Introduction
Broken clavicle (collar bone) is a common injury.
The clavicle connects the ribcage(sternum) and shoulder blade (scapula). The clavicle acts as a rigid strut between the shoulder and the rest of the body. It also serves to protect underlying blood vessels and nerves.
Clavicle Fractures comprise 5% of all fractures and most commonly occur in males around 20 years of age.
80% of clavicle fractures occur in the middle part of the bone. Fractures of the outer edge (lateral) clavicle are more complex and may involve ligament or joint injury as well.
Causes
This injury occurs as a result of a fall onto the affected arm. For example:
- Fall during sport.
- Falling off a bicycle.
- Footy tackle.
- Motor Vehicle Accident.
Symptoms and Signs
Diagnosis is based on patient symptoms, examination findings and x-ray:
- Pain.
- Deformity (Bump) where the bone is broken.
- Bruising.
- Swelling.
- Tenderness to touch.
- Skin injury in open fractures, there is disruption of skin over the fracture.
Tests
X-ray
This will show the fracture. The fracture may be simple two-part fracture or may involve more than two parts (comminuted fracture).
X-ray will reveal the amount of displacement (how much separation) there is between the fracture fragments.
Non-surgical treatment
Fractures with minimal displacement of bone fragments can usually heal well without the need for surgery. The treatment for these patients includes a number of things.
Sling
A shoulder immobiliser sling is used to keep the clavicle still to allow the fracture to heal and settle the pain down.
Pain Killers / Anti-inflammatory Medications
These assist with pain only.
Ice
Ice will help with pain and swelling in first 2-3 days.
Follow up visits / x-rays
The bone fragments can sometimes move until the fracture heals. Follow up x-rays and visits are required to ensure that the fracture is healing in satisfactory alignment.
Physiotherapy
Physiotherapy may be required in some cases to return shoulder to normal strength and movement after fracture has healed.
Recovery and Return to Sport
Arm is kept in sling for 6 weeks. Return to sports occurs at the earliest 6-10 weeks post injury.
It may take 3-4 months before achieving normal strength and movement in affected shoulder.
Risks of Non-Surgical Treatment
- Non-union (Failure of healing) 5%.
- Malunion (Healing in abnormal position) 10-20%.
- Cosmetic deformity / bump.
- Weakness.