How long does it take for a broken collarbone to heal. What are the treatment options for a fractured clavicle. When is surgery necessary for a broken collarbone. How does the recovery process differ between surgical and non-surgical treatments.

Understanding Clavicle Fractures: Causes and Prevalence

Clavicle fractures, commonly known as broken collarbones, are a frequent injury, particularly in sports-related activities. These fractures often occur due to falls onto the shoulder or direct impacts to the side of the body. While they can affect anyone, they are more prevalent in men and are commonly seen in contact sports such as football, soccer, and skiing.

Dr. Bruce Thomas, an orthopedic surgeon at the University of Utah, explains that most collarbone fractures happen in the shaft or mid-portion of the bone. A smaller percentage occurs near the shoulder end of the clavicle, which almost always requires treatment.

Common Causes of Clavicle Fractures

• Falls onto the shoulder
• Side impacts
• Blunt trauma
• Sports-related accidents

Diagnosis and Initial Assessment of Collarbone Fractures

When a person experiences a clavicle fracture, they typically know something is wrong due to pain and limited mobility in the shoulder area. However, a proper diagnosis by a medical professional is crucial to determine the severity and best course of treatment.

Why is professional assessment important for clavicle fractures? A thorough examination helps determine the extent of the injury, the displacement of the bone, and whether surgery might be necessary. X-rays are usually performed to visualize the fracture and assess its characteristics.

Key Factors in Clavicle Fracture Assessment

1. Location of the fracture
2. Degree of displacement
3. Presence of multiple fragments
4. Shortening of the clavicle
5. Patient’s age and activity level

Natural Healing vs. Surgical Intervention: Making the Right Choice

The treatment of clavicle fractures has evolved over the years. Traditionally, many were treated without surgery, with a non-healing rate of about 3%. However, recent research has shown that surgical intervention may be beneficial in certain cases.

Is natural healing always the best option for a broken collarbone? Not necessarily. The decision between natural healing and surgical intervention depends on several factors, including the patient’s age, activity level, and the characteristics of the fracture.

Factors Favoring Natural Healing

• Minimal displacement of bone fragments
• Less than 1 cm of shortening
• Lower activity demands
• Younger patients with higher healing potential

Indications for Surgical Intervention

• Significant displacement (more than 1 cm of shortening)
• Multiple fragments
• High-demand athletes or workers
• Risk of non-union or malunion

Surgical Techniques for Clavicle Fracture Repair

When surgery is deemed necessary for a clavicle fracture, the primary goal is to realign the bone fragments and provide stability for proper healing. Dr. Thomas explains that the most common surgical approach involves using a plate as an internal cast to support the bone and keep it aligned during the healing process.

How is a broken collarbone surgically repaired? The procedure typically involves making an incision over the clavicle, realigning the bone fragments, and securing them with a plate and screws. The plate can be placed either on top of the collarbone or on its front surface.

Types of Surgical Fixation

1. Plate and screw fixation
2. Intramedullary fixation (less common)
3. External fixation (rare cases)

Is the hardware removed after healing? In some cases, especially when the plate is placed on top of the collarbone, it may be removed later due to prominence under the skin, which can cause discomfort with seatbelts or backpacks.

Recovery Timeline and Rehabilitation Process

The healing time for a clavicle fracture can vary depending on factors such as age, overall health, and the severity of the fracture. Dr. Thomas provides a general timeline for healing:

• Young children: 4-6 weeks
• Adults: 6-8 weeks (up to 12 weeks in some cases)

What role does physical therapy play in collarbone fracture recovery? Physical therapy is an essential part of the rehabilitation process, especially after surgery or prolonged immobilization. It helps reduce stiffness, improves range of motion, and aids in a quicker return to normal activities.

Stages of Rehabilitation

1. Early motion exercises (as fracture stability allows)
2. Progressive strengthening
3. Sport-specific or occupation-specific training
4. Return to full activities

Long-Term Outcomes and Potential Complications

While most clavicle fractures heal well with appropriate treatment, there can be potential long-term effects or complications. Understanding these possibilities is crucial for patients and healthcare providers alike.

Can a poorly healed clavicle fracture affect shoulder function? Yes, if the fracture doesn’t heal properly or if there’s significant shortening of the clavicle, it can impact shoulder biomechanics. This may lead to weakness, reduced range of motion, or discomfort during certain activities.

Potential Complications

• Non-union (failure of the bone to heal)
• Malunion (improper alignment of healed bone)
• Hardware-related issues (in surgical cases)
• Shoulder stiffness or weakness
• Nerve or blood vessel injury (rare)

Interestingly, Dr. Thomas notes that older literature suggests about half of the patients with non-union don’t experience significant symptoms. However, this may depend on their activity level and demands on the shoulder.

