The collarbone (clavicle) connects the arm to the body; most fractures come from a direct blow to the shoulder or a fall [1]. A fracture that has not moved is treated with a sling, painkillers and gentle exercise; surgery is advised if the broken ends are badly displaced [1]. Most people return to normal activities within 3 months of the injury [1].
What is a collarbone fracture?
The clavicle lies between the breastbone and the shoulder blade and connects the arm to the body. Important nerves and blood vessels run beneath it, so they are checked for injury as well [1].
What causes it?
Most fractures follow a direct blow to the shoulder: a fall, a road traffic collision or a sports injury. Falling onto an outstretched arm is also a common cause. Babies can break it during birth [1].
What are the symptoms?
- The shoulder sags downwards and forwards
- Not being able to lift the arm because of pain
- A grinding feeling when you try to raise the arm
- A visible deformity or bump at the fracture
- Bruising, swelling and tenderness over the collarbone
Diagnosis
We look for deformity and test for nerve and blood vessel damage. X-rays show where the fracture is and how severe; a CT scan may be ordered for complex breaks [1].
Non-surgical treatment
For a fracture that has not moved, a sling gives comfort, paracetamol or anti-inflammatory painkillers manage pain and gentle exercises keep the shoulder moving. Once the bone begins to heal the pain eases and shoulder exercises are given to prevent stiffness [1].
When is surgery recommended?
Surgery is advised when the broken ends are very displaced (out of normal alignment). In open reduction and internal fixation the fragments are repositioned and held with plates and screws (usually permanent unless they cause discomfort) or with pins or screws (usually removed after healing) [1].
Recovery
Most people return to their regular activities within 3 months of the injury. Complete healing takes several months, and healing is delayed in people with diabetes and in tobacco users [1]. Once the bone has fully healed it is safe to return to sport and other physical activities [1].
What can go wrong?
With non-surgical treatment the bone may fail to heal (nonunion), heal out of position (malunion) or leave a prominent bump. With surgery there can be infection, bleeding, wound healing problems, numbness below the collarbone, irritation from the implant, nerve and vessel damage and, rarely, lung injury [1].
Frequently asked questions
- Does a broken collarbone heal by itself?
- A fracture that has not moved heals with a sling and gentle exercise; if the broken ends are badly displaced surgery is advised [1].
- When can I return to work and sport?
- Most people are back to normal activities within 3 months; sport follows once the bone has fully healed [1].
- Is the plate removed afterwards?
- Plates and screws are usually permanent unless they cause discomfort; pins and screws are generally removed after healing [1].
- Does smoking affect healing?
- Yes, healing is delayed in tobacco users and in people with diabetes [1].
At our clinic we weigh the fracture against what you need your arm to do, looking at how far the broken ends have moved.
Sources
- Clavicle Fracture (Broken Collarbone). American Academy of Orthopaedic Surgeons (OrthoInfo), n.d.. orthoinfo.org
This article is general information and does not replace an examination or imaging. If you have symptoms, see a doctor.
More in this area
- Bursitis: what is it, what causes it? Elbow bursitis, symptoms and treatment
- Frozen shoulder: how long does it last, and when are injections or surgery considered?
- Shoulder pain and rotator cuff problems: is surgery needed?
- Calcific tendinitis of the shoulder: why it happens and how it is treated
- Dislocated shoulder: what happens after it is put back, and is surgery needed?
- Shoulder pain: what causes it, what helps and who to see
- Tendinitis (tendon inflammation): what causes it and what helps it settle?
- Tennis elbow: what do steroid injections, PRP and surgery add?