How long does it take for a broken collarbone to heal in children. What are the causes and symptoms of a collarbone fracture. How is a broken collarbone diagnosed and treated.

Understanding Collarbone Fractures in Children

The collarbone, also known as the clavicle, is an S-shaped bone connecting the breastbone (sternum) to the shoulder blade (scapula). Collarbone fractures are particularly common in children due to their active lifestyles and developing bone structure. While these injuries can sometimes raise concerns about potential child neglect or abuse, they are often the result of typical childhood activities.

Parents and caregivers must be vigilant, as young children may struggle to articulate their pain effectively. Recognizing the signs of a broken clavicle is crucial for prompt medical attention and proper healing.

Why are collarbone fractures common in children?

Children’s bones are more flexible and less dense than those of adults, making them more susceptible to fractures. Additionally, children engage in numerous physical activities that put them at risk of falls or direct impacts to the shoulder area.

Common Causes of Collarbone Fractures in Children

Collarbone fractures in children typically occur due to the following reasons:

• Falls on the side of the shoulder
• Direct blows to the collarbone (e.g., from a baseball or hockey stick)
• Falls on an outstretched arm (less common)

Sports with a high risk of falling, such as football, soccer, hockey, and biking, are common culprits for collarbone fractures in children. To minimize the risk, it’s essential to use proper protective gear and teach children safe techniques for participating in these activities.

Can newborns experience collarbone fractures?

Yes, collarbone fractures can occur in newborns, typically during the birthing process. This injury is the most common birth-related fracture and can result from various factors:

• Large size of the newborn
• Narrow birth canal
• Shoulder dystocia (when the baby’s shoulder gets stuck during delivery)
• Use of assistive tools during delivery

Diagnosing a Broken Collarbone in Children

If you suspect your child has a broken collarbone, seeking immediate medical attention is crucial. The diagnostic process typically involves:

1. Physical examination of the affected area
2. X-rays to confirm the fracture and assess its severity
3. Additional tests if joint or artery damage is suspected

What additional tests might be necessary?

In some cases, the doctor may order further tests to get a more comprehensive view of the injury:

• Arteriogram/Arteriography: Uses X-rays and dye to visualize the inner parts of arteries
• CT scans: Provides more detailed images than standard X-rays
• Ultrasound: Uses sound waves to create images of internal structures

Recognizing Symptoms of a Broken Collarbone

Identifying the signs of a collarbone fracture in children is crucial for prompt treatment. Common symptoms include:

• Pain at the top of the shoulder or clavicle, especially during movement
• Difficulty moving the arm or shoulder
• Bruising or weakness in the affected area
• A visible lump or deformity along the collarbone
• Weakness, tingling, or numbness in the shoulder or arm
• The child supporting the affected arm with their other hand to reduce pain

How do symptoms differ in newborns?

In newborns, the signs of a broken collarbone may be more subtle:

• Crying when the affected arm is moved
• Pain when lifted under the arms
• Limited movement in the injured arm compared to the unaffected side
• The injured shoulder appearing slightly lower than the other
• A lump developing at the fracture site after a few weeks

Treatment Options for Broken Collarbones in Children

The primary goal in treating a broken collarbone is to restrict movement and promote proper healing. Treatment approaches may include:

Non-surgical treatments

• Arm sling: Worn for 3-6 weeks, depending on the severity of the fracture
• Pain management: Over-the-counter or prescription medications to alleviate discomfort
• Physical therapy: Exercises to improve strength, flexibility, and range of motion

When is surgery necessary for a broken collarbone?

In some cases, surgical intervention may be required. Situations that might necessitate surgery include:

• Injury to nerves or blood vessels
• Compound fractures (where the bone breaks through the skin)
• Severely displaced bone fragments

The surgical procedure for collarbone fractures is called open reduction and internal fixation (ORIF). This operation realigns the broken bone pieces and secures them in place using plates, screws, or pins.

Collarbone Healing Process and Recovery Time

The healing time for a broken collarbone can vary depending on several factors, including the child’s age, overall health, and the severity of the fracture. However, there are some general timelines to consider:

How long does it take for a child’s collarbone to heal?

