How long does it take to recover from a broken collarbone. What are the treatment options for a clavicle fracture. When is surgery necessary for a fractured clavicle. How can you speed up healing after collarbone surgery.

Understanding the Clavicle: Anatomy and Function

The clavicle, commonly known as the collarbone, plays a crucial role in our upper body’s structure and function. This long, doubly curved bone connects the arm to the body, acting as a support for the shoulder and allowing a full range of arm motion. Located between the ribcage (sternum) and the shoulder blade (scapula), the clavicle serves as more than just a structural component.

One of its vital functions is to protect the important nerves and blood vessels that run from the neck through the armpit. This protective role highlights the clavicle’s significance in our overall upper body anatomy.

Key Functions of the Clavicle:

• Connects the arm to the body
• Supports the shoulder and arm
• Enables full range of arm motion
• Protects underlying nerves and blood vessels

Causes and Mechanisms of Clavicle Fractures

Clavicle fractures are relatively common injuries, primarily due to the bone’s role in transmitting forces from the upper limb to the body. These fractures can occur through two main mechanisms: direct and indirect trauma.

Direct Trauma:

This occurs when a force is applied directly to the clavicle itself. For example, a direct blow to the collarbone during contact sports or a car accident can cause a fracture.

Indirect Trauma:

More frequently, clavicle fractures result from indirect trauma. This typically happens when a person falls onto their shoulder or outstretched arm. The compressive force travels across the clavicle, causing it to snap or break.

Are certain activities more likely to cause clavicle fractures? Indeed, high-impact sports, cycling accidents, and falls are common scenarios leading to these injuries. Understanding these causes can help in prevention and prompt recognition of potential fractures.

Diagnosing a Clavicle Fracture: Signs and Tests

Accurate diagnosis of a clavicle fracture is crucial for determining the appropriate treatment plan. Healthcare providers use a combination of physical examination and imaging tests to confirm and assess the extent of the fracture.

Physical Examination:

During the initial assessment, the physician will inquire about how the injury occurred. They will look for common signs of a clavicle fracture, which typically include:

• Obvious deformity or bump over the collarbone
• Swelling and tenderness at the fracture site
• Pain when attempting to move the arm

Imaging Tests:

To confirm the diagnosis and get a clearer picture of the fracture, doctors typically order:

1. X-rays: The primary diagnostic tool for clavicle fractures
2. CT scans: Used in some cases to visualize complex fractures in greater detail

Can a clavicle fracture be mistaken for other injuries? While the signs are often quite clear, it’s possible to confuse a clavicle fracture with other shoulder injuries. This is why imaging tests are crucial for an accurate diagnosis.

Treatment Options: Non-Surgical vs. Surgical Approaches

The treatment for a clavicle fracture depends on the nature and severity of the break. Treatment options fall into two main categories: non-surgical and surgical approaches.

Non-Surgical Treatment:

For fractures where the bone ends have not significantly shifted out of place, non-surgical treatment is often sufficient. This typically involves:

• Wearing an arm sling for 6-8 weeks
• Refraining from arm and shoulder movement for the first 2 weeks
• Gradually resuming movement after 2 weeks to prevent stiffness
• Regular follow-up appointments and occasional imaging tests

Surgical Treatment:

Surgery may be necessary for more complex fractures, especially when:

• The bone pieces are significantly displaced (more than 2 cm apart)
• The clavicle length has shortened
• There’s a risk of the bone healing improperly

Does the type of fracture always determine the treatment method? While the nature of the fracture is a primary factor, other considerations such as the patient’s age, overall health, and activity level also play a role in deciding between surgical and non-surgical approaches.

Innovative Surgical Techniques: Minimally Invasive Plate Osteosynthesis (MIPO)

Advancements in surgical techniques have led to more effective and less invasive methods for treating clavicle fractures. One such innovative approach is the Minimally Invasive Plate Osteosynthesis (MIPO).

