there is a decrease in the tension of the patient’s skeletal muscles.

Amplipulse therapy creates an analgesic effect, leads to relaxation of muscle fibers. The physiotherapeutic method actively affects the vessels, expanding them, which enhances tissue trophism. Thus, amplipulse therapy stimulates the reduction of puffiness, resorption of infiltrates, and also activates the recovery processes in the injured area.

UHF-therapy creates an active warming effect, which directly affects cell metabolism. So, the microcirculation processes are activated, the muscular layer of the vessels relaxes, the swelling of the damaged area decreases.As a general effect, UHF therapy reduces the tone of the sympathetic nervous system, increasing the tone of its parasympathetic division.

Ultrasound therapy actively stimulates the processes of blood circulation, as well as lymph circulation. At the local level, capillary permeability increases, which affects the intensity of wound healing.

Remote shock wave therapy activates the synthesis of special biologically active components. They provide vasodilation in the damaged area, which stimulates the processes of cell and tissue proliferation in the injured area.Cell division provides a direct process for the repair of the bone and cartilaginous base.

Regardless of immobilization, electrophoresis of vasodilators, low-frequency magnetotherapy and mineral water intake can be performed. Low-frequency magnetotherapy becomes an excellent stimulating factor for reparative processes. In addition, this method has a good anti-inflammatory effect. Mineral waters restore the balance of electrolytes in the human body and provide the supply of essential minerals for active healing of damaged bone and cartilage tissue.

Conclusion

In case of a clavicle fracture, you should not panic: you just need to take a number of correct actions in order to accurately transport the patient to the emergency department of a trauma hospital, to prevent complications. And the specialists of http://letay.org/ will help you find the best doctor for quality treatment and quick recovery!

Question-Answer

What is the prognosis for clavicle fractures?

In the prevailing number of cases, if the bone injury occurred without complications from other pathological conditions, doctors note a favorable prognosis for the patient.As a rule, bone fragments heal well, and even if there is some residual displacement, this does not affect the active movements of the hand on the injured side. In the case when a person has developed complications (for example, damage to the pleura or a large nerve trunk, the main vessel), the outcome of the disease depends on the quality, time and literacy of providing first aid to the patient.

How long does it take for a patient to recover from surgery?

Absolute restoration of the structure of the clavicle and the function of the injured limb occurs within 6 to 8 months.After surgery, the removal of auxiliary structures (pins, screws or medical plates) is performed approximately 6-12 months after the intervention, depending on the intensity of the restoration processes in the bone.

How to properly prevent clavicle fractures?

The main preventive measures are to reduce injuries during dangerous periods of the year (for example, winter time, which is often accompanied by ice). So, it is necessary to choose stable shoes with dense non-slip soles to reduce the likelihood of falling.Clavicle fractures often occur in young children who are inaccurate on the street or in everyday life.