On average, bone union in children takes about 3 to 6 weeks. This process can be faster in younger children due to their higher bone regeneration rates. During this time, it’s crucial to follow the doctor’s instructions regarding activity restrictions and proper care of the injury.

What is the recovery timeline for newborns with collarbone fractures?

In newborns, collarbone fractures typically heal with minimal intervention. The focus is on pain control and careful handling of the baby. Most newborns recover fully within a few weeks to a month, with the formation of a callus (a hard lump at the fracture site) indicating proper healing.

Rehabilitation and Long-Term Care for Collarbone Fractures

After the initial healing period, rehabilitation plays a crucial role in restoring full function and strength to the affected area. The rehabilitation process may include:

• Gentle range-of-motion exercises while still wearing the sling
• Progressive strengthening exercises as healing advances
• Physical therapy sessions to improve flexibility and coordination
• Gradual return to normal activities and sports

How long before a child can return to sports after a collarbone fracture?

The timeline for returning to sports varies depending on the severity of the fracture and the specific sport. Generally, children may be able to resume non-contact activities after 6-8 weeks, with a full return to contact sports often possible after 3-4 months. However, it’s essential to follow the guidance of the treating physician and physical therapist to ensure a safe return to athletic activities.

Preventing Collarbone Fractures in Children

While it’s impossible to prevent all injuries, there are steps parents and caregivers can take to reduce the risk of collarbone fractures in children:

• Ensure proper use of protective gear during sports and recreational activities
• Teach children safe falling techniques
• Maintain a safe home environment to prevent falls
• Encourage strength-building exercises to improve overall bone health
• Ensure children receive adequate calcium and vitamin D for strong bones

Are there specific exercises to strengthen the collarbone area?

While you can’t directly strengthen the collarbone itself, exercises that target the surrounding muscles can help improve overall shoulder stability and potentially reduce the risk of injury. Some exercises that may be beneficial include:

• Shoulder shrugs
• Wall push-ups
• Arm circles
• Rowing exercises
• Scapular retractions

Always consult with a pediatrician or physical therapist before starting any new exercise regimen for your child.

Long-Term Implications of Childhood Collarbone Fractures

While most collarbone fractures in children heal well with proper treatment, it’s natural for parents to have concerns about potential long-term effects. Understanding the possible outcomes can help in managing expectations and ensuring appropriate follow-up care.

Do childhood collarbone fractures affect growth?

In most cases, collarbone fractures do not significantly impact a child’s growth or long-term shoulder function. The clavicle has a remarkable ability to remodel as the child grows, often resulting in little to no visible deformity or functional impairment in adulthood. However, in rare cases where the fracture involves the growth plate, there may be a risk of growth disturbances.

Can a broken collarbone lead to future shoulder problems?

While uncommon, some children may experience long-term effects from a collarbone fracture, such as:

• Slight asymmetry in shoulder appearance
• Mild limitation in range of motion
• Increased risk of re-injury in the same area
• Potential for earlier onset of arthritis in the affected shoulder joint

Regular follow-up appointments and adherence to rehabilitation protocols can help minimize these risks and ensure optimal long-term outcomes.

Emotional and Psychological Aspects of Collarbone Fractures in Children

While the physical aspects of a collarbone fracture are often the primary focus, it’s important not to overlook the emotional and psychological impact on children. Dealing with an injury, especially one that limits their usual activities, can be challenging for young patients.

How can parents support their child’s emotional well-being during recovery?

Parents and caregivers can play a crucial role in helping children cope with the emotional aspects of a collarbone fracture:

• Provide clear, age-appropriate explanations about the injury and healing process
• Encourage expression of feelings and address any fears or concerns
• Maintain a positive attitude and focus on progress, no matter how small
• Engage in alternative activities that the child can enjoy while healing
• Involve the child in decision-making regarding their care when appropriate
• Consider seeking professional support if the child shows signs of prolonged distress or anxiety

By addressing both the physical and emotional aspects of recovery, parents can help ensure a more positive healing experience for their child.

