What is a clavicle fracture. How is a broken collarbone diagnosed. What are the treatment options for a clavicle fracture. How long does it take to heal a broken collarbone. What are the potential complications of a clavicle fracture. How can athletes prevent clavicle fractures. What is the rehabilitation process for a broken collarbone.

Understanding Clavicle Fractures: Causes and Anatomy

A clavicle fracture, commonly known as a broken collarbone, accounts for up to 5% of all fractures. The clavicle’s vulnerability stems from its location just beneath the skin and its role in connecting the arm to the body. But what exactly causes these fractures?

• Falls onto the shoulder (85% of cases)
• Direct impact
• Falls onto an outstretched hand
• Violent seizures
• Chronic stress leading to micro-fractures
• Tumors or lesions weakening the bone

The clavicle’s unique S-shape and its anatomical divisions play a crucial role in understanding these fractures. Divided into thirds, the bone connects to the sternum at the inner third and the shoulder blade at the outer third. The middle third, lacking muscular reinforcement, is the most common site for fractures.

Did you know?

The clavicle is the first bone to begin ossification in the fifth week of fetal life and the last to complete growth, sometimes as late as age 25.

Recognizing the Symptoms of a Broken Collarbone

Identifying a clavicle fracture promptly is crucial for proper treatment. Athletes with a broken collarbone often present with distinctive symptoms. Can you recognize these signs?

• Supporting the affected arm with the other arm
• Bruising and abrasions in the area
• Asymmetric appearance of the shoulders
• Pain and motion between bone ends upon palpation
• Possible tingling or loss of sensation in hand/fingers

It’s important to note that associated injuries, such as rib fractures or lung injuries, may occur alongside clavicle fractures, especially in high-energy trauma cases.

Diagnostic Procedures for Clavicle Fractures

Accurate diagnosis of a clavicle fracture requires a combination of physical examination and imaging techniques. How do medical professionals confirm a broken collarbone?

1. Physical examination: Assessing pain, deformity, and range of motion
2. X-rays: Standard anteroposterior and axillary views
3. CT scans: For complex fractures or suspected additional injuries
4. MRI: In cases of suspected soft tissue or vascular damage

During the examination, physicians must carefully evaluate for open fractures, where the bone protrudes through the skin, as these are surgical emergencies. Additionally, a thorough neurological assessment is crucial to rule out any nerve or blood vessel damage.

Treatment Options for Clavicle Fractures

The treatment of clavicle fractures has evolved significantly over the years. What are the current approaches to managing a broken collarbone?

Non-Operative Treatment

For many clavicle fractures, especially those with minimal displacement, non-operative treatment can be effective. This typically involves:

• Immobilization with a sling or figure-of-eight brace
• Pain management
• Gradual rehabilitation exercises

The duration of immobilization varies but generally lasts 4-6 weeks. During this time, it’s crucial to maintain shoulder mobility to prevent stiffness.

Surgical Intervention

In cases of significantly displaced fractures, open fractures, or fractures with associated neurovascular injuries, surgery may be necessary. Surgical options include:

• Plate fixation: Using a metal plate and screws to stabilize the fracture
• Intramedullary fixation: Inserting a rod through the center of the bone
• External fixation: In cases of severe soft tissue damage or infection

The choice of surgical technique depends on the fracture pattern, patient factors, and surgeon preference.

Recovery and Rehabilitation After Clavicle Fracture

Recovering from a clavicle fracture is a gradual process that requires patience and dedication. What does the typical rehabilitation timeline look like?

1. Immediate post-injury/surgery phase (0-2 weeks): Focus on pain management and protection
2. Early rehabilitation phase (2-6 weeks): Gentle range of motion exercises
3. Intermediate phase (6-12 weeks): Progressive strengthening exercises
4. Advanced rehabilitation (12+ weeks): Sport-specific training and return to activity

The exact timeline can vary depending on the severity of the fracture, treatment method, and individual healing rates. It’s essential to follow the guidance of healthcare professionals throughout the recovery process.