Special Considerations for Athletes and High-Demand Individuals

For athletes and individuals with high physical demands, the decision-making process regarding clavicle fracture treatment may differ. The goal is often to return to play or work as quickly and safely as possible while ensuring optimal long-term function.

How does an athlete’s status influence treatment decisions for a broken collarbone? The type of sport, level of competition, and timing within the season can all play a role. In some cases, surgical intervention might be chosen to potentially expedite return to play and ensure proper healing for long-term performance.

Factors Influencing Treatment for Athletes

• Type and level of sport
• Position played
• Timing within the competitive season
• Long-term career considerations
• Risk tolerance for potential complications

It’s crucial for athletes to work closely with their orthopedic surgeon, athletic trainers, and physical therapists to develop a comprehensive treatment and rehabilitation plan tailored to their specific needs and goals.

Advances in Clavicle Fracture Treatment and Future Directions

The field of orthopedics continues to evolve, bringing new insights and techniques to the treatment of clavicle fractures. Recent advancements have led to more nuanced approaches in deciding between conservative and surgical management.

How have treatment guidelines for clavicle fractures changed over time? Dr. Thomas points out that the threshold for considering surgery has shifted. Previously, up to 2.5 centimeters of shortening was accepted before considering surgery. Now, that number has decreased to about 1 centimeter, reflecting a better understanding of shoulder biomechanics and long-term outcomes.

Recent Advancements and Future Possibilities

• Improved surgical techniques and materials
• Better understanding of biomechanical implications
• Enhanced imaging technologies for precise assessment
• Potential for biologics to accelerate healing
• Personalized treatment algorithms based on patient-specific factors

As research continues, we may see even more refined approaches to clavicle fracture management, potentially including minimally invasive surgical techniques or biological interventions to enhance healing.

In conclusion, the management of clavicle fractures requires a tailored approach, considering the individual patient’s needs, fracture characteristics, and functional demands. Whether opting for natural healing or surgical intervention, proper assessment, treatment, and rehabilitation are key to ensuring optimal outcomes and a return to normal activities.

Let a Broken Collarbone Heal Naturally, or Not? | University of Utah Health

Dr. Miller: You have a broken collarbone or a fractured clavicle? Do you need to have the treated surgically or can it heal naturally?

Announcer: Access to our experts with in-depth information about the biggest health issues facing you today. “The Specialists” with Dr. Tom Miller is on the Scope.

Dr. Miller: I’m here Dr. Bruce Thomas. He is an orthopedic surgeon here at the University of Utah in the Department of Orthopedics. Bruce, tell us a little bit about fractured clavicles.

Dr. Thomas: Fractured clavicles are a common sports injury, men more than women, and the treatment of it has evolved over the years. Traditionally, many of them were treated without surgery and the rate of non-healing was about 3%.

Dr. Miller: Before we get into that, how does one fracture a clavicle or bust the collarbone as they say on the athletic field?

Dr. Thomas: Usually, it’s a fall to the shoulder.

Dr. Miller: Outstretched hand, that sort of thing?

Dr. Thomas: Mostly, not outstretched. More to the point of the shoulder and occasionally from blunt trauma. But usually, it’s a fall to the shoulder or a side impact.

Dr. Miller: Mostly seen in contact sports like football?

Dr. Thomas: Contact sports, you see it in soccer and skiing as well. The contact with the ground is usually the contact. Most of the collarbone fractures occur in the shaft and in the mid portion of it and the smaller percentage will occur way out towards the end of the clavicle near the shoulder. Those require treatment almost uniformly. The ones in the shaft, less, less uniform require treatment.

Dr. Miller: So does it matter what type of an athlete you are? Might you consider surgery to get back into the playing field sooner in some cases?

Dr. Thomas: They’re finding it definitely affects the biomechanics. Traditionally, you would accept 2.5 centimeters of shortening before you would consider surgery and now, the number is about 1 centimeter. And keeping that strut at the right length helps in the position of your shoulder and the movement of your shoulder blade.

Dr. Miller: So if it doesn’t heal appropriately or if the distance between the fracture is, you know, there is a gap I guess, then you could lose function or sacrifice some function in the shoulder?

Dr. Thomas: You could. Without a nice, strong strut there as you load the shoulder, you’ll feel weakness. But interestingly, the older literature shows that half of the patients that have a non-union don’t have a lot of symptoms. But that could be depending on what their activity is.

Dr. Miller: What their activity level is. So kind of who you are matters in terms of whether you might consider surgery. So I guess it’s a bit of a personal decision and you as the orthopedic surgeon explain that to the patient.

