The clavicle is a commonly injured bone in both children and adults. The clavicle is also known as the collar bone. It is the first ossified bone in the human body and connects the arm to the trunk. Clavicle fractures are relatively common, accounting for 5% of fractures in adults in the United States. Management of collar bone fractures in adults depends on the extent of the injury. Nondisplaced fractures can be managed conservatively while displaced fractures necessitate surgery. Displaced fractures require the consultation of an orthopedic surgeon. Clavicle fractures are a common cause of shoulder pain.
What is the Clavicle (Collarbone)?
The clavicle, or collarbone is a long, thin bone overlying the chest. Specifically, it connects the front, flat plate of the rib cage, the sternum, to the scapula via the acromion, a bony prominence right before the shoulder joint. The clavicle is connected to these bones by multiple ligaments. It has multiple functions. First, it stabilizes the arm’s connection to the trunk acting a strut holding your arm out to length. Second, it acts as another layer of protection for the delicate nerves and vessels lying underneath.
How does someone break their collarbone?
Due to its location and the forces it experiences, the collarbone is prone to injury. 69% of collar bone fractures, occur in the middle of the bone rather than the ends. The vast majority of clavicle injuries are caused by a fall onto the shoulder. In younger people, these falls often occur in traffic accidents or sporting incidents. In a small number of people, the injury occurs after falling onto an outstretched hand.
What does a collarbone fracture feel like?
A broken collarbone typically presents with pain and difficulty moving the affected side. There may be bruising, swelling, a bump, or tenderness over the area of the clavicle. The patient can have difficulty raising the arm on the affected side or they can have difficulty moving that arm due to pain. The shoulder can also sag downward and forward.
Typically, a clavicle fracture is diagnosed with imaging. A physician will normally conduct a physical exam and then order X-Rays. X-rays can show bony surfaces and relatively adequate detail. Therefore, there are useful when looking for fractures. However, X-Rays will not show any damage to the muscle or soft tissue of the shoulder joint. If a physician suspects more extensive injuries to the shoulder joint, he or she may order additional imaging, such as Magnetic Resonance Imaging.
How to Treat a Clavicle Fracture
A clavicle fracture can be treated surgically or non-operatively. Choosing the correct management option depends on the extent of the injury.
Non-operative management is ideal for people whose fracture is relatively nondisplaced, meaning that the fractured pieces have not significantly shifted. Non-operative management revolves around rest, pain management, and ultimately physical therapy. Typically, patients will rest their arm using a sling while the clavicle heals. Pain relief can be accomplished through medications, like acetaminophen, or other measures, like ice. Eventually, physical therapy can help strengthen the joint. Physical therapy should be done with qualified professionals. It is important to slowly build strength and improve mobility as tolerated. The disadvantage of non-operative management is that it increases the risk of malunion. A malunited bone is one that has not shown evidence of bone healing.
Surgical treatment is well-suited for people whose clavicle fractures are displaced and need to be shifted back into the proper position. Surgery can involve plates or pins and screws. Some surgeons favor plates and screws because certain studies have demonstrated that plates improved shoulder scores more than other methods, particularly with unstable fractures. In other situations, some surgeons may favor pins because the incision is smaller. Like non-operative management, surgical management will most likely involve physical therapy. Physical therapy helps improve the strength and mobility of the joint as it continues to heal. The disadvantages of surgery are the complications associated with surgery. These include infection, blood loss, blood clots, and complications secondary to anesthesia.
The clavicle is a thin bone that connects the arms to the trunk. It is easily injured by falls, traffic accidents, or sporting incidents. Symptoms include pain and difficulty moving the arm on the affected side. Depending on the extent of the injury, the primary physician may consult an orthopedic surgeon for expert management. Clavicle fractures can be managed surgically or non-operatively. Both treatment options will involve physical therapy. Ask Dr. Morton about your options in regards to clavicle fractures. He can review your imaging with you and show you if your clavicle meets the condition for surgery or for nonoperative treatment.
Frequently Asked Questions About Clavicle Fractures (FAQ)
Are there any special braces or slings for a clavicle fracture?
Orthopedic surgeons used to treat many patients with figure-of-eight braces. We found out that these braces do not make an impact on the final outcome or healing rate of broken collarbones. Most orthopedists have abandoned the practice of using a figure-of-eight sling. We commonly treat people with a regular sling until they are comfortable moving their arm on their own.
How long will it take to heal my broken collarbone?
It can take up to 3 months for your collarbone to completely heal. Dr. Morton will obtain regular x-rays to evaluate the healing of your clavicle fracture. Many patients are no longer in pain within the first 1 to 2 months. Range of motion activities and physical therapy can accelerate your recovery.
What is the fastest way to heal my collarbone fracture?
To ensure a speedy recovery you should avoid nicotine products, you may take anti-inflammatories (ibuprofen, naproxen, etc), work on range-of-motion exercises, and eat a healthy diet with calcium and protein.
How can you sleep comfortably after a broken clavicle?
You can sleep in a more upright position, using pillows to support yourself. Ice-packs and anti-inflammatory pain medication will help improve the swelling and pain. Stay mobile with range-of-motion activities for your shoulder, elbow, and wrist.
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Meet Dr. Paul N. Morton, MD
Dr. Paul N. Morton, MD is a fellowship-trained orthopedic surgeon in hip and knee surgery, specializing in robotic joint replacements, complex joint reconstruction, sports injuries, and trauma. Reach out to him to learn more about treatment options for your problem.
Written By: Dr. Paul N. Morton, MD
Post Published on April 22, 2020