MIPO Procedure:

1. 2-3 small incisions are made instead of a large open incision
2. Bone fragments are held in place with special screws and metal plates
3. The procedure is performed without directly interfering with the fracture site

Advantages of MIPO:

• Improved biological healing
• Preservation of surrounding tissues and nerves
• Reduced pain and post-operative complications
• Faster recovery and quicker return to daily activities

How does MIPO compare to traditional open surgery for clavicle fractures? MIPO offers several advantages, including smaller incisions, less tissue damage, and potentially faster healing times. However, the choice between MIPO and traditional surgery depends on the specific fracture pattern and the surgeon’s expertise.

Recovery Timeline and Rehabilitation Process

The recovery from a clavicle fracture, whether treated surgically or non-surgically, is a gradual process that requires patience and adherence to medical advice. Understanding the typical timeline and rehabilitation process can help patients set realistic expectations and optimize their recovery.

Non-Surgical Recovery Timeline:

1. Weeks 1-2: Strict immobilization with an arm sling
2. Weeks 3-6: Gradual introduction of gentle arm movements
3. Weeks 7-12: Progressive increase in range of motion and light activities
4. Months 3-6: Return to most normal activities, avoiding high-impact sports

Surgical Recovery Timeline:

1. Days 1-7: Post-operative care and pain management
2. Weeks 2-4: Begin passive range of motion exercises
3. Weeks 5-8: Active range of motion exercises and light strengthening
4. Months 3-6: Progressive strengthening and return to most activities

What factors can influence the recovery time for a clavicle fracture? Several factors can affect healing time, including the severity of the fracture, the patient’s age and overall health, adherence to rehabilitation protocols, and whether the treatment was surgical or non-surgical.

Rehabilitation Exercises:

As part of the recovery process, patients are often prescribed specific exercises to regain strength and mobility. These may include:

• Pendulum exercises
• Isometric shoulder exercises
• Gradual range of motion exercises
• Progressive resistance training

It’s crucial to follow the guidance of your healthcare provider or physical therapist when performing these exercises to avoid re-injury or complications.

Potential Complications and Long-Term Outcomes

While most clavicle fractures heal without significant issues, it’s important to be aware of potential complications that can arise during the recovery process. Understanding these risks can help patients and healthcare providers take proactive measures to prevent or address them promptly.

Complications in Non-Surgical Treatment:

• Incomplete bone healing (nonunion)
• Healing with deformity (malunion)
• Limited arm or shoulder movement

Complications in Surgical Treatment:

• Numbness at the surgical site on the upper chest
• Infection at the incision site
• Hardware irritation or failure

How common are complications after clavicle fracture treatment? While complications can occur, they are relatively rare when proper treatment protocols are followed. The risk of complications is generally higher in complex fractures or in patients with underlying health conditions.

Long-Term Outcomes:

Most patients who receive appropriate treatment for their clavicle fracture can expect good long-term outcomes. However, some factors that may influence long-term results include:

• The severity and location of the initial fracture
• The chosen treatment method
• Patient compliance with rehabilitation protocols
• Individual healing capacity and overall health

Can patients return to high-impact activities after a clavicle fracture? Many patients can return to their pre-injury activity levels, including sports, after full recovery. However, this depends on the individual case and should be guided by the treating physician’s recommendations.

Prevention Strategies and Risk Reduction

While not all clavicle fractures can be prevented, there are strategies that can help reduce the risk of injury, especially for individuals engaged in high-risk activities or sports.

Protective Equipment:

Using appropriate protective gear can significantly reduce the risk of clavicle fractures in certain activities:

• Wearing properly fitted shoulder pads in contact sports
• Using a well-fitted helmet when cycling or motorcycling
• Employing safety harnesses in activities with fall risks

Strength and Conditioning:

Building strength and improving flexibility in the upper body can help protect against injuries:

• Regular shoulder and upper body strengthening exercises
• Improving overall body balance and coordination
• Maintaining good posture to reduce stress on the clavicle

Are there specific exercises that can help prevent clavicle fractures? While no exercise can completely prevent fractures, strengthening the muscles around the shoulder girdle can provide better support and potentially reduce injury risk.

