Clavicle fractures

What is a clavicle fracture?

A clavicle fracture, more commonly known as a broken collarbone, frequently occurs in children, adolescents and young adults. The clavicle is the bone that joins the shoulder blade to the upper part of the breastbone and it is not fully hardened until around the age of twenty, which is why children and adolescents are more at risk.

Older people are also more prone to clavicle fractures as the bones become weaker with age. Babies may also fracture a collarbone during the birthing process.

If you suspect you have fractured your clavicle, you should see a doctor immediately. Although fractures normally heal well, if they are not diagnosed and treated appropriately, healing may be incomplete and surgery may be needed to realign the broken bone.

What causes a clavicle fracture?

Fractures normally occur as the result of:

Landing heavily on your shoulder during sports such as ice-skating, tennis or rugby
Trips and falls, particularly if you fall onto your shoulder or outstretched hand
A car, bike or motorbike accident
Birth injury in babies

Clavicle fracture

What are the symptoms of a clavicle fracture?

Symptoms include:

Swelling, bruising and tenderness
A lump on or near your shoulder
Restricted movement in your shoulder
Pain that is worse when you use your shoulder
Newborns that are reluctant to move their arm

Although most clavicle fractures heal well, complications can occur if:

There is damage to the nerves or blood vessels caused by the displacement of the broken collarbone. You should seek immediate medical attention if your arm or hand becomes numb or cold following a clavicle fracture.
The break is severe and the bones do not meet fully during the healing process the collarbone may become shortened.
A lump develops where the broken ends of bone knit together. Most lumps get smaller or can disappear over time but some may be permanent.
The fracture occurs in the joints connecting your collarbone to your shoulder blade or breastbone. This can increase your risk of osteoarthritis.

How is a clavicle fracture diagnosed?

After a physical examination, your consultant will refer you for an X-ray to determine the location and extent of the fracture and whether or not there is injury to the joints. If necessary you may also be referred for a CT scan, which will provide more detailed images.

How is a clavicle fracture treated?

Some fractures can be treated without surgery. You will need to wear an arm sling to immobilise the fracture and allow the collarbone to heal. It normally takes three to six weeks for bones to heal in children and six to twelve weeks in adults. During this time you may need painkillers. You will also need physiotherapy to help you rehabilitate and avoid joint stiffness. A baby that has sustained birth injuries will normally heal well with pain control and careful handling.

Open reduction and internal fixation (ORIF): In some cases where the fracture has resulted in the bone fragments being jolted out of alignment, you may require surgery to stabilise and heal the clavicle. ORIF brings the bones back into place and keeps them there until they are able to heal completely.

An “open reduction” means your surgeon will reposition the bones during surgery.Internal fixation uses plates and screws to hold the bones in the correct alignment so that they can heal correctly. The procedure is performed under general anaesthetic.After surgery you will need to wear an arm sling but generally for less time than if the fracture is treated non-operatively. Physiotherapy will also be needed after surgery to regain the movement and strength in your shoulder joint.