Anatomy of the Clavicle
Commonly known as the “collarbone”, the clavicle is a long, thin bone that runs from the scapula (shoulder blade) to the sternum (so, the human body has two clavicles). As such, it helps in connecting the arm to the rest of the body. It also lies just above several key blood vessels and nerves, but fortunately these are hardly ever injured when the clavicle is broken or fractured. Most of these injuries tend to happen in the middle of the bone.
Clavicle fractures or “broken collarbones” are relatively common among athletes, and since the clavicles do not harden completely until a person reaches their early 20s, children are much more likely to experience them than adults. When it comes to athletes, a hard fall to the elbow or shoulder can cause the clavicle to break simply through transmission of force.
- Difficulty lifting the arm
- Visible deformities or bumps
- Should sagging forward and down
- “Grinding” sensations when attempting to lift the arm
Clavicle fracture sites are usually easy to find thanks to visible bumps or other deformities. Additionally, any applied pressure on the area can cause pain. While it is rare for clavicle fractures to result in bones poking through the surface of the skin, sometimes fragments form a sort of skin “tent” that helps lead a doctor to the site of injury. In any case, your doctor will carefully evaluate your injury and examine the area to assess the amount of damage (sometimes nerves and blood vessels are affected). An X-ray may also be done for further assessment.
The good news is that most clavicle fractures heal quite well without surgical intervention. Arms may be placed in slings to keep the area immobilized so the bones can heal. Children generally have to wear a sling for up to three or four weeks, while adults may be required to wear them for up to six or even eight weeks.
In the meantime, anti-inflammatory medication like aspirin or ibuprofen may also be recommended to help ease any pain. Analgesics like acetaminophen may also be prescribed.
Large bumps may develop on the injured area during the healing process, but this is normal and they will most likely disappear as time goes on. However, it is also normal for a small bump to remain.
Shoulder mobility will gradually return in time. Only in cases of severe injury will there be any lasting limitations. Still, with proper strengthening and motion-range exercises the results will be better. These exercises can start almost as soon as pain from the injury goes away. Nevertheless, sports should not be resumed until the shoulder’s full strength comes back.
In more severe cases, surgical intervention may be necessary. Additionally, when it comes to clavicle fracture patients who do a lot of overhead manual labor or young patients who are active athletes, modern research indicates that surgical treatment may actually have a better outcome than non-surgical treatment. Recent studies have demonstrated that surgery in these groups can result in more regained strength and agility in the shoulder.
Surgery is indicated when:
- A significantly displaced fracture
- Significant deformity to the shoulder
- Damage to the skin near or overlaying the injury
- When a previous fracture fails to heal after surgery, also known as a “non-union”
When a previous fracture heals, but in the wrong position, also known as “mal-union”