Environmental Awareness:

Being mindful of one’s surroundings and potential hazards can help prevent accidental falls:

• Ensuring proper lighting in living and working spaces
• Removing tripping hazards from walkways
• Using caution on slippery or uneven surfaces

By implementing these preventive strategies, individuals can reduce their risk of experiencing a clavicle fracture and other related injuries. However, it’s important to remember that accidents can still occur, and prompt medical attention is crucial if an injury is suspected.

Accidents, falls and injuries can potentially lead to broken collarbone (clavicle fracture)

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Accidents, falls and injuries can potentially lead to broken collarbone (clavicle fracture)

Get to know the clavicle

The clavicle or collarbone is located between the ribcage (sternum) and the shoulder blade (scapula). The clavicle is a large doubly curved long bone that connects the arm to the body. It functions as a strut to support the shoulder and arm, allowing for a full range of motion of the arm.

In addition, the clavicle lies above several important nerves and blood vessels, therefore it protects these nerves and blood vessels from injuries, starting in the neck and running through the armpit.

Causes of clavicle fracture

A clavicle fracture is a break in the collarbone. This type of fracture is fairly common since the clavicle acts to transmit forces from the upper limb to the body. Clavicle fractures can be caused by either direct or indirect trauma. Clavicle fractures occur directly when direct force is applied to the clavicle. Quite often, clavicle fractures happen due to indirect trauma, for instance, when a fall onto the shoulder or an outstretched arm causing a compressive force across the clavicle and making the clavicle snap or break.

Diagnosis

During physical examination, the physician needs to know how injury has occurred. In a clavicle fracture, there is usually an obvious deformity or bump present with swelling, pain or tenderness over the clavicle at the fractured site after injury. Diagnostic test used to confirm the clavicle fracture is imaging tests such as X-ray. A computerized tomography (CT) scan to visualize the fractures in better details might be additionally considered in some cases.

Treatments

Most fractures occur in the middle portion (or shaft) of the bone. Occasionally, the bone breaks where it attaches at the ribcage or shoulder blade. Nevertheless, clavicle fractures widely vary. The bone can only crack slightly or completely break into several pieces (known as comminuted fracture). The broken pieces of bone may line up straight or may be far out of place, called displaced fracture. If the broken ends of the bones have not significantly shifted out of place, it can be treated by non-surgical approaches such as wearing an arm sling to keep the arm and shoulder from moving while the bone heals. In general, this supportive sling needs to be worn 6-8 weeks to complete the bone healing process. To keep affected clavicle stabilized during the first 2 weeks, patients are strictly advised to refrain from moving arms or shoulders. After 2 weeks, moving arm and shoulder can be gradually resumed in order to minimize stiff shoulder and increase movement flexibility. Follow-up appointments will be frequently made to monitor treatment outcomes and imaging tests might be occasionally required to ensure the bone heals in a proper position.

With some other forms of clavicle fracture, however, the pieces of broken bone might be shifted out of place, greater than 2 cm. apart or the length might become shorter. For these complicated fractures, surgery may be needed to realign the broken clavicle. Surgery typically involves putting the broken pieces of bone back into normal position and preventing them from dislocation until they are completely healed. Due to advanced techniques, surgery with reduction and fixation can significantly help enhancing bone healing process while minimizing the chance of deformity or malalignment. To treat clavicle fractures, a minimally invasive plate osteosynthesis or MIPO has been evolved and considered an effective surgical technique. During MIPO, 2-3 small incisions are made. Through these small incisions, the bone fragments are held in place with special screws and metal plates without having a large open incision along the length of the clavicle. Superior advantages over conventional approach are seen as MIPO technique does not interfere with the fractured site and therefore provides improved biological healing while preserving surrounding tissues and nerves. More importantly, this minimally invasive technique substantially reduces pain and post-operative complications, allowing the patients to recover faster with a quick return to their daily lives and activities.

Possible complications

In some cases with non-surgical treatments, possible complications involve incomplete bone healing or healing with deformity, resulting in limited movement of arm or shoulder, especially if the fracture fragments have been shifted apart. In patients who underwent surgery with plate and screw placement, common complication might involve numbness at the surgical site on the upper chest. Although a palpable bump over the fracture site may develop as the fracture heals, surgery using plates and screws substantially enhances proper bone healing process and reduces the chance of malalignment or deformity. To achieve the best possible outcomes and minimize undesired effects, treatment should be performed based primarily on indications and treatment protocols. More crucially, depending on severity and individual conditions, a customized treatment plan should be mutually agreed by both patients and orthopedic surgeons to delivery patient‐engaged care with satisfying results.

