Woodland Sports Medicine Center

Broken Collarbone

A broken collarbone, also known as a clavicle fracture, is a break in one of the main bones in your shoulder. The collarbones, or clavicles, are the two long bones on both the left and right side of the body that connect the breastbone (sternum) to the shoulder blade forming the shoulder girdle. The clavicle is the most commonly fractured bone, and accounts for almost five percent of all adult fractures.

Clavicle Fracture Causes

Breaking your collarbone typically results from a direct blow to the shoulder; either from falling downward onto your shoulder or onto an outstretched arm. This type of fracture is a common sports injury that can result from either falling on the field, or direct contact with another player in high impact sports like football, hockey, wrestling, and skiing.

The collarbone doesn’t finish developing, or hardening, until the age of 20, putting children and young adults at the highest risk of a broken collarbone. Older adults with decreased bone strength and osteoporosis also have a higher risk of a clavicle fracture.

Broken Collarbone Symptoms

If you have had an injury to your shoulder and think you may have fractured your clavicle, there are a few signs and symptoms that should tell you it is time to seek medical attention. Symptoms include:

  • Severe pain that increases with shoulder movement
  • Swelling and bruising over the collarbone
  • The shoulder is slumped downward and forward
  • A definitive bump around the area of the potential break
  • A grinding or cracking sound when you try to raise your arm

If you have experienced trauma to the shoulder, are presenting any of the previous symptoms, and have enough pain to prevent normal use of your shoulder, you should see a doctor immediately. If the broken bone is poking through the skin, there is associated numbness in the arm, or if you have any difficulty breathing, it is recommended that you go to the Emergency Department right away.

Diagnosing a Broken Collarbone

In order to diagnosis your broken collarbone, the doctor will ask you questions about how the injury occurred and perform a physical examination to assess the break site. Your doctor will also test the nerves in the arm to ensure no neural injury has occurred. Additionally, your doctor will listen to your breathing to make sure no injury to the lungs has occurred from the broken bone. Then, your doctor will take an X-ray to identify the fracture site and make sure the collarbone has not broken in multiple places. If the fracture isn’t visible on X-ray, your doctor may order a CT scan.

Broken Collarbone Treatment

Conventional Treatment

More often than not, a broken collarbone will heal on its own with time and the proper care. In order for any bone to heal, you must restrict any and all movement of the bone. Because of the location of the collarbone, a cast or brace is usually not necessary. To restrict movement of the collarbone, you will need to wear an arm sling. The arm sling immobilizes and supports the arm to keep the bones in their normal position until the break is healed. You will need to wear the sling at all times until there is no more pain with the movement of your arm and shoulder, which will usually take six to eight weeks for adults and three to six weeks for young children depending on the severity of the fracture. You will need to avoid contact sports for at least six weeks after the initial injury and may take over-the-counter medication to regulate your pain. In some cases, your doctor may prescribe pain medications to reduce pain and inflammation. Applying ice to the shoulder area for 20 to 30 minutes at a time for the first few days after the break will also greatly reduce pain and swelling.

Physical Therapy

It is important to begin rehabilitation of the broken collarbone as soon as pain with movement has reduced. A gentle physical therapy routine of low impact exercises like squeezing a ball in your hand or soft shoulder rotations, as well as soft tissue massage, should prevent your arm and shoulder from weakening and stiffening as it heals. Your doctor or physical therapist may recommend additional physical therapy to regain muscle strength and joint flexibility once your sling is removed.

After the bone has healed and physical therapy has restored normal function to your arm and shoulder, your collarbone should be fully recovered in about three months. Follow up with your healthcare provider until the fracture site has completely healed.

Surgical Treatment

In rare cases, surgical treatment may be required for a broken collarbone if the broken collarbone has fragmented, become displaced with the break, or fractured in multiple places. However, this is quite rare, and surgical treatment is needed in only about 5-10% of clavicle fractures.  

The most common surgical procedure for a broken clavicle is known as open reduction and internal fixation. During this surgery, your doctor will reposition the collarbone into its normal position and then attach metal, surgical screws, plates, or rods to the outer surface of the bone fragment. The metal hardware keeps the fragments in place so that the bone can heal correctly. Plates and screws are not usually removed after the bone has healed unless they are causing discomfort. Although uncommon, the plates and screws may cause irritation and can be removed after the fracture has fully healed. Instead of plates, pins can be inserted through smaller incisions to hold the bone fragments in place. Unlike plates and screws, pins are usually removed after the fracture has healed because they often cause irritation in the skin.

Prevention

The easiest way to prevent clavicle fracture, specifically in sports, is to ensure that you are using proper sports equipment, like shoulder pads, during contact sports such as football and hockey. Other ways to prevent bone fracture are to consume recommended amounts of Calcium and Vitamin D, exercise frequently, and ask your doctor about a bone mineral density test.

Care at The Woodlands

If you have experienced a broken collarbone and are seeking treatment and physical therapy rehabilitation, The Woodlands offers specialized, quality care for sports related injuries. At The Woodlands Sports Medicine Centre, our trained staff and experienced orthopedic surgeons offer a variety of services including diagnosis, conservative treatments, surgery, and rehabilitation.

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