Tips for Optimal Recovery

• Adhere to the prescribed immobilization period
• Perform rehabilitation exercises as directed
• Maintain a nutritious diet to support bone healing
• Avoid smoking, as it can impair bone healing
• Gradually increase activity levels as advised by your healthcare provider

Potential Complications of Clavicle Fractures

While most clavicle fractures heal without incident, complications can occur. What are the potential risks associated with a broken collarbone?

• Nonunion: Failure of the bone to heal properly
• Malunion: Healing in an incorrect position
• Nerve or blood vessel injury
• Shoulder stiffness or weakness
• Persistent pain or discomfort
• Hardware-related issues (in surgical cases)

Early recognition and appropriate management of these complications are crucial for optimal outcomes. Regular follow-up appointments and adherence to rehabilitation protocols can help minimize these risks.

Prevention Strategies for Clavicle Fractures in Athletes

While not all clavicle fractures can be prevented, athletes can take steps to reduce their risk. How can athletes protect themselves from this common injury?

1. Use proper protective equipment: Ensure well-fitting shoulder pads in contact sports
2. Improve shoulder and upper body strength: Focus on exercises that stabilize the shoulder girdle
3. Practice proper falling techniques: Learn to roll and distribute impact when falling
4. Maintain good bone health: Ensure adequate calcium and vitamin D intake
5. Avoid overtraining: Allow for proper rest and recovery between intense training sessions

Coaches and athletic trainers play a crucial role in implementing these preventive strategies and educating athletes about the risks associated with their sport.

Long-Term Outcomes and Return to Sport After Clavicle Fracture

For many athletes, a primary concern following a clavicle fracture is their ability to return to their sport. What can athletes expect in terms of long-term outcomes?

The majority of athletes can return to their pre-injury level of activity following proper treatment and rehabilitation of a clavicle fracture. However, the timeline for return to sport can vary significantly based on several factors:

• Severity of the initial injury
• Treatment method (surgical vs. non-surgical)
• Compliance with rehabilitation protocols
• Individual healing rates
• Sport-specific demands

On average, athletes can expect to return to non-contact sports within 3-4 months, while return to contact sports may take 4-6 months or longer. It’s crucial to achieve full range of motion, strength, and confidence before returning to competition.

Criteria for Return to Sport

Before clearing an athlete for return to sport, healthcare providers typically look for:

1. Complete bone healing on imaging studies
2. Full, pain-free range of motion in the affected shoulder
3. Restored strength (at least 90% compared to the uninjured side)
4. Successful completion of sport-specific drills and activities
5. Psychological readiness and confidence in the healed clavicle

A gradual return-to-play protocol, with progressive increase in intensity and contact, is often implemented to ensure a safe transition back to full competition.

Advances in Clavicle Fracture Treatment

The field of orthopedics continues to evolve, bringing new innovations to the treatment of clavicle fractures. What are some of the recent advancements in this area?

• Minimally invasive surgical techniques: Reducing soft tissue damage and potentially speeding up recovery
• 3D-printed custom implants: Tailored to individual patient anatomy for optimal fit and function
• Biological augmentation: Use of bone grafts or growth factors to enhance healing in complex cases
• Advanced imaging techniques: Improved preoperative planning and intraoperative guidance
• Wearable technology: Monitoring rehabilitation progress and providing real-time feedback

These advancements aim to improve outcomes, reduce complications, and accelerate return to function for patients with clavicle fractures. However, it’s important to note that not all new technologies have long-term data to support their use, and the choice of treatment should be made on a case-by-case basis in consultation with an orthopedic specialist.

The Impact of Clavicle Fractures on Different Athletic Populations

Clavicle fractures can affect athletes across various sports and age groups differently. How does the impact of this injury vary among different athletic populations?

