Understanding Clavicle Injuries

What is a Collar Bone (clavicle) Fracture?

A collarbone fracture occurs when the collarbone (clavicle) breaks. This bone connects the breastbone (sternum) to the shoulder blade (scapula) and is crucial for shoulder stability and movement.

Types of Collar Bone (clavicle) Fractures 

Collarbone fractures can be classified based on their location and the nature of the break. Here are the main types:

1. Mid-shaft Fractures: These occur in the middle part of the collarbone. They are the most common type and often result from falls onto the shoulder or direct trauma.
2. Distal Fractures: These occur at the end of the collarbone near the shoulder joint. They can involve the acromioclavicular (AC) joint, where the collarbone meets the shoulder blade. These fractures might be associated with AC joint injuries.
3. Proximal Fractures: These occur at the end of the collarbone near the sternum (breastbone). They are less common and can be more complex, sometimes involving the sternoclavicular (SC) joint where the collarbone meets the sternum.

Fractures are classified based on their pattern:

• Simple Fractures: The bone breaks cleanly into two parts without additional complications.
• Compound (Open) Fractures: The broken bone pierces the skin, increasing the chance of infection.
• Comminuted Fractures:  This is when the bone breaks into several pieces, complicating treatment and healing.

The treatment approach depends on the type of fracture.

Prevalence of Collar Bone Fractures 

Collarbone (clavicle) fractures are quite common, particularly among certain groups and in specific situations:

• General Population: They are among the most frequently fractured bones in the body, accounting for approximately 5-10% of all fractures.
• Age Groups:
  • Children: Collarbones are often fractured in children due to falls or sports injuries. The clavicle is a common site for fractures in pediatric trauma.
  • Adults: Adults, especially those involved in contact sports or accidents, also commonly experience collarbone fractures. In adults, these fractures can be more severe due to the increased risk of complex injuries.
  • Older Adults: In older adults, collarbone fractures can occur more easily due to decreased bone density and the increased risk of falls.
• Gender: Both men and women are affected, though men tend to have a higher incidence due to higher involvement in contact sports and physical activities.
• Sports and Activities: High-impact sports such as football, hockey, and cycling are associated with a higher incidence of collarbone fractures.

Overall, while collarbone fractures are common, most heal well with appropriate treatment, though recovery times and outcomes do depend on the severity of the fracture and the individual’s overall health.

Symptoms and Causes of Collar Bone Fractures 

The symptoms of Collar Bone (clavicle) Fractures include:

• Pain: Sharp pain at the site of the fracture, which may worsen with movement.
• Tenderness: Sensitivity to touch over the collarbone area.
• Swelling: Swelling and bruising around the collarbone and shoulder.
• Deformity: A visible bump or deformity along the collarbone. In severe cases, the bone may be visibly out of place.
• Limited Mobility: Difficulty moving the shoulder due to pain and swelling.
• Bruising: Discoloration of the skin over the fracture site.

The common causes of Collar Bone (clavicle) Fractures include:

• Falls: Falling onto the shoulder or outstretched arm is a common cause. This is especially prevalent in children and older adults.
• Direct Trauma: Blows to the collarbone from sports injuries, accidents, or physical altercations can cause fractures.

• Sports Injuries: Contact sports like football, hockey, or cycling accidents can lead to collarbone fractures.