Steps to Take for Clavicle Fractures
Jeffrey A. Housner, MD; John E. Kuhn, MD
Practice Essentials Series Editors:
THE PHYSICIAN AND SPORTSMEDICINE - VOL 32 - NO. 1 - JANUARY 2004
Note: For the complete clinical review article see Clavicle Fractures: Individualizing Treatment for Fracture Type
The bones that reach from the middle of your chest to the shoulders form the struts that make up the front of the shoulder. They can be broken when they are overstressed.
Q. What is a fracture of the clavicle?
A. The clavicle (or collar bone) connects the breastplate (sternum) to the shoulder blade (scapula). It is the most commonly broken (fractured) bone in the body. Fractures may occur in sports activities, falls, or other accidents.
Q. What should I do if I think my collar bone is broken?
A. It is best to seek medical attention as soon as possible. Before you go to an emergency department or urgent care facility, the arm should be supported by holding it close to the body, or by using a sling. Over-the-counter pain medication such as acetaminophen or ibuprofen can be used to help relieve pain. Ice can also help to reduce pain and swelling, but ice should be used for only 15 to 20 minutes at a time. You must be careful not to freeze the skin. If the injury causes shortness of breath or difficulty swallowing, you should seek immediate medical attention.
Q. How are clavicle fractures treated?
A. An x-ray is usually needed to confirm that there is a fracture. Nearly all fractures can be successfully treated with immobilization using either a sling or a special brace called a "figure-of-eight" splint. The sling or splint should be worn until there is no discomfort during normal use of the arm. As the pain in the clavicle subsides, you should begin gentle motion of the shoulder. Your doctor may show you some exercises or send you to a physical therapist for instructions.
Usually, clavicle fractures heal in 4 to 5 weeks in children, 6 to 8 weeks in adolescents, and 10 to 12 weeks in adults. Nearly all clavicle fractures will heal without surgery.
Q. How will I know when my fracture is healed?
A. Having full motion of the shoulder and experiencing no pain when pressing on the fracture site are two good signs that the fracture has healed. Your doctor may want you to get an x-ray to confirm that the bone is completely healed.
Q. What if my fracture does not heal?
A. If the fracture does not heal, an operation may be necessary. Many factors determine whether a clavicle fracture will need surgery, so you should discuss the options with your doctor.
Q. What result can be expected once the fracture heals?
A. Most patients will have full shoulder motion and can return to all activities without limitations. Occasionally, a small bump remains over the site of the fracture. It is extremely rare for this bump to cause any pain or affect the function of the shoulder.
Q. When will I be able to play sports again?
A. Many factors are involved in determining when it is safe to return to sports activities after a clavicle fracture. In helping you to make a decision, your doctor will consider your age, how severe the fracture is, the amount of healing, and the type of sport that you will be playing.
Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.
Dr Housner is clinical assistant professor in the departments of orthopedic surgery and family medicine at the University of Michigan in Ann Arbor. Dr Kuhn is associate professor and chief of shoulder surgery in the department of orthopedic surgery at Vanderbilt University in Nashville, Tennessee.
© 2003, by the McGraw-Hill Companies, Inc. Permission to photocopy is granted for educational purposes.