Youth Athletes

In younger athletes, clavicle fractures often heal more quickly due to their active growth plates. However, special considerations include:

• Potential for growth disturbances if the fracture involves the growth plate
• Need for longer-term follow-up to ensure proper growth and development
• Importance of age-appropriate rehabilitation protocols

Professional Athletes

For professional athletes, clavicle fractures can have significant career implications:

• Pressure to return to play quickly, potentially risking re-injury
• Financial implications of missed playing time
• Need for sport-specific rehabilitation to maintain competitive edge

Overhead Athletes

Athletes in sports requiring overhead motions (e.g., swimmers, baseball pitchers) may face unique challenges:

• Higher risk of shoulder dysfunction post-fracture
• Need for more extensive rehabilitation to regain full overhead motion
• Potential long-term impact on performance if not properly managed

Understanding these differences is crucial for healthcare providers to tailor treatment and rehabilitation plans to the specific needs of each athletic population.

Psychological Aspects of Clavicle Fracture Recovery

The psychological impact of a clavicle fracture on an athlete should not be underestimated. How can athletes cope with the mental challenges of recovery?

1. Set realistic expectations: Understand the typical recovery timeline and milestones
2. Stay connected with the team: Maintain involvement in team activities when possible
3. Focus on controllable factors: Emphasize adherence to rehabilitation and nutrition plans
4. Seek support: Utilize sports psychologists or counseling services if available
5. Use visualization techniques: Mentally rehearse successful return to sport

Coaches and medical staff play a crucial role in supporting the athlete’s psychological well-being throughout the recovery process. Open communication and a supportive environment can significantly impact an athlete’s motivation and adherence to the rehabilitation program.

Addressing Fear of Re-injury

Fear of re-injury is a common concern among athletes returning from a clavicle fracture. Strategies to address this include:

• Gradual exposure to sport-specific activities
• Confidence-building exercises in controlled environments
• Education about the healing process and the strength of the repaired bone
• Peer support from athletes who have successfully returned from similar injuries

By addressing both the physical and psychological aspects of recovery, athletes can achieve a more comprehensive and successful return to their sport following a clavicle fracture.

broken collar bone

By Asheesh Bedi, MD

Last Updated on January 17, 2023 by SportsMD

A broken collar bone (clavicle fracture) comprises up to 5% of all fractures. The clavicle is a bone in the upper part of the torso popularly referred to as the “collarbone.” The clavicle is the most commonly broken bone in the body, probably due to its location just beneath the skin and the forces it is subjected to in connecting the arm to the body.  Generally, a fall onto the shoulder causes 85% of these fractures. Direct impact and fall onto an outstretched hand comprise the other 15%. Occasionally, the clavicle can break during violent seizures, from chronic stress resulting in “micro-fractures,” or due to tumors or other lesions that weaken the bone.

The clavicle is an S-shaped bony strut that connects the arm to the trunk. Interestingly, the clavicle is the first bone to start to ossify in the fifth week of the fetal life and last to conclude the growth through its growth center as late as the age 25. It is a very prominent structure with only skin and “supraclavicular” skin sensory nerves crossing its surface.

Conceptually, the clavicle can be divided longitudinally along its length into thirds. The “medial” or inner third is closest to the center of the body and connects to the chest bone (sternum) at the sterno-clavicular (SC) joint. The outer (distal) third is furthest away from the center of the body and makes the connection with the shoulder blade (acromion portion) through the acromio-clavicular (AC) joint. Both joints are minimally mobile and occasionally can be dislocated, but this rarely occurs in conjunction with the clavicle fractures. Clavicle motion mostly occurs with elevation of the arm to the side and in front of the body. This becomes important if the clavicle fracture is treated non-operatively, as the fracture fragments can move independently and displace relative to each other.

The cross-sectional profile of the clavicle changes from one side to the other. The inner third of the clavicle shaft is tubular in cross section and protects the network of nerves (brachial plexus) and the blood vessels on their way to the arm and the hand. It also protects the tip of the lungs, which is just below this section of the clavicle. The outer third of the clavicle is flat and provides origin to the trapezius and deltoid muscles along with the suspensory ligaments that connect the clavicle to the shoulder blade (scapula). These ligaments can be injured and result in what is commonly referred to as the “shoulder separation” or AC joint dislocation. 

The middle third is a transition zone between the tubular inner third and relatively flat outer third. It lacks any muscular reinforcements and is structurally the weakest point along the shaft of the clavicle. For this reason, a broken collar bone most commonly occurs in the middle-third. This shape of the clavicle along with its ligamentous and muscular attachments are responsible for the pattern of displacement following fractures in this location.

