Clavicle Fracture (Broken Collarbone)

A clavicle fracture is a broken collar bone. In our practice, we see a lot of these injuries in cyclists and also during the winter season in snowboarders. It is usually due to a fall at relatively fast speeds with the impact of the fall borne by the shoulder and collar bone. There is usually pain at the collarbone with an obvious swelling and deformity in that region.

Doctor Examination for Clavicle Fracture 

There is usually an obvious deformity, or “bump,” at the fracture site. Gentle pressure over the break will bring about pain. Although a fragment of bone rarely breaks through the skin, it may push the skin into a “tent” formation.

We will carefully examine your shoulder to make sure that no nerves or blood vessels were damaged and also assess if there are associated injuries.

X-rays of the entire shoulder will often be done to check for additional injuries. If other bones are broken, we may order a computed tomography (CT or CAT) scan to see the fractures in better detail.

Clavicle Fracture Surgery

If your bones are out of place (displaced), your doctor may recommend shoulder surgery. Surgery can align the bones exactly and hold them in good position while they heal. This can improve shoulder strength when you have recovered. The advantage of surgery is that you do not need to immobilise the shoulder and can move it immediately after surgery. This means that you are unlikely to develop shoulder stiffness and weakness.

During the operation, the bone fragments are repositioned to their normal position. Then, they are held in that position with special screws. Some doctors may also attach some metal plates on the outer surface of your bone. After the surgery, you can notice that there are some small patches on your skin. These patches will be less noticeable as time passes. In some cases, you may feel the metal plates through your skin.

These screws and plates are usually not removed. However, there are some cases where the screws and plates cause discomfort. In these cases, they can be removed by surgery after the fracture has healed completely.

Rehabilitation for Clavicle Fracture 

Therapy programmes usually start with gentle range of motion exercises. Once fracture healing has progressed well and pain has subsided, the focus of rehabilitation shifts towards regaining strength and function in the muscles around the shoulder and clavicle.

Surgical Complications 

People who have diabetes, are elderly, or are smokers have higher risks of getting complications after surgery.

The commoner risks include:

• Infection
• Bleeding
• Pain
• Damage to blood vessels or nerves
• Delay in bone healing
• Rarely, injury to the lung (that lies below the clavicle or collar bone)

Outcome 

Complete healing for upper limb fractures usually takes 3 months. A return to high impact and high load activities such as weight lifting might require a longer period of rehabilitation. Discuss this with your surgeon for the treatment of your clavicle fracture.