Dr. Thomas: That’s true. And what your demands are make a big difference on whether you need surgery or not.

Dr. Miller: And so how do you repair the clavicle? Do you put a plate in or do you just . . . I mean, it’s kind of hard to put a cast on the shoulder, obviously.

Dr. Thomas: That’s true. And so, the hardware serves as an internal cast and supports the bone and keeps it aligned while it heals. And most commonly is used a plate, either on the top of the collarbone or on the front of the collarbone.

Dr. Miller: And you leave that in after the period of healing?

Dr. Thomas: On the top, eventually the bone heals, the swelling goes away. And on top, there’s not much tissue between the collarbone and the skin. And those are kind of prominent and people will feel them with their seatbelts or backpacks. And so if the plate is on top, it’s more likely to be removed later.

Dr. Miller: So would you say that anyone who has a clavicular fracture should probably see an orthopedic surgeon and discuss the reason for her need for surgery or healing?

Dr. Thomas: I think that’s a great rule and especially if you’re in high demand sports or heavy activities, making sure that your strut is the right length and ensuring healing is important.

Dr. Miller: Once you fracture a clavicle, whether it’s plated or not, how long is the period of healing, generally?

Dr. Thomas: It varies, obviously. In young children, it will very quickly, four to six weeks. Adults, six to eight weeks, usually, and a small number up to 12 weeks.

Dr. Miller: And so physical therapy, is that any part of the rehabilitation of the shoulder or clavicle, rather?

Dr. Thomas: It certainly is. People tend to get stiff when you immobilize them or after a surgery. And as the fracture becomes more stable, early motion helps reduce the amount of stiffness and aids people getting back to their activities quicker.

Dr. Miller: So generally, somebody who’s been injured in a sports-related activity or at work, they would know if they had a fracture. I mean it’s painful, it’s prominent. You can see the changes because the bone is so close to the skin.

Dr. Thomas: That’s true. Most of the time, they know instantly and pretty quickly, everyone around them can tell as well.

Dr. Miller: So bottom line, then, for our listeners would be that if you have a clavicle fracture, called the collarbone in everyday usage, but if you have a fracture, you should probably see an orthopedic surgeon and have that evaluated because surgery might assist you in healing. And a certain percentage of patients will go on to surgery and have a good result.

Dr. Thomas: That’s true.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.

updated: October 26, 2018
originally published: January 15, 2017

Broken Collarbone Treatment Farmington | Clavicle Fractures Treatment Avon CT

Home // Educational Resources // Shoulder // Conditions // Broken collarbone (clavicle fractures)

Clavicle fracture, also called broken collarbone is a very common sports injury seen in people who are involved in contact sports such as football and martial arts as well as impact sports such as motor racing. A direct blow over the shoulder that may occur during a fall on an outstretched arm or a motor vehicle accident may cause the clavicle bone to break. Broken clavicle may cause difficulty in lifting your arm because of pain, swelling and bruising over the bone.

Broken clavicle bone, usually heals without surgery, but if the bone ends have shifted out of place (displaced) surgery will be recommended. Surgery is performed to align the bone ends and hold them stable during healing. This improves the shoulder strength. Surgery for the fixation of clavicle fractures may be considered in the following circumstances:

• Multiple fractures
• Compound (open) fractures
• Fracture associated with nerve or blood vessel damage and scapula fracture
• Overlapping of the broken ends of bone (shortened clavicle)

Plates and Screws fixation

During this surgical procedure, your surgeon will reposition the broken bone ends into normal position and then uses special screws or metal plates to hold the bone fragments in place. These plates and screws are usually left in the bone. If they cause any irritation, they can be removed after fracture healing is complete.

Pins

Placement of pins may also be considered to hold the fracture in position and the incision required is also smaller. They often cause irritation in the skin at the site of insertion and have to be removed once the fracture heals.

Complications

Patients with diabetes, the elderly individuals and people who make use of tobacco products are at a greater risk of developing complications both during and after the surgery. In addition to the risks that occur with any major surgery, certain specific risks of clavicle fracture surgery include difficulty in bone healing, lung injury and irritation caused by hardware.

Percutaneous elastic intramedullary nailing of the clavicle is a newer and less invasive procedure with lesser complications. It is considered as a safe method for fixation of displaced clavicle fractures in adolescents and athletes as it allows rapid healing and faster return to sports. The procedure is performed under fluoroscopic guidance. It involves a small 1 cm skin incision near the sternoclavicular joint, and then a hole is drilled in the anterior cortex after which an elastic nail is inserted into the medullary canal of the clavicle. Then the nail is passed on to reach the fracture site. A second operation to remove the nail will be performed after 2-3 months.