Advances in Collarbone Fracture Treatment for Children

Medical science continues to evolve, bringing new approaches and technologies to the treatment of collarbone fractures in children. These advancements aim to improve healing outcomes, reduce recovery times, and minimize long-term complications.

What are some recent innovations in pediatric collarbone fracture treatment?

Several promising developments have emerged in recent years:

• Minimally invasive surgical techniques: These procedures offer smaller incisions and potentially faster recovery times
• Bioabsorbable implants: Made from materials that gradually dissolve in the body, eliminating the need for implant removal surgeries
• 3D-printed casts and braces: Custom-fit supports that provide better comfort and potentially improved healing
• Advanced imaging techniques: More precise diagnostics for better treatment planning
• Bone stimulation technologies: Non-invasive methods to promote faster bone healing

While not all of these technologies may be widely available or suitable for every case, they represent exciting possibilities for improving the care of children with collarbone fractures.

The Role of Nutrition in Collarbone Fracture Recovery

Proper nutrition plays a vital role in bone healing and overall recovery from collarbone fractures. Ensuring that children receive adequate nutrients can help support the healing process and potentially reduce recovery time.

Which nutrients are crucial for bone healing in children?

Several key nutrients contribute to optimal bone health and fracture recovery:

• Calcium: Essential for bone formation and strength
• Vitamin D: Aids in calcium absorption and bone mineralization
• Protein: Necessary for the production of new bone tissue
• Vitamin C: Supports collagen production, which is important for bone structure
• Zinc: Plays a role in bone formation and healing
• Vitamin K: Helps regulate bone metabolism

Parents should consult with their child’s healthcare provider about potential dietary changes or supplements that may be beneficial during the recovery period. A balanced diet rich in fruits, vegetables, lean proteins, and dairy products can often provide the necessary nutrients for optimal healing.

Broken Collarbone | Let our Doctors fix your child’s Collarbone

Broken Collarbone

The collar bone (also known as clavicle) is an S-shaped bone that connects the breastbone (i.e. sternum) to the shoulder blade bone (scapular). The collarbone breaks most often in children.

Although in some cases, collarbone fracture may signify child neglect or abuse, it is usually common as a result of the normal activities of a toddler. Since young children may not be able to describe their pain, it is important to know the signs of a broken clavicle so that you can spot an injury in your child.

Causes of a Broken Collarbone

Collarbone fractures usually occur when the child falls on the side of the shoulder. They can also be a result of a direct blow to the collarbone. For instance, if the child is hit in front of the shoulder with a baseball or stick, it can lead to a broken collarbone. In rare cases, broken collarbones occur as a result of a fall on an outstretched arm.

Broken collarbones are mostly common in children that participate in football, soccer, and hockey or sports that have a high risk of falling, like biking. It is important to use adequate padding and also take measures to reduce the risk of collarbone fractures.

How Collarbone Fracture Occurs in a Newborn

A broken collarbone is the most common injury that newborns sustain during birth. It occurs as a result of trauma or difficult delivery. Some factors that increase the risk of a newborn sustaining a broken clavicle include the newborn’s large size, a narrow birth canal, the newborn’s shoulder getting stuck, and the use of tools to help in delivering the baby.

Diagnosis

If you think your child has broken his or her clavicle, it is important to seek medical attention immediately. The medical practitioner will:

• Examine the affected area
• Take X-rays of the injury to determine if there’s a fracture. The X-rays will also help the doctor know the exact location of the break, how severe it is, and if other bones have also broken.

If the doctor thinks a joint or artery has been damaged, he will request more tests like:

• Arteriogram/ Arteriography: This uses X-rays and dyes to see the inner parts of the arteries.
• CT scans: They provide more detailed pictures than X-rays.
• Ultrasound: This uses sound waves to create an image of what’s going on in the body.