Diagnosis of broken collar bone 

After a traumatic fall or collision, athletes with a broken collar bone tend to present with the affected arm supported by their other arm in an attempt to offload the fracture. Frequently, there is bruising in the area and/or an abrasion directly over the broken bone. Physicians should carefully examine any skin cuts to make sure that the broken clavicle ends did not poke out through the skin (“open fracture”), as these injuries are a surgical emergency. Careful evaluation of sensation and motor function in the extremity is necessary to ensure no injury to the nerves and blood vessels behind the clavicle. Athletes that report any tingling, loss of sensation in their hand/fingers, or inability to move their fingers should be evaluated very carefully for occult injury to these structures.

An asymmetric appearance of the shoulders with deformity in the broken collar bone is often apparent. Palpation along the clavicle can elicit pain and frank motion between the ends of the bones. Because these fractures can often occur in the setting of associated injuries, a detailed examination of the head, neck, and chest wall should also be performed. Associated rib fractures are not uncommon with high-energy trauma. It is also important to listen to the patient’s chest and breath sounds to confirm no lung injury or perforation (“pneuomothorax”) has occurred.

In cases of a high-energy mechanism of injury such as in the fall from significant height or direct blow at high velocity, physicians should examine the shoulder blades for symmetry to confirm no dissociation between the shoulder blades (scapula) and the chest wall (scapulothoracic dissociation). In addition, the joints at both clavicle ends (SC and AC joints) should be evaluated for evidence of dislocation by checking for asymmetry from the opposite side and pain that reproduced with palpation. In patients younger than 25 yrs of age, the last growth center may still be open and susceptible to injury (“physeal injury”). This would mimic dislocation of the joint between the chest bone and the clavicle (SC joint).

Plain radiographs are used to confirm the diagnosis and determine the fracture pattern, location, and degree of displacement. Views should include standard “front-to-back” (AP) view and one or more of other specialty views. Careful scrutiny of the lung fields and the ribs should be performed to avoid missing associated rib or thoracic injuries. Physicians should use radiographs to carefully characterize the fracture pattern and the amount of shortening that has occurred between the fractured ends of the bones. Significant comminution, or “shattering” of the bone at the fracture site, is also an important finding that suggests a high-energy mechanism of injury and may warrant surgical intervention.

How does a broken collar bone occur in athletes? 

The clavicle can break in any location along its length. Presently, the exact location of the fracture along the clavicle shaft and the type of trauma is not fully understood. Because of its unique anatomy, the middle-third of the clavicle is most commonly broken. As mentioned previously, 85% of these breaks occur as a result of a fall or a blow directly onto the “point” of the shoulder. Such injuries are common in contact sports such as football, hockey, or rugby, but also occur with falls in “extreme” sports such as biking, skateboarding, or motor-cross. Falls in virtually any sport onto an outstretched hand can also transmit significant indirect forces to the clavicle and account for the remaining 15% of broken collar bones. Other less common but documented mechanisms of a clavicle fracture include trauma from the seat belt strap during a motor vehicle accident, or from the direct blow of a hockey or lacrosse stick.  Elite athletes who have suffered and been treated for a clavicle fracture include multiple time Tour De France winner Lance Armstrong, NHL star Oscar Moller of the Los Angeles Kings, and Arizona Cardinals quarterback Matt Leinart.  

Treatment for broken collar bone 

The primary goal of the treatment of a broken collar bone is to restore the anatomy and thereby full, pain-free range-of-motion and function of the shoulder. These goals remain the same for all athletes whether non-operative or operative treatment is pursued. The decision for surgical versus conservative management is complex and based on a number of factors, including patient expectations, demands, the severity of injury, fracture pattern, and associated injuries. This decision must be individualized after an extensive discussion between the athlete and physician, with a full understanding of the risks and benefits of each treatment plan.