Reference:

Dr. Pongtorn Sirithianchai

Orthopedic Surgeon, Orthopedic Center, Bangkok International Hospital.

For more information, please contact:

Orthopedic Center, Bangkok International Hospital.

Tel: +662 310 3000 or 1719 (local calls only)

Email: [email protected]

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Clavicle Fracture – Downtown Los Angeles, CA: LA Orthopaedic Specialists

Fractures of the clavicle or collarbone are relatively common injuries in adults. The majority of clavicular fractures can be treated effectively with immobilization. The number of patients undergoing repair is increasing as the results of surgical repair have shown clear benefits over non-operative treatment. Patients who undergo surgical repair are able to move the arm without pain within a short period of time after surgery and have a much faster recovery and return to work. Indications for surgical treatment include a large amount of angular deformity, shortening of the clavicle more than 1.5 cm and segmental fractures. These types of fractures typically occur after high energy injuries such as cycling accidents in which the rider goes over the handle bars.

Surgical repair involves an incision over the collar bone and fixation with titanium or stainless steel plates and screws. Early return of function can be expected and most patients are able to reach overhead without pain within 5-7 days of surgery. Thinner patients and women commonly have irritation over the plate and elect to have the plate removed after the bone heals, generally in the range of 8-12 months after fixation.

Orthopedic surgeons have begun repairing more of these fractures. With the uncertain economic climate, many patients are anxious to return to work quickly and being out on disability for 4-6 weeks in a sling represents a financial hardship for many individuals. Most patients can return to work with light lifting and repetitive lifting of the arm within a week and do not require strong pain medication. Another benefit is that long term shoulder function may be improved with repair of the clavicle. The rate of non-union, failure of the bone to unite after a fracture, is much less with surgical repair than non-operative treatment. Patients have much less pain and much faster return to normal activities with repair. Finally, many of these fractures heal with significant cosmetic deformity which is often an issue.

The link below is a randomized, prospective study (the highest level of evidence possible) comparing non operative treatment with surgical repair. This study demonstrated a clear benefit to repair of the clavicle using plates and screws.

Mckee et al, JBJS 2008

The surgery takes roughly one hour and is done as an outpatient procedure, meaning you go home the same day as the surgery. Most patients report dramatic improvement in pain and shoulder function within the first week after surgery. The risks of surgery are infection (about 1%), wound problems (0.5%) and numbness around the chest area (10-15%). The numbness is caused by stretching of the nerves around the incision and usually resolves over a 6-8 month period. The risk of non-union (failure of the bone to unite) is less than 2% with operative intervention vs. about 10% with non-operative management. About 1/3 of patients have some irritation over the plate after the bone heals and request to have the bone plates removed.

Post-Op Shoulder Fracture Instruction Sheet

Rehabilitation after a fracture with a displacement

Description

Fractures with a displacement – a type of bone defect, when a bone fracture is accompanied by fragments spreading in different directions.

As a rule, recovery after fractures with displacement takes longer and requires more responsibility than in the case of fractures without displacement. This is due to the following reasons:

• fractures with displacement often occur when a powerful force is applied, therefore, in such cases, damage to surrounding tissues is more pronounced;
• there is a secondary traumatization of soft tissues by diverging sharp bone fragments;
• Often, displaced fractures require surgical intervention, which significantly increases the period of immobility and increases the risk of complications.

Causes

Displacement of bone fragments during a fracture can occur as a result of the impact of the force that caused the fracture, as well as as a result of a painful spasm of the muscles that separate the fragments in different directions.

It must be said that most often displaced fractures occur under the combined influence of both of the above-described causative factors.

Development

The first step in the treatment of displaced fractures is to stabilize the fracture. In cases where this cannot be achieved by conservative methods, the dispersed bone fragments are stabilized during the operation.