Symptoms of a Broken Collarbone

The signs and symptoms of a broken collarbone in children include:

• Pain at the top of the shoulder or the clavicle, especially when the child moves the shoulder
• Difficulty in moving the arm or shoulder
• Bruising or weakness
• Lump in the affected area
• Weakness, tingling, or numbness in the shoulder or arm
• Deformed collarbone
• The child supports the arm with the other hand to reduce pain

The commonest sign of a broken collarbone in a newborn is crying with the movement of the affected arm as a result of pain in the collarbone. The newborn will feel pain when he or she is lifted under the arms. The baby may not be able to move the injured arm as much as the arm that is not injured.

If the injury has affected the nerves of the arm, the newborn may find it difficult to move the arm and the arm may hang limply at his or her side. The injured shoulder will appear slightly lower than the other shoulder. The healing process of the bone may cause a lump to develop at the spot of the fracture (this will be noticed after a few weeks and can be felt when you touch the area).

Treatment for Broken Collarbone

It is important to restrict the movement of any fracture to help in healing. To restrict the movement of a broken collarbone, the child will need to wear an arm sling.

How long this will be worn will be determined by how severe the fracture is. Bone union takes about three to six weeks for children. A collarbone fracture in a newborn will heal with only pain control and by carefully handling the baby.

The Treatment for a Broken Collarbone also known as a clavicle fracture in children:

Medications

The doctor may recommend an over-the-counter pain reliever to reduce inflammation and pain. If the pain is severe, the child will need a prescription medication that contains a narcotic for some days.

Therapy

Therapy starts after Treatment for a Broken Collarbone. It is usually important to start some motion to reduce stiffness in the shoulder while the child is still wearing a sling. After removing the sling, the doctor may recommend other physical therapies to improve the strength of the muscle, joint motion, and flexibility.

Surgery

Surgery may be required to treat a broken collarbone if:

• Nerves or blood vessels are injured
• The broken bones break through the skin
• Pieces of the broken collarbone are in a critical position

The surgery for collarbone fracture is referred to as open reduction and internal fixation. The operation will put pieces of the broken collarbone back to their position (reduction). The process involves the use of metal devices to keep the bones in place (fixation). The orthopedic surgeon may perform the surgery using the following:

Plates and screws

These will be attached to the external surfaces of the bone. They are not removed until after the bone heals. They are only removed if they cause discomfort (usually at least a year after the surgery).

Pins or screws

These are removed once the injury has healed.

When Can the Child Go Back to Sports?

The doctor will have to see the child again to know if he or she is in good condition to go back to sports. The child can go back to sports when the following are noticed:

• There is no pain when the collarbone is pressed
• The strength of the shoulder is normal, and
• The child can move and use the arm and shoulder without feeling any pain.

Generally, kids can resume non-contact sports (like swimming or running) after 6 weeks and contact sports (like hockey, football, and lacrosse) within 8 to 12 weeks.

Complications of a Broken Collarbone

Broken collarbones usually heal without any difficulty. If complications occur, they might include:

Blood vessel or nerve injury

The rough ends of the broken collarbone may injure nerves and blood vessels in their vicinity. If you notice coldness or numbness in your child’s arm, seek immediate medical help.

Delayed healing

A collarbone that is severely broken may not heal quickly. The bone may also become short as a result of the poor union of the bones while healing.

A lump in the bone

The area where the bone joints together usually form a bony lump (this is part of the healing process). Most of them disappear with time while some are permanent.

How Long Does it Take a Broken Collarbone to Heal?

How long it takes a broken clavicle to heal depends on a series of factors. These include the age of the child, the location of the fracture, and the number of pieces the bone breaks into. Collarbone fractures in children below the age of 8 years may heal within 4 or 5 weeks. Broken collarbones in adolescents may take up to 6 and 8 weeks to heal.

However, clavicle fractures in adults or teenagers that have stopped growing may take about 10 to 12 weeks to heal (it can also take longer). Most broken collarbones heal completely within four weeks in adults.

Collarbone that breaks into more pieces usually takes longer to heal than those with a few fragments.

What Can Be Done While Waiting for the Broken Collarbone to Heal?

