Clavicle Fracture

Clavicle fractures typically occur due to a fall onto the shoulder or an outstretched arm. They can also result from direct impact to the collarbone, such as during a car accident or sports injury.

Individuals with a clavicle fracture often experience sharp pain at the site of the fracture, difficulty lifting the arm, a sagging shoulder, and a grinding sensation when attempting to raise the arm. A visible bump over the fracture site, bruising, and swelling may also be present.

Some clavicle fractures can heal on their own, particularly if the broken ends of the bone are well aligned. Rest, immobilization with a sling, pain management, and gradual rehabilitation exercises can aid this natural healing process.

Diagnosis typically involves a physical examination and imaging tests. During the examination, the doctor will look for tenderness, swelling, and deformity. X-rays are the primary imaging test used to confirm a clavicle fracture and evaluate its severity.

There are three types of clavicle fractures, classified by their location:

1. Midshaft fractures, which occur in the middle of the collarbone and are the most common.
2. Distal fractures, which occur at the end of the collarbone, near the shoulder.
3. Medial fractures, which occur at the end of the collarbone, near the sternum.

Treatment for clavicle fractures can be either non-surgical or surgical. Non-surgical treatment, typically recommended for fractures with well-aligned bone fragments, includes immobilization with a sling, medication for pain control, and physical therapy. If the bones are significantly displaced, surgery may be necessary.

Surgery is usually recommended for individuals who have severely displaced fractures, open (skin-penetrating) fractures, fractures associated with nerve or blood vessel damage, or fractures that failed to heal properly (nonunion). Even some fractures that are displaced and heal that way (malunion) or do not heal (nonunion) may not cause symptoms. However, in very active patients, or those who do a lot of overhead activities, fractures that heal out of place or shortened may cause some dysfunction and pain in the shoulder. This can be corrected with surgery, but the surgery is more difficult once it is healed. Additionally, many patients are able to get back to activities and be more comfortable sooner with surgery. The timing of surgery depends on the specific circumstances of the patient and the fracture, but typically should try and have it fixed within a week or two from injury.

During surgery, the bone fragments are first repositioned into their normal alignment. They’re then held in place with special hardware, such as metal plates and screws. An emerging method used frequently by shoulder surgeon Dr. Mayo is using two, thinner plates, called Dual Plating, which can minimize irritation from the hardware while providing strong fixation.

The recovery process involves a period of immobilization to allow the bone to heal, followed by physical therapy to restore shoulder strength and mobility. Full recovery can take several months.