It must be said that a brilliantly performed operation does not guarantee full restoration of limb function. The fact is that a fracture with a displacement is a severe injury to all tissues surrounding the bone.

The situation is aggravated by the fact that with such injuries, as a rule, the microcirculation of blood and intercellular fluid in the lesion is disturbed. Therefore, the nerve fibers located in the area of ​​the fracture suffer from hypoxia and are poisoned by the toxins accumulating here.

However, the main problem is that the mechanism of development of a displaced fracture causes a shift of all soft tissue elements surrounding the bone – muscles, their fascial sheaths, tendons, vessels and nerves.

Violation of the relationship between tissues negatively affects the recovery capabilities of the body and prevents full rehabilitation after a fracture with displacement.

Symptoms

Pain after a displaced fracture is the first and obligatory symptom. In this case, the severity of the pain syndrome can reach an extreme degree (up to the development of pain shock).

The second mandatory symptom is a sharp decrease in the function of the affected area of ​​the musculoskeletal system. When attempting passive movement (for example, bending the injured limb by the rescuer), the pain becomes unbearable due to the displacement of bone fragments.

In addition, with a displaced fracture, there is a visible violation of the configuration of the affected area, and in the case of long tubular bones, shortening of the injured limb.

Clinic “BIOSPHERA” reminds: the sooner you seek help from a specialist, the more likely you are to stay healthy and reduce the risk of complications:

Make an appointment with a specialist

Complications rehabilitation period. Often, even in cases where the function of the damaged bone is fully restored, the pain syndrome reminds of a tragic incident months, years and decades after the injury.

In this case, pain can occur in response to increased load or prolonged stay in an uncomfortable position, as well as hypothermia and sharp fluctuations in atmospheric pressure. It is not uncommon for pain after a displaced fracture to appear years after the injury for no apparent reason.

Meanwhile, the true cause of chronic post-traumatic pain syndrome is a violation of the relative position of tissues in the fracture zone, degenerative processes in nerve fibers, as well as remaining circulatory disorders in the region.

Another serious complication is the incomplete restoration of the function of the damaged bone. Inadequate rehabilitation after a displaced fracture can contribute to the progression of a variety of pathologies. In cases where we are talking about a broken leg, lameness occurs and the entire musculoskeletal system suffers. When the belt of the upper limb is affected (fracture of the scapula or collarbone), severe disability often develops, with incomplete recovery after a fracture of the rib, there is a tendency to chronic lung diseases, etc.

Treatment

Osteopathy is an indispensable method of rehabilitation after displaced fractures. Osteopathic techniques have a mild targeted effect on deeply located tissues and restore the disturbed relationships between them, resulting in the following effects:

• return to each structural element of the affected area of ​​natural elasticity;
• restoration of the tone of deep muscle fibers;
• harmonization of motor acts by improving the interaction of different muscle groups;
• improvement of tissue trophism;
• creation of conditions for the restoration of the functions of nerve fibers;
• restoration of tissue elasticity in the affected area.

There are practically no contraindications to osteopathy, the techniques are well tolerated by patients, do not cause any inconvenience and do not cause unpleasant side effects.

An important advantage of osteopathy is the ability to use the technique even with chronic injuries and complications. In our clinical experience, significant improvement can be achieved with osteopathic techniques even in cases where months or years have passed since the fracture.

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Osteopathic doctor. Head of the course of visceral osteopathy, Faculty of Medicine, St. Petersburg State University.

Elena Nikolaevna Yanova
Osteopathic doctor, author of training programs, expert in osteopathy of the Main Bureau of Forensic Medical Examination of St. Petersburg.

Karina Alekseevna Kharazyan
Osteopath, chiropractor, neonatologist of the highest category. Doctor of osteopathy.

Rehabilitation after bone fracture in the elderly in St. Petersburg

Bedridden care

October 28, 2016

Apparatus for mechanotherapy

901 06 November 6, 2016

Fracture is a condition when the load on the bone in the human skeleton exceeds the maximum allowable (a sharp impact with a strong weight or a sudden fall – a collision with an object from the outside world) and this area of ​​\u200b\u200bthe bone does not withstand and a bone fracture occurs. The fracture can be in one place, or it can be in several at the same time. A fracture can vary in severity from a minor crack in the bone to an open fracture where the bone protrudes from the skin. Fractures after a car injury are especially dangerous, since they are often multiple and are accompanied by the development of traumatic shock.

