Clavicle Fracture (Broken Collarbone)

About clavicle or collarbone

The clavicle (also called collarbone) is one of the main bone in the shoulder and the one that connects the breastbone to the shoulder.

A broken collarbone is a quite common injury, particularly in children and young adults.

Broken Collarbone possible causes

Most clavicle fractures occur as a consequence of a fall onto the shoulder or an outstretched arm.

This can happen practicing sports such us football, hockey, skiing, skateboarding, biking or also during a car crash or any accidental fall.

A clavicle may break also at birth, when the baby pass  through the birth canal.

What Are the Signs & Symptoms of a Broken Collarbone?

Signs and symptoms of a broken collarbone include:

• Pain over the clavicle that increases with shoulder movement
• Swelling
• Tenderness
• Bruising
• Inability to move the shoulder
• A bulge or “bump” over the shoulder
• A grinding or crackling when raising the arm

How is a Broken Collarbone Diagnosed?

First of all, the orthopedic surgeon will perform a physical exam to inspect the affected area. He or she will also perform tests to ensure that no blood vessels or nerves were damaged.

X-rays may be ordered to determine the extent of a broken collarbone and its location. The doctor might also recommend a CT scan to get more-detailed images.

Broken Collarbone Recovery and Treatment

Most broken collarbones heal without difficulty.

If the bones have no significantly shifted out of place, surgery may not be necessary.

Nonsurgical Treatment

Nonsurgical treatment may include:

• Ice for pain and swelling
• Arm support. An arm can be supported by a sling or a shoulder immobilizer, immediately after the break.  The support will be worn for about a month and will keep the arm and shoulder in position while the injury heals.
• Physical therapy. It is important to maintain arm motion to prevent stiffness. Most patients will start exercises immediately after the injury.
• Follow-up. It is important to see the doctor regularly until the fracture heals. After the sling is removed, the doctor might recommend additional rehabilitation exercises to restore muscle strength, joint motion and flexibility.

Broken Collarbone Surgery

The orthopedic surgeon may recommend surgery if the collarbone has broken through your skin, or if bones have significantly shifted out of place.

Surgery is performed to put the broken pieces of bone back into position and maintain them in proper position during healing.

Open reduction and internal fixation is the most often used procedure to treat clavicle fractures. During the procedure, orthopedic surgeon repositions (reduces) the bone fragments into their normal alignment. Then those pieces of bone are then held in place with special metal hardware such as plates, pins and screws.

Plates, pins and screws are not routinely removed after the bone has healed, unless they are irritating the skin, causing discomfort.

Outcome and Complications

Whether the treatment involves surgery or not, it can take several months for a clavicle to heal.

Usually, people return to their normal life within 3 months. But always refer to your doctor that is the only one who can tell you when your injury is stable enough to return to regular activities.

Most broken collarbones heal without difficulty, but some complication may occur, such as:

• Moving out of place: clavicle fracture can move out of place before it heals. Always follow up regularly with your doctor to make sure the bone stays in position.
• Nerve or blood vessel injury. if you notice numbness or coldness in your arm or hand, you should seek immediate medical attention
• Poor or delayed healing. If the injury is particularly severe, clavicle might heal slowly or incompletely.
• A lump in the bone. As the fracture heals, a large bump over it may develop (in the place where the bone knits together). Most lumps get smaller over time and disappear, but some may remain permanently.
• Osteoarthritis. If the fracture involved the joints that connect the clavicle to the shoulder blade or the breastbone, this may increase the risk of developing arthritis in that joint.

Prof. Nicola Portinaro’s experience

Prof. Portinaro may ask you some questions like

• How did the injury occur?
• Have you ever had a broken bone before?
• Are you affected by any underlying condition such as been osteoporosis or weakened bones?

He may also ask for X-Rays or other tests if you don’t have already taken them.

Then he will decide with you the best treatment for your condition and discuss the risks and benefits of both non-surgical treatment and surgery when needed.

He will also suggest you:

• when you can start using your arm and return to work and normal activities
• exercises and physical therapy

Prof. Portinaro is has been treating clavicle fractures for more than 30 years.

He has personally performed more than 200 surgeries both in adults and child with successful techniques.