The child should be able to move his or her fingers, wrist, and shoulder without too much pain within a few days of sustaining the injury. As the pain in the collarbone area reduces, the child should start moving the shoulder joint a little to prevent the joint from tightening up. As the pain starts subsiding, it is required to start moving the shoulder to prevent frozen shoulder (a condition where the shoulder gets stiff).

The doctor may show you the motions of the shoulder. The shoulder motion does not prevent the broken collarbone from healing once the injury has started healing. Once the fracture has completely healed, motion is not restricted. You should only try to strengthen the arm and shoulder after the fracture has healed. Exercises should also be directed by the physician.

Request an Appointment

A broken collarbone is a painful injury. In most cases, patients don’t need surgery, while some require an operation to arrange the pieces of the collarbone back in their position. Physical therapy is also required to help the child resume daily activities.

If you notice any sign of a broken collarbone in your child (or other forms of fracture), talk to the orthopedic experts at Medical City Children’s Orthopedic and Spine Specialists. We will examine the child to know what the problem is. We will also provide the Treatment for a Broken Collarbone and suggest exercises that will reduce pain and stiffness and restore strength.

Our board-certified physicians and fellowship-trained orthopedic surgeons are skilled in treating children and teenagers with broken collarbones. Contact us today to schedule an appointment.

We Can Help!

Finally, our doctors at Medical City Children’s Orthopedics and Spine Specialists understand the importance of maintaining your child’s health. In addition, our experts and specialists have the training, knowledge, and experience required to take care of a sprained or broken ankle that is causing pain to your child. If your child experiences any form of ankle pain, don’t hesitate to call our office at 214-833-0917 to schedule an appointment at one of our four locations. 

Clavicle Fractures | Texas Children’s Hospital

What is a Clavicle Fracture and How Does it Occur?

The clavicle, also known as the “collarbone,” is a thin bone that attaches the shoulder to the sternum (breastbone). A broken collarbone usually happens when a child falls directly onto the shoulder.

How is a Clavicle Fracture Diagnosed?

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A child with a clavicle fracture usually has pain, swelling, and possibly bruising directly over the clavicle, usually midway between the neck and the shoulder. Most likely, they will initially support the elbow with the opposite hand as allowing the arm to hang at the side is usually painful. They will probably not want to use or move the arm that is injured. In most cases, X-rays confirm the diagnosis. Occasionally, a very subtle fracture cannot be seen on X-ray, and your physician can make the diagnosis through their exam.

How is a Clavicle Fracture Treated?

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Unlike other fractures, a clavicle fracture does NOT need to be lined up perfectly to heal well. Clavicle fractures are initially treated by putting the arm on the injured side in a sling until the pain improves. The sling does not stabilize the fracture or help it to heal sooner. It is used to provide comfort to the child. The sling is not needed when sleeping.

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Once the pain improves (usually in 2-3 weeks), the child does not need to wear the sling any longer and may start working on moving the shoulder. Caregivers may still consider having the child wear the sling to school as a reminder not only to them but also to other children that the fracture has not completely healed. It is also a reminder that activities putting the child at risk for a fall should be avoided. Your physician may have the child return to clinic for X-rays in approximately 6 weeks.

Clavicle fractures in younger children may heal within 6 weeks, but it may take 10-12 weeks for a clavicle fracture to heal in an older child or adolescent. Clavicle fractures rarely require surgery in children. Surgery is occasionally considered in teenagers with significantly displaced fractures.

What is the Long-Term Outcome After a Clavicle Fracture?

Clavicle fractures in children usually heal in 6 to 12 weeks. Children should have no problems returning to sports or other physical activities after the fracture is healed. Clavicle fractures usually heal with a significant amount of callous (new bone that surrounds the fracture as it heals). Because the clavicle is directly under the skin and because of the new bone that the body creates to heal the fracture, the child will have a “bump” at the fracture site. In younger children, the bump will usually go away over time. In adolescents, the “bump” may improve but will likely remain. Children are unlikely to have any functional problems following a healed clavicle fracture.

