Definition
A clavicle fracture is a break in the clavicle bone (also called the collarbone). It connects the sternum (breastplate) to the shoulder.
The clavicle can fracture in three different places:
- Middle third—the middle portion of the clavicle, which is the most common site for a clavicle fracture
- Distal third—the end of the clavicle connecting to the shoulder
- Medial third—the end of the clavicle connecting to the sternum
Causes
A clavicle fracture is caused by trauma to the clavicle bone. The trauma is usually caused by:
- Direct blow to the clavicle
- Falling on an outstretched arm
- Newborn babies can break a clavicle passing through the birth canal
Risk Factors
A risk factor is something that increases your chance of getting a disease, condition, or injury.
- Advancing age, because of the increased risk of falling
- Osteoporosis
- Certain congenital bone conditions
- Participating in contact sports
- Violence
Symptoms
Symptoms include:
- Pain, often severe
- Sagging shoulder, down and forward
- Inability to lift the arm because of pain
- A lump or visible deformity over the fracture site
- Tenderness and swelling of the affected area
Diagnosis
The doctor will ask about your symptoms, physical activity, and how the injury occurred. The injured area will be examined.
Tests may include x-rays. This is a test that uses radiation to take a picture of structures inside the body, especially bones to look for a break.
Treatment
Treatment will depend on the severity of the injury. Treatment involves:
- Putting the pieces of the bone back in position, which may sometimes require anesthesia and more rarely surgery
- Keeping the pieces together while the bone heals itself
Brace or Sling
Most clavicle fractures can be treated with either a figure-of-eight strap, which is wrapped around the body and the shoulders, or with the arm in a sling. These devices help hold the shoulder in place while the clavicle heals. The doctor may prescribe pain medication.
Surgery
Surgery may be needed to set the bone. The doctor may insert pins or a plate and screws in the bone to hold it in place while it heals. You will still need to wear the sling or figure-of-eight strap while you heal.
Exercises
When your doctor decides you are ready, start shoulder range-of-motion and strengthening exercises. You may be referred to a physical therapist to assist you with these exercises. Do not return to sports activity until your clavicle is fully healed.
Healing Time
- A child may heal as quickly as 3-4 weeks.
- An adolescent may take 6-8 weeks to heal.
- An adult who has stopped growing may require 8-10 weeks to heal.
Prevention
To help prevent clavicle fractures:
- Do not put yourself at risk for trauma to the clavicle bone.
- Eat a diet rich in calcium and vitamin D.
- Build strong muscles to prevent falls and to stay active and agile.
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