If the broken collar bone is minimally displaced with good apposition of the ends of the bones, non-operative treatment may be needed. Previous studies have reported relatively good results with minimally displaced fractures of the middle-third of the clavicle without significant shortening. If the broken collar bone is treated non-operatively, it usually involves using a simple sling for shoulder comfort and immobilization. In the past, a “figure-of-8” brace that would wrap around the front of the shoulders and upper back was used. Recently, its use has dramatically decreased because of the discomfort associated with its prolonged use and its inability to demonstrate an improved rate or speed of healing. Most physicians will restrict lifting with the arm on the involved side to avoid displacement of the fracture ends until some healing has occurred. Distal range-of-motion of the elbow and wrist, however, is encouraged. If the healing is progressing well, the sling can be gradually weaned and discontinued. Healing is assessed clinically to be a resolution of pain with motion and tenderness at the fracture site. It is radiographically confirmed by the new appearance of “fracture callus” (new bone) between the fractured ends. Frequently, intermittent and mild discomfort at the site of the break can persist for up to 3 months.

A broken collar bone that has significant shortening, overlap, poor alignment, distraction or multiple fragments should undergo surgical fixation. In addition, fractures that could poke out through the skin or ones that have already broken the skin should also be fixed urgently. Any fractures with associated nerve and blood vessel injury should be treated surgically. Finally, a broken clavicle that occurs in the setting of multiple other injuries (“polytrauma”) including fractures of the legs, opposite arm, and/or multiple rib fractures should undergo surgical fixation in order to enable the athlete to immediately use the arm in their mobilization and rehabilitation process.

Surgical fixation of a broken collar bone has evolved over time. In the past, surgeons used wires or pins inserted through the center of the clavicle (“intramedullary”) to maintain their alignment. However, because of a well-established risk of spontaneous “migration” of these devices, most surgeons today use “plate and screw” fixation for the surgical treatment of a broken collar bone. Breaks of the central third usually require standard plates and those at the outer third may require the use of specially designed plates for their fixation.

Traditionally, the skin incision is made over the clavicle and centered over the fracture. Careful dissection will ensure better cosmesis and fewer wound complications. If the skin “supraclavicular” nerve branches are recognized during the dissection, they should be preserved but when necessary they can be sacrificed with the caveat that the athlete may experience some numbness just below their collar bone. The fracture is identified, cleared of interposing debris, aligned anatomically, and rigidly fixed with the plate and screws. The plate can be placed along the top or front of the bone based on the fracture pattern. Care must be taken during fracture manipulation and fixation for protecting the critical underlying blood vessels and nerves. With an anatomically aligned fracture and stable fixation construct, the patient can begin immediate unrestricted motion with the exception of the overhead lifting for 6 weeks.

Complications of broken collar bone 

Complications from the broken collar bone can occur in athletes that pursue either nonoperative or operative treatment. Nonoperative management can result in the bone healing in an imperfect position (“malunion”) with resultant cosmetic deformity and shortening. In addition, the bone can partially heal or fail to heal (“nonunion”) leading to instability, persistent pain or limitation in the shoulder motion that prevents a successful return to sports. Generally, failure of healing in the nonoperatively treated athletes occurs if the fracture pattern is highly unstable, inappropriately immobilized, or soft tissue interposition has occurred during traumatic displacement.

Complications of surgical treatment of broken clavicle also include a small risk of delayed or incomplete healing (0-5%). They are frequently associated with smoking, inadequate alignment or fixation of the fracture (i.e. poor technique), failure of fixation due to premature return to strenuous activity, indolent infection, or poor nutrition. Other complications of surgery can include skin numbness below the incision, a painful plate that would require removal (as high as 50%), or recurrent fracture following the plate removal at the empty screw holes (“stress risers”) (5%).

A broken collar bone that does not heal in athletes (“nonunions”) should be fixed surgically regardless of the prior treatment method. Generally, they do tend to go on to full healing after effective surgical treatment. The addition of bone graft may be necessary to stimulate healing of these chronic injuries.