Dislocation of the collarbone: symptoms, treatment, prevention

The collarbone is a small bone that connects the shoulder to the sternum, stabilizing the movement of the arm. Sudden movements, contact sports, unsuccessful falls on an outstretched hand provoke a dislocation of the collarbone. In this situation, the bone is displaced from the joint either from the side of the sternum or in the shoulder region (where it connects to the upper end of the scapular bone), there is a sharp pain that becomes stronger if the person tries to move the arm or lift it. Similar symptoms are possible with a fracture, injuries of other bones in this area, so it is important to contact a traumatologist who will make the correct diagnosis and determine the tactics of treatment.

Dislocation of the collarbone: how can it happen?

Often, dislocation of the collarbone occurs in adolescents and young men who play football, handball or volleyball, extreme sports (auto, motorcycle racing, rock climbing, parkour), contact (wrestlers, boxers, judoists), lift heavy objects. A dislocation of the collarbone is possible if there is a fall on the arm or back, with blows to the shoulder, when the greatest force falls on the region of the scapula, shoulder joint or the collarbone itself.

A special variant of dislocation of the clavicle occurs in newborns, during complicated, rapid childbirth.

According to trauma departments, this injury occurs in 5-12% of all dislocations. There are two types of dislocation of the clavicle:

• sternoclavicular, if that part of the bone that is adjacent to the sternum is displaced from its place;
• acromioclavicular, if the integrity of the joint connecting the scapula (due to the acromial process of the bone) with the clavicle is violated.

Damage in the area of ​​the shoulder and the process of the scapula occurs 4-5 times more often, since this part of the body is more mobile. Often, injury occurs if a person falls, reflexively moving his arm away and trying to slow down the movement of the body. Symptoms of dislocation are possible if a sharp direct blow falls on the junction of the clavicle, with a sharp transverse compression of the zone of the scapula, sternum and the clavicle itself.

Direct injury most commonly causes dislocation of the acromial joint. Indirect damage, if adjacent tissues are injured, leads to the exit of the clavicle from its rightful place in the sternum.

Clavicular joints are quite strong, inactive, strengthened by strong ligaments. Therefore, rather powerful injuries lead to dislocations. Along with the displacement of the clavicle, ligament rupture occurs. If only one ligament is torn, incomplete dislocation is determined (doctors call it subluxation), if two ligaments with the capsule surrounding them are damaged, this is a complete dislocation.

An injury to the collarbone is considered fresh if a doctor examines and detects a dislocation within 3 days of the injury. In the period from 3 days to 3 weeks – this is a stale dislocation. When damage is detected after 3-4 weeks or even later, these are chronic dislocations. It is much more difficult to treat them, as the tissues gradually change, adjusting to the new position of the collarbone.

Symptoms of dislocation of the collarbone

The symptoms that occur after a dislocation of the collarbone differ depending on the nature of the injury – whether the acromial (shoulder) end of the clavicle or the sternal end is affected.

Acromioclavicular dislocation is manifested by sharp pain at the site of injury, severe swelling of tissues under the skin. The edge of the clavicle protrudes upward and towards the back, any touch to this place is painful, because of this, hand movements are limited. A special “symptom of the key” may appear – if you press on the protruding end of the clavicle, it temporarily falls into place, and if you remove your finger, it sticks again. If one ligament is injured (incomplete dislocation) – the edge of the collarbone does not stick out much. If the injured arm is pulled down, the shoulder moves, and the collarbone also sticks out. With a complete dislocation, the edge of the clavicle is very noticeable, slight pulling of the arm leads to an even greater protrusion of the edge of the clavicle.

Sternoclavicular dislocation is, first of all, pain in the upper part of the sternum, severe swelling of the tissues. If the clavicle is dislocated forward, a tubercle appears under the skin, if the clavicle is dislocated backward, the skin over the joint is noticeable, there may be a feeling of difficulty breathing or pain with a deep breath. If this is a suprasternal dislocation, the edge of the clavicle protrudes above the upper edge of the sternum.

Chronic dislocation of the clavicle is usually incomplete, and then there are practically no complaints of pain and swelling. A person can only note the deformation of tissues in the area of ​​​​the shoulder or sternum. If this is a complete chronic dislocation, there may be periodic pain at the site of bone displacement and a decrease in muscle strength in the arm.

Treatment of dislocation of the clavicle

In order to properly treat an injury in the region of the collarbone, an accurate diagnosis is needed to determine the type of dislocation and its localization (sternal or scapular part of the clavicle).

Diagnosis

An experienced traumatologist can diagnose immediately after examining the patient and clarifying the method of injury (fall, blow to the shoulder, road accident). When examining, the doctor notes changes in the area of ​​​​the shoulder girdle, swelling and the protruding edge of the collarbone, gently probes the damaged area, noting where the pain is most pronounced and whether there is a distance between the collarbone and the sternum or scapula.

Radiography helps to confirm the diagnosis and clarify the type of dislocation. If this is an incomplete dislocation, the doctor compares the collarbones from the affected and healthy side, in some cases, before taking the picture, the patient is given a small weight in the arm so that the shoulder drops. In this case, the deviation of the clavicle will be more noticeable.

Modern methods of treatment

We asked questions about the tactics of treatment of dislocations of the clavicle orthopedist Maxim Kolinsky .

Indications for surgical treatment, i.e. open reduction of dislocation, sternal end of the clavicle with joint fixation and ligament suturing are strictly limited. The operation is performed only for athletes or young people leading an active lifestyle. In case of damage to the acromioclavicular joint, if only the acromioclavicular ligament is affected, and, therefore, there is no complete dislocation of the clavicle, conservative treatment is indicated.

In case of complete dislocation of the acromial end of the clavicle, when not only the acromioclavicular, but also the coracoclavicular ligaments are torn, recovery is possible only in case of surgical treatment!

The most modern and optimal method is a combination of thread and fixation buttons placed above the clavicle and below the coracoid process. This technique is minimally invasive (intervention is minimal) and can even be performed arthroscopically, so it is easier for the patient to tolerate and has virtually no complications. In fact, it is a prosthesis of the coracoclavicular ligament. To date, this is the only method of fixation of the acromioclavicular ligament that does not violate the biomechanics of the movement of the clavicle, which significantly speeds up the recovery time.

In the case of conservative treatment and in the early postoperative period, it is better to use modern orthopedic orthoses and braces for the shoulder joint for immobilization, rather than bulky and uncomfortable plaster casts. An alternative and quite convenient, inexpensive method is the use of teip bandages.

Prevention of dislocation of the clavicle

The main method of prevention of dislocation of the collarbone is the prevention of injuries in sports and at home, in various hazardous industries. If you fall and experience pain in the shoulder or near the sternum, you should immediately seek help from a doctor.

Popular questions and answers

What complications can occur in case of dislocation of the collarbone

Anterior and upper dislocations are not dangerous, with the posterior one, compression of large vessels may occur, as well as difficulty in breathing in the victim, which requires urgent reduction of the dislocation in a hospital and under anesthesia . As for the dislocation of the acromial end of the clavicle, there are usually no life-threatening complications here.

But untimely seeking specialized help, or incorrect tactics of treatment and rehabilitation entails the development of instability in the sternoclavicular or acromioclavicular joints with the development of post-traumatic arthrosis, which is accompanied by chronic pain syndrome, muscle weakness and a decrease in the function of the entire upper limb.

How long does recovery after a dislocation of the clavicle last?

In the early post-traumatic and post-operative periods, osteopathic treatment is indicated for quick relief of edema and pain (1-3 sessions once a week are enough), as an auxiliary method – kinesiology taping. Further, it is necessary to undergo an individual exercise therapy course aimed at restoring the function of dynamic stabilizers of the acromioclavicular joint (trapezius and deltoid muscles) and including all myofascial dynamic circuits of the damaged limb into operation. With proper treatment, complete recovery of function occurs within 2 to 3 months.

Other methods of surgical treatment and rehabilitation are possible. The choice depends on the equipment of the clinic, individual indications, the qualifications and skills of the surgeon, the rehabilitation doctor, as well as the patient’s desire to recover and his trust in the doctor.

Shoulder pain after a fall?

Skiers, snowboarders and many other “extreme” sports enthusiasts often experience an acromioclavicular joint (ACJ) tear. Usually it happens like this: I rode, fell, got bruised shoulders and shoulder blades. When conducting R-graphy of the shoulder joint, it turned out that the ACL was damaged. The wording of the diagnosis can be different: complete or partial rupture. In the first case, surgical treatment is indicated, in the second, conservative therapy may be limited.

According to the degree of severity, injuries are distinguished:

• I degree – tear of the clavicular-acromial ligament is characterized by pain in the projection of the clavicular-acromial joint. R-grams showed no visible damage, sometimes there is a slight (2-3 mm) expansion of the joint space compared to a healthy limb. The clavicular-coracoid ligament is intact;
• II degree – rupture of the clavicular-acromial ligament, tear of the fibers of the clavicular-coracoid ligament. The injury is characterized by pain in the projection of the clavicular-coracoid joint, protrusion of the acromial end of the clavicle, and a positive “key” symptom. On R-grams there is an expansion of the joint space of more than 5 mm. The upper edge of the clavicle protrudes above the acromion to half its diameter;
• III degree – rupture of the clavicular-acromial and clavicular-coracoid ligaments is characterized by pain, dysfunction of the upper limb. The symptom of the “key” is sharply positive, the abduction of the upper limb is limited. On R-grams, there is a pronounced expansion of the joint space (more than 7 mm). The clavicle is displaced upward by more than the diameter of the acromion;
• IV degree – rare cases – posterior dislocation, exfoliation of the acromial end of the clavicle like “banana peel”, etc. (2) According to the time elapsed since the moment of injury, injuries are divided into: fresh – from the moment of injury no more than 3 days have passed; stale – from 3 days to 3 weeks; old – more than 3 weeks.

Tears of the first and second degree are treated conservatively, with a kerchief or bandage on the shoulder joint. The patient is prescribed non-steroidal anti-inflammatory drugs in ointment and tablet forms, and the simplest local hypothermia (applying an ice pack to the pain site on the first day from the moment of injury).

The main symptom of ACL injury is pain in the shoulder joint and shoulder girdle, from mild pain with a slight sprain of the shoulder ligaments to severe pain with a complete rupture of the ACL. The second and third degree of rupture is accompanied by local edema and the formation of a bruise – a hematoma. A “height” appears in the area of ​​the shoulder girdle, and clicking sounds in the shoulder when moving the hand.

The treatment option for a third-degree tear is chosen by a traumatologist. Perhaps conservative treatment or surgery. A complete rupture of the ligaments triggers degenerative post-traumatic changes in the acromioclavicular joint and contributes to the development of arthrosis. In sports medicine, a complete rupture of the ACL of the 3rd degree is almost always eliminated with the help of surgery (reposition of the bones and fixation in the anatomical position with a metal structure). After restoring the integrity of the ACS, the metal structure is removed.

Physiotherapy (laser therapy, electroanalgesia and magnetotherapy) is prescribed after the operation. Superficial massage is useful for relieving muscle spasm and swelling.

The development of movements in the shoulder joint begins with passive exercises (the movements of the patient’s hand are performed by the exercise therapy doctor) and active movements 6-8 weeks after the restoration of the anatomical integrity of the injured segment.

It is important to understand that “subluxation of the collarbone” is a conditional term. When the ACL is torn, all ligaments in the area are affected. A frivolous attitude to pain in the shoulder after a fall or incorrect therapy can lead to very sad consequences.

Make an appointment with an orthopedic traumatologist

Orthopedic traumatologist — Roman Alekseevich Tarasov

Orthopedic traumatologist — Oleg Nikolayevich Gorbachev

Services that will help

• Assistance with injuries
• Help with fractures
• Treatment of joints, tendons and ligaments
• Help with dislocations

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