Broken Collarbone

A broken collarbone, also called a clavicle fracture is a very common injury that can happen at all ages, but these fractures are more common in children and young adults as these bones do not harden until they reach adulthood.

The collarbone is a thin, long bone between the upper part of your breastbone and your shoulder blade.

A broken collarbone usually occurs by landing on your shoulder during a fall or while resisting a fall with your outstretched arms.

Common causes of a broken collarbone include falls, sports injuries, and trauma from vehicle accidents.

In newborn infants, collarbones may break during the natural birth process, while passing through the birth canal.

Most clavicle fractures respond well to conservative treatments such as ice, pain relievers, a sling, physical therapy and time.

However, a complicated fracture need surgical realignment of the broken bone with the placement of implant plates, screws or rods into the bone for the bone to be held in place during the healing process.

The signs and symptoms of a broken collarbone include:

• Pain that increases while moving your shoulder or arm
• Bruising, swelling, and tenderness of the collarbone
• A crackling or grinding sound heard when raising an arm
• A sagging shoulder
• A deformity or bump over the collarbone area
• Stiffness causing inability to move your shoulder
• A tingling sensation or decreased feeling in your arms and fingers

If you have had a fall and any of the above signs or symptoms of a broken collarbone, seek immediate medical attention as delayed diagnosis and treatment may lead to poor healing of the fracture.

Common causes of a broken collarbone include:

• Falling onto your shoulder
• Sports injuries, such as a direct blow to your shoulder
• Trauma due to a vehicle collision
• Birth injury in an infant while passing through the birth canal

Making a diagnosis of broken collarbone is done by several tests.

Depending on the severity of your fractured bone, your family doctor or the emergency room physician will refer you or your child to an orthopedic surgeon.

You should prepare a list that includes:

• Details about your symptoms and the event that caused the fracture
• Information regarding your past medical conditions
• All your current medications and dietary or homeopathic supplements
• Questions you may want to ask your doctor

Your doctor may ask some of the following questions:

• How did the injury occur?
• Did you have a broken bone in the past?
• Have you been diagnosed with weak bones?

During the physical examination, your doctor will carefully examine your shoulder to check for tenderness, swelling, deformity or an open wound.

X-rays of the entire shoulder area may be ordered to determine the extent and severity of the broken collarbone, its exact location, and to check if other joints are damaged.

Your doctor may also recommend a CT scan to view the fractures in better detail or if there is evidence of other broken bones.

Specific treatment is not necessary for broken collarbone. A broken collarbone can fuse together without surgery if the broken ends of the bone line up in correct position without being displaced.

Limited movement of the broken bone is crucial for proper healing as well as:

• Arm support and immobilization: A simple arm sling or figure-of-eight wrap is usually worn to support your arm and and immobilize the broken collarbone while it heals. It requires at least 3-6 weeks for bone healing to be complete in children and about 6-12 weeks in adults. The period of immobilization depends on the severity of the fracture. The collarbone fracture that takes place during labor normally heals with careful handling of the baby and pain control.
• Medications: Your doctor will advise over-the-counter painkillers to reduce pain and inflammation. If the pain is very severe, you may be prescribed narcotic medications for few days.
• Physical Therapy: Rehabilitation should begin as soon as the initial treatment is complete. You are likely to lose muscle strength in your shoulder while you are wearing the sling. As the pain decreases, once your bone heals, your doctor will teach you gentle shoulder and elbow exercises that prevent stiffness in your shoulder.
• Surgery: Surgery may be required if the broken collarbone is severely displaced or is exposed through a skin breach or is broken into several pieces. Surgery to repair a broken collarbone usually includes placement of fixation devices such as plates, screws or rods to maintain correct position of your bone during healing. Surgical complications, though rare, can include infection and lack of bone healing.

Lifestyle modifications are necessary in order to cope with broken collarbone.

Applying an ice pack to your shoulder can relieve your pain.

On the day of your injury, apply the ice-pack to the affected areas for about 20 minutes, every hour while awake.

Then, the ice-pack may be placed once in every 3-4 hours for about 20 minutes

For the initial few days, when the bone healing takes place, it is advised to wear a sling or wrap.

This helps in the following ways:

• Holds your collarbone in the correct position during the healing period
• Avoids movement of your arm, which can be painful

Once you are able to move your arm without any pain, you can perform gentle exercises that help to increase the strength and improve your arm movements.

The return to normal activities should be gradual, and if you feel pain in your shoulder or arm, stop exercising immediately and take rest.

For people involved in contact sports, all sports activities should be avoided for 1 month after the collarbone has healed.

There are several risks and complications associated with broken collarbone.

As the ossification of the collarbone is complete only at the age of 20, this bone in children and teenagers is more susceptible to fracture.

The risk of a broken collarbone is less after the age of 20, but then again the risk is higher in elderly people as their bone strength decreases with age.

Most of the time, the broken collarbone heals normally without any problem.

Complications of a broken collarbone, when they occur, might include:

• Injury to the nearby nerves or blood vessels by rough ends of a broken collarbone. Seek immediate medical attention if you feel your arm or hand is numb or cold.
• Malunion: The fractured bone may get displaced out of its position before it heals, and if the bone fragments heal in that position, it is termed,"malunion". Poor union of the bones may cause a decrease in the length of the bone.
• Poor or a delay in healing: A severely broken collarbone may heal slowly or incompletely.
• A large bump at the fracture site: As the fracture healing takes place, a large bump may develop at the place where the bone joins together. These bumps may become smaller over some time, but a small bump remains permanently.
• Osteoarthritis: If a fracture involves the joints that connect your collarbone to your shoulder blade or your breastbone, there is a higher risk of developing arthritis in that joint.