Return to sport after a broken collar bone 

Multiple factors determine an athlete’s return to unrestricted sport participation after a broken collar bone. Return to sports depends on complete bone healing and full, pain-free recovery of shoulder strength and motion. Physicians counseling an athlete on return to sports must take into consideration different levels of physical demand associated with each sport. Athletes returning to contact or overhead sports such as football will need more time before they can return to unrestricted play than the athletes returning to non-contact sports. Most physicians recommend that an athlete with a broken clavicle use a sling for 2 to 6 weeks with both nonoperative or operative treatment based on the athlete’s individual comfort level. During this time, the athlete is not recommended to lift using the affected arm is encouraged to move the elbow and the wrist. Athletes can commence assisted, gentle range of motion when they become pain-free and stop using the sling, usually by 4 to 6 weeks. Overhead activities can begin after clinical and radiographic findings confirm bone healing. Return to unrestricted sport activities is generally recommended 4 to 6 weeks after the complete healing, typically by 3 months after the injury or surgical fixation. Most athletes can ultimately expect a full return to sport participation without any consequences after their fracture has healed with satisfactory alignment.  

Can Telemedicine Help?

Telemedicine is gaining popularity because it can help bring you and the doctor together quicker and more efficiently. It is particularly well suited for sports injuries and facilitating the diagnoses and treatment of those injuries.  Learn more about  speaking with a sports specialized provider via SportsMD’s 24/7 Telemedicine Service.

References

• Rockwood and Green’s Fractures in Adults. Edited by: Bucholz, Robert W.; Heckman, James D.; Court-Brown, Charles M.; Tornetta, Paul. Lippincott Williams & Wilkins. 7th ed. 2009.
• Khan LA, Bradnock TJ, Scott C, Robinson CM. Fractures of the clavicle. J Bone Joint Surg Am. 2009 Feb;91(2):447-60.
• Jeray KJ. Acute midshaft clavicular fractures. J Am Acad Orthop Surg. 2007 Apr;15(4):239-48.
• Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007 Jan;89(1):1-10.

Clavicle Fracture/Broken Collar Bone | Lurie Children’s

The collar bone (clavicle) is an S-shaped bone that connects the sternum (breastbone) to the scapula (shoulder blade bone). Injuries to the clavicle are fairly common and are often easily recognized. The clavicle is the most frequently fractured bone during childhood. Most fractures occur in the middle of the bone.

What Causes a Clavicle Fracture/Broken Collar Bone?

Fractures of the collar bone most commonly occur with a fall onto the side of the shoulder. Fractures can also be from a direct blow to the clavicle, for instance, if an athlete is hit in the front of the shoulder with a hockey stick or baseball. Less commonly, clavicle fractures may happen with a fall onto an outstretched arm.

Broken collar bones are most common in athletes who participate in football, hockey, and soccer or sports with a high risk of falling, such as biking or horseback riding. Using adequate padding during contact sports and taking measures to prevent falls will reduce the risk.

How Is a Clavicle Fracture/Broken Collar Bone Diagnosed?

The doctor will take a detailed history of the injury and examine the shoulder to make the diagnosis. The doctor will also check feeling in the arm and circulation to evaluate for nerve or blood vessel injury related to the fracture. X-rays are obtained to evaluate fracture alignment and position, identify other fractures related to the injury and to confirm proper healing.

What Are the Symptoms of a Clavicle Fracture/Broken Collar Bone?

Clavicle fractures are often easily recognized. As with any broken bone, affected individuals have immediate pain and may feel or hear a snap or crack at the time of injury. Pain and swelling are common. For most individuals with clavicle fractures, the contour of the fracture on the affected side looks abnormal when compared to the uninjured side. Many individuals with broken collar bones feel more comfortable holding the arm in a cradled position.

How Is a Clavicle Fracture/Broken Collar Bone Treated?

Immediate treatment is focused on relieving pain and swelling with icing, rest and pain medication. Holding the arm at the side or cradled by the other arm also often helps relieve pain. Broken collar bones rarely require surgery in younger children who have significant growth remaining. Most clavicle fractures heal very well with minimal treatment. The doctor may prescribe a sling or a shoulder strap for comfort and to keep the ends of the bone from moving.