Rehabilitation after a fracture bones of the clavicle, hip, arm, leg and ankle in the “Regional Rehabilitation Center” – requires a special approach to patients. The fusion of the bone requires complete immobility (immobilization) of the part of the body where the fracture occurred. Only in this case it is possible to achieve a full restoration of the functionality of the limb. Immobilization is achieved by applying plaster bandages, splints, splints. Especially in elderly patients, due to the fact that a broken limb will be immobilized for a significant time, atrophic changes occur. Therefore, procedures aimed at starting recovery processes in this part of the body will be of great importance. This can be achieved through activities such as:

• therapeutic massage – to enhance tissue trophism and eliminate fluid stagnation in the injured limb,
• physiotherapy exercises (LFK) – a special set of physical exercises to improve the general condition of the body and prevent atrophic phenomena in the tissues of the injured limb,
• drug therapy – aimed at preventing osteoporosis, improving metabolism and blood circulation in tissues.
• physiotherapy – the use of ultrasound and electromyostimulation. This is necessary to reduce swelling, pain relief, improve blood and lymph microcirculation.
• classes on simulators of the Artromot series –

1. ARTROMOT F (Apparatus for the development of the joints of the hand) – the device allows you to daily work out the joints of all fingers. It is necessary after prolonged immobilization of the hand.
2. ARTROMOTS3 (Apparatus for the development of the shoulder and elbow joints) – used in mechanical rehabilitation after fractures of the bones of the shoulder girdle and related complications. Allows you to use individual settings of rehabilitation parameters for faster restoration of movement in the injured limb.
3. SNS-care and MANUPED are analogues of conventional exercise machines that we are used to seeing in gyms, only arranged in such a way that people who are undergoing rehabilitation after fractures of the hip and knee joints can work on them.
4. ARTROMOTK-1 (Knee and Hip Joint Development Machine) – used for earlier and painless recovery of immobilized joints, as well as to prevent all complications associated with prolonged immobilization.

Tasks for rehabilitation after fractures.

Ensuring proper bone fusion after a fracture is one of the main tasks in rehabilitation in our center. The main tasks after a fracture is also a gradual increase in physical activity for that part of the body that needs recovery. It is also important to follow a special diet prescribed by a specialist of our center.

We are proud of our equipment, which we install and use in our center with reverent care for our patients and the desire for their speedy recovery.

Standard rehabilitation

• room accommodation and three meals a day
• consultation, tailor-made rehabilitation plan
• therapeutic massage by an experienced massage specialist
• physiotherapy exercises under the supervision of a specialist of our center
• exercises on special simulators designed for recovery after fractures

4700 rub/day

2500 rub/day

Full rehabilitation

• Standard rehabilitation +
• exercises with a speech therapist
• introduction of mesotherapy cocktails
• treatment with leeches (hirudotherapy)
• intravenous and intravenous drug administration
• stimulation of muscles with electrical impulses

6800 rubles/day

3500 rubles/day

Rehabilitation after a fracture in the elderly requires an integrated approach. You can be sure that the St. Petersburg Medical Regional Rehabilitation Center will cope with the task of recovering from a fracture quickly and professionally. The patient will undergo a set of measures that favorably affect both the general condition of the patient and a specific area of ​​the body that requires rehabilitation and special proper care after a fracture.

Your loved one needs your help and support, and the “Regional Rehabilitation Center” is ready to make every effort to ensure that your care brings prompt and visible results!

Additionally, in the “Regional RC” after fractures it is possible to carry out

Bioacoustic method of stimulating brain neurons

A method approved by the Russian Academy of Sciences and MAPO, which consists in the processing and self-regulation of acoustic (sound) signals by our brain and self-adjustment to the normal activity of the patient. It works on the principle of feedback – I register the bioelectric activity of the brain and converts it into a sound of a different range, returning it back through the speakers of headphones or speakers.