Treatment of malunion fractures – Surgery Center SM-Clinic St. Petersburg

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Preparing for surgery How is the intervention? Rehabilitation

Insufficient fixation of the fracture, early removal of the plaster cast, excessive loads when the bone has not yet healed can lead to improper healing of the fracture. Because of this, shortening of the limb, impaired motor function, and muscle atrophy can occur. In order to restore the normal functions of the damaged area of ​​the body, it is necessary to start treatment of an incorrect fused fracture as soon as possible.

Operation

Before prescribing treatment for improperly healed fractures, in order to accurately determine the type of deformity, the doctor will examine the patient and prescribe a series of examinations:

• X-ray;
• vascular examination;
• study of nerve conduction.

Standard preoperative tests will also be ordered to get a complete picture of the patient’s health status. Elimination of bone deformity is carried out exclusively by the surgical method.

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During the procedure, the doctor re-separates the bones and then fixes them in the correct position. During the intervention, the patient is under anesthesia, without experiencing any pain. In some cases (with a strong displacement), in addition to eliminating the deformity, bone grafting is indicated (bone grafting to replace the damaged area).

Recovery

The first day or two the patient is shown being in the hospital. In total, recovery takes an average of 1.5 months. During this time, the patient must regularly come to the doctor’s examinations to monitor the process of restoring the integrity of the bone.

To avoid re-deformity, it is extremely important to minimize the load on the injured limb until it is fully restored.

Misalignment of bones is a fairly common complication of fractures. The treatment of improperly fused fractures requires high professionalism from doctors, since it is necessary to exclude the possibility of re-deformation.

If your bones have grown together incorrectly after a fracture, then seek help from the specialists of the SM-Clinic medical center by phone in St. Petersburg: +7 (812) 435-55-55

Author of the article:
Nikitin Alexander Vladimirovich
operating traumatologist at the SM-Clinic

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Slowly consolidating fractures – symptoms of trauma, first aid and treatment, rehabilitation – Department of Traumatology NCC No.

2 (CCH RAS)

Fracture is a painful condition in which there is a violation of the integrity of the bone resulting from an injury under the influence of a damaging factor that is stronger than the strength of the bone tissue. Fractures are of two types: open and closed, with and without displacement of bone fragments. After an injury, the bones grow together until a callus is formed. This process is called fracture consolidation . Accordingly, a consolidating fracture is a fused fracture. Distinguish between fast and slow consolidation. Rapid consolidation is the complete fusion of the bones, in which a callus is formed and blood circulation is restored. Delayed consolidation is a bone union disorder with slow callus formation. As a result, the fracture can grow together incorrectly and cause a lot of inconvenience to the patient.

The main causes of injury.

There are general and local reasons due to which the process of bone tissue repair slows down. These include:

• Severe illnesses (diabetes mellitus, osteoporosis)
• Bad habits (smoking, alcohol)
• Depletion of the body
• Old age (over 60)
• Multiple fractures
• Women’s dysmenorrhea
• Entry of infection or foreign bodies into the wound
• Serious soft tissue injuries
• Circulatory disorders

Signs of slowly consolidating fractures.

Signs of delayed callus formation include:

• Unnatural mobility of bone fragments in the area of ​​injury
• Pain in the area of ​​bone injury
• X-ray shows gap between bone fragments

Diagnostics.

You can recognize the slowdown in the process of proper fusion of bone tissues in the area of ​​the fracture:

• during a clinical examination (the doctor, by bending and pressing hard on the area of ​​injury, determines whether pain is preserved, whether elasticity and springiness appear at the fracture site)
• by radiography (can only be used 16-22 days after the fracture, the fracture line will be clearly visible on the x-ray, and the callus is vague)

List of specialists to contact:

• Traumatologist-orthopedist
• Surgeon

Treatment.

With delayed bone fusion, two treatment options are possible – conservative and surgical.

• Conservative treatment is the prolongation of the immobilization of the fracture, sufficient for its union. A nonunion fracture is treated with the introduction of drugs that stimulate the process of bone formation, it is possible to inject the patient’s blood into the gap between the fragments, and to inject strengthening and tonic injections.
• If the terms of consolidation increase by more than 1.5-2 months, then the patient is prescribed surgical treatment. In the Department of Traumatology, the patient will undergo one of the necessary operations according to indications: extrafocal compression osteosynthesis, bone grafting, tunnelization according to Beck, or surgery with a sliding graft according to Khakhutov.

Rehabilitation.

To speed up the recovery of slowly growing fractures, the following is prescribed:

• Physiotherapy (iontophoresis of calcium salts, UHF, anabolic hormones, quartz irradiation, etc.