Clavicle fractures rarely fail to heal on their own, but surgery may be required if:

• The fracture breaks the skin
• There is nerve or blood vessel damage
• The fracture pieces are significantly displaced, particularly in older children and teens

Surgery may be necessary for a fracture that does not show signs of healing in the first four to six weeks after injury. Surgery should be avoided for purely cosmetic reasons as risks of surgery include infection, poor fracture healing, and prominent scarring.

What Are the Long-term Effects of a Clavicle Fracture/Broken Collar Bone?

These fractures generally heal in three to six weeks. There may be a residual bump left at the fracture site after healing is complete. In younger children, the bump tends to resolve over months or years. However, in older children, teens and young adults, the bump may persist. Having a small bump at the site of the fracture does not usually result in pain or difficulty using the arm.

Returning to Sports and Activities After a Clavicle Fracture/Broken Collar Bone

The goal is to return to activity as quickly and safely as possible. Returning to play before full healing puts the patient at risk for re-injury. Determining when to return to activity depends on the location and severity of the clavicle fracture, the amount of healing seen on x-ray and the sport played.

Recovery involves a gradual return to activity. Once the pain subsides, range of motion exercises may begin without the sling to prevent joint stiffness. Once the fracture is healed, there is no tenderness and there is full and painless range of motion of the shoulder with nearly full strength, participation in non-contact sports may begin. This is typically achieved by about six weeks from the time of the injury.

The doctor may delay the return to contact sports for several months, depending on the severity and location of the fracture. Fractures heal very quickly in young children, so kids are often able to return to sports more quickly than adolescents and adults with the same type of injury. For extra protection during contact sports, some athletes may consider using a donut pad or fiberglass shoulder shield worn under the jersey or pads.

symptoms, causes, signs, types and methods of treatment of fractures in the Center of Surgery “SM-Clinic”

General information

Classification

Symptoms

Diagnostics

Operations

Expert opinion of a doctor

Rehabilitation

Question answer

General information

A clavicle fracture is a pathological condition in which the integrity of the clavicle is broken. The key symptoms of injury are acute pain, tissue swelling, and limitation of motor functions. The diagnosis of a clavicle fracture is established on the basis of an internal examination and a complex examination by traumatologists or surgeons.

A clavicle fracture is one of the most common types of shoulder girdle injuries. Most often, it is faced by children, adolescents, the elderly, as well as those whose activities are associated with increased physical exertion (athletes, dancers, representatives of extreme sports and martial arts).

The cause of a clavicle fracture can be direct blows to this area, falls from various heights, compression of the body when it hits a blockage, etc.

Classification

Symptoms

Diagnosis

Physical examination and x-ray examination remain the main diagnostic measures for suspected such an injury.

• Visual examination allows the doctor to determine which symptoms of a clavicle fracture predominate, whether there are visible tissue damage; assess the general condition of the patient and the need for emergency surgery.
• X-ray helps to examine the damaged area: to view the fracture zone, the direction of displacement of the fragments, to identify internal pathologies caused by the fracture.

As an additional diagnostic, a basic set of laboratory tests is carried out, in complex cases, CT or MRI is used. With signs of damage to nerve fibers, a consultation with a neurologist is indicated.

Operations for fractures of the clavicle

The method of treatment of a fracture of the clavicle is selected, depending on the characteristics and severity of the injury. Conservative tactics are appropriate only in the case of simple closed injuries without changing the position of bone fragments and other complications.

Surgical treatment is aimed at restoring the integrity of bone structures and full-fledged functions of the limb. Depending on the type of fracture, several options for surgical interventions are used.

Osteosynthesis

After manual comparison of the bone elements, pin, extra-osseous or intraosseous fixation of the fragments is performed.

Open reduction

It consists in the connection of individual sections of the bone with subsequent external fixation.

Closed reduction

It is carried out with the help of special devices that, without incision of soft tissues, provide anatomically correct position of bone structures.

In most cases, after the end of the operation, a fixing bandage or plaster is applied to the damaged area, which ensures complete immobility of the clavicle and accelerates the fusion of bone tissues.

Doctor’s expert opinion

Rehabilitation

Q&A

Yes, as with any injury. To avoid damage to the collarbone, you need to be careful about the choice of seasonal shoes, avoid falls, bruises, follow safety precautions when playing sports and training.

