A clavicle fracture is a broken collarbone.
A clavicle fracture is a broken collarbone.
What is a clavicle fracture?
A clavicle fracture is a break of the collar bone which links the upper arm to the torso. It commonly occurs following a fall onto the outstretched arm or directly onto the shoulder.
Collarbone injuries are very common particularly in children and in sports people, especially contact sports and cycling. The fractures are classified by their location in the bone (middle or ends), how many pieces it is broken into and whether the nearby joints are involved.
The symptoms of a clavicle fracture are notoriously painful and almost impossible to ignore. Immediately, you will feel sudden, intense pain at the site of the break, followed by swelling or tenderness around the injury. You may also notice a bump in your skin over the break, and in some rare cases, the bone may break through the skin, causing you to bleed. You will have pain with moving your shoulder or lifting your arm. Other rare symptoms include numbness or pins and needles in the arms, indicating possible nerve damage.
In the case of clavicle fracture, a physical examination by your doctor is usually enough to determine the cause of pain, as the skin around the injury often shows signs of swelling, deformity, and tenderness. Dr Cheriachan will take an X-ray to determine the severity of the injury to the bone and the surrounding joints, and in turn, the best treatment option. In some cases a CT scan may be required to better assess the bony fragments particularly if they are close to the joints.
The most appropriate treatment depends on the severity and location of your clavicle fracture. If the break is simple – for instance, the bone is broken in the middle into two pieces – it will likely heal with non-surgical management in a sling. For more complex breaks, such as breaks in multiple fragments, involving the surrounding joints or significant misalignment of the bone, surgery may help increase the likelihood of the bone healing. Surgery does not make the recovery quicker it just reduces the risk of the bone not healing. For example with fractures in the middle of the bone in multiple pieces the risk of the bone not healing is 15% with non operative management compared to 5% with surgery.
If you choose to have surgery, Dr Cheriachan will restore your clavicle to its correct anatomic position and insert a plate and screws to hold the fracture in the right position until it heals.
Most people who have broken clavicles heal and are able to get back to regular life and activites within three months. Even if you have had surgery to reset bones, it’s especially important that you adhere to Dr Cheriachan’s advice and avoid any activities that may disrupt the healing process. Otherwise, it’s possible to refracture the bone, or the bone may not heal and have to begin the process again.
Whilst the majority of people who undergo shoulder surgery do well and are very happy with their function and result, there are risks which are specific to shoulder surgery in addition to the general risks of surgery as listed in the FAQ section of this website.
The specific risks of surgery to fix a clavicle is hardware irritation. With the plate close to the skin irritaion may occur and require the plate to be removed in a follow-up operation if it continues to be an issue.
Patients are likely to experience some numbness over the front of their chest that will improve with time. This is caused by the superficial skin nerves being cut during the operation. Less common risks such as the bone not healing despite the operation which is more likely in people who smoke and in people with diabetes. There are also extremely rare complications such as nerve or vessel injury which have been reported in the literature. Dr Cheriachan will discuss these risks with you in detail during your consultation.
The post-surgery rehabilitation process for a broken clavicle is the same with or without surgery. Surgery does not make the recovery quicker, it improves the healing process of the bone.
Rehabilitation begins at 6 weeks (3 to 4 for children) of immobilisation in a sling. During this time, gentle motion exercises are prescribed for the arms and shoulders. Maintaining arm motion is important for preventing stiffness, especially in the elbows.
After six weeks you can stop using your sling and commence driving, light activities and lifting. Heavy lifting and impact activities should be avoided for a further six weeks.
Twelve weeks after your injury or operation you can commence strengthening exercises and return to most activities. Contact sports should be avoided until 6 months post injury or operation to reduce the risk of re-fracturing the bone. Nearly all patients regain full motion and strength.
Additional information can be found here.
Preparing for your visit
Your first visit will be used to carefully assess your condition as well as gathering all related health information. It is important that you bring all relevant documents including scans and x-rays. We also ask that you wear clothing that allows freedom of movement as your visit will include a physical examination.