Clavicle Fractures

The clavicle is the collar bone, and it connects your shoulder blade to your breastbone. You can feel both of your clavicles very easily because they are right under your skin. The bone bends like an S as it goes from the center of your chest to your shoulder blade.

How do clavicle fractures occur?

Most clavicle fractures occur after direct impact on the side of the shoulder. Some common instances include when bike riders crash and fall over their handle bars and land directly on the shoulder.

Other high energy incidents, such as a car accident, can result in a clavicle fracture.

How do you diagnose a clavicle fracture?

The most common symptom after a clavicle fracture is severe pain.

The clavicle fracture will cause a deformity over the shoulder and there will be swelling and black and blue areas the next day. Your provider will confirm the diagnosis with an x-ray.

How is a clavicle fracture treated?

Most clavicle fractures will heal as long as the arm is immobilized in a sling. When the clavicle heals, there will be a bump around the fracture, but the strength and motion of the arm will be normal. The fracture needs 12-16 weeks of healing before the patient can use it for full activity. Some fractures will heal better if they are fixed with surgery. This depends on the location of the fracture, the amount of displacement between the ends of the broken bone and the number of breaks in the bone.

Your surgeon will be able to recommend the best treatment path after looking at the x-ray.

To help your clavicle heal following a fracture, there are certain things you should avoid doing. This includes smoking, which brings high levels of carbon monoxide into your body keeps the microscopic blood vessels from delivering oxygen to the fracture. Without enough oxygen, the fracture will not heal.

Also, early use of the arm before the doctor allows the sling to be taken off will delay or inhibit healing.

What do I need to know about surgery for clavicle fractures?

Surgery can be done to repair displaced clavicle fractures. The decision to have early surgery for a clavicle fracture depends on many factors, and you should understand the risks and the benefits of surgery before making a decision to have surgery for a clavicle fracture.

The benefits of surgery include a higher healing rate by 10-20%, 20% less pain after the fracture heals and an earlier healing time of about two weeks.

However, risks from surgery include infection or irritation of the hardware that is used to fix the clavicle and injury to the nerves and blood vessels under the clavicle during the surgery. Some patients may need a second surgery to remove the hardware used to repair the clavicle if it is painful.

Before the surgery, you will get a nerve block to numb the shoulder so that you will have minimal pain when you wake up from anesthesia.

Surgery to repair the clavicle starts with an incision over the clavicle that is about 5-10 cm long. The surgeon will carefully put the pieces of bone back where they belong and hold them in place with a metal plate and screws.

The incision is closed, and a waterproof dressing is placed over the clavicle.

When you wake up, you will have your arm in a sling. You'll have to keep your arm in the sling for 4 weeks.

If x-rays show your clavicle has healed significantly at 4 weeks, you may stop using the sling and perform very light activity with the arm.

Three months after surgery, x-rays are taken to confirm healing of the fracture and you can gradually return to normal activity.

Recovery Timeline

• First 4 weeks: Your arm will be in a sling to protect the repair. You will take the sling off for showers and to bend the elbow a few times a day. Absolutely no reaching, lifting or pushing with the arm. You can move the arm away from the body to wash your underarm. You can type with your hand and hold a cell phone.
• 4 weeks: You can stop using the sling. You can reach with the arm, but no lifting anything more than a coffee cup with the arm. You can start stretching the shoulder in all directions with the counter top stretch, internal rotation stretch, and external rotation stretch.
• 10 weeks after surgery: If your x-rays show healing of the fracture, you can start to return to your normal activities gradually.
• Return to work: You can return to work within a few days after your surgery as long as you are no longer taking narcotic pain medications. You will be able to use the hand to type and write, but no lifting is allowed.