No, this is a delusion. On the contrary, the area of ​​the fracture, even with the fastest and most successful recovery, will forever remain a “weak link”, which can again be injured under appropriate circumstances.

Video

Traumatology and Orthopedics Center “SM-Clinic”

Sources

Make an appointment

fields marked with * are required to fill in

Telephone*

By clicking on the button, you consent to the processing of your personal data

Registration through the site is preliminary. Our employee will contact you to confirm the appointment with a specialist. We guarantee non-disclosure of personal data and the absence of advertising mailings by the phone number you specified. Your data is necessary to provide feedback and arrange an appointment with a clinic specialist.

This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.

Clavicle fracture treatment | KB No. 85 FMBA of Russia

About the collarbone

The clavicle

(lat. – Clavicula) is a typical S-shaped bone, in simple terms, connecting the arm (free upper limb) to the body. Like most long bones of the skeleton, the clavicle consists of a body and two ends – the inner or sternal, external or acromial .

The ends of the clavicle are involved in the formation of 2 joints: sternoclavicular and clavicular-acromial. 6 muscles and several ligaments are attached to the collarbone. The shape and function of the clavicle is of great importance when it is damaged.

Clavicle fracture

Clavicle fractures are quite common and account for 2.6-12% of the total number of

skeletal bone fractures. 44-66% of cases of fractures of the shoulder girdle. In 80% of cases, the fracture occurs in the middle third, in 15% – a fracture of the acromial end of the clavicle and in 5% – the sternal end.

Fractures of the clavicle in most cases occur as isolated injuries , less often in combination with other injuries of bones and soft tissues. Damage to the clavicle, as a rule, occurs as a result of the indirect impact of high-energy forces (falling on the shoulder brought to the body, falling on the outstretched arm, etc.).

Fractures of the clavicle also occur with direct impact on the bone. Therefore, this damage is common among athletes, active people, as well as in disasters, military operations and traffic accidents.

Diagnosis of clavicle fractures

Diagnosis of clavicle fractures

, as well as dislocations of its ends in most cases is quite simple and is based on clinical (examination, comparative assessment, measurement, palpation, etc.) and X-ray logical examination of a patient with taking into account the patient’s complaints and anamnesis.

As a rule, the victim is examined by a traumatologist. Already at the sight of the patient, one can suspect a fracture of the clavicle by the characteristic posture of the patient – the patient supports the hand brought to the body on the damaged side. When examining a patient with a fracture of the body of the clavicle, depending on the displacement, it is often possible to detect deformation in the projection of the clavicle, swelling of the soft tissues of the shoulder girdle, and subcutaneous hemorrhage.

If there is a wound with fragments protruding into it (wound), they speak of an open fracture of the clavicle. When feeling (palpation) of the collarbone, the doctor can identify the most painful point, as well as identify the area of ​​pathological mobility – i.e. fracture location . During a clinical examination, it is possible to accurately diagnose a fracture of the clavicle.

The diagnosis of a clavicle fracture is confirmed , usually radiographically when radiographs are taken in standard layouts. In some difficult-to-differentiate cases, X-ray computed tomography (CT) is performed, and sometimes, if necessary, magnetic resonance imaging (MRI).

Complications of clavicle fracture

Complications of clavicle fracture and treatment – occur in 5. 7 – 25.3% of cases. And they can be associated with damage to the structures surrounding the collarbone: damage to the neurovascular bundle, damage to the apex of the lung – quite dangerous complications manifested by bleeding, neurological disorders in the injured arm, respiratory disorders, requiring immediate surgical treatment.

In the treatment of fractures of the clavicle , both without surgery and with operatively modern methods, there may also be a complication in the form of nonunion of the bone or its incorrect union.

Treatment of clavicle fractures

In the trauma and orthopedic department of our clinic, fractures of the clavicle, fractures of the forearm, fractures of the hand, fractures of the fibula, and dislocations of its ends, depending on the type and type of damage, are treated. There are options for conservative (non-surgical) and surgical treatment.

X-rays of a fracture of the acromial end of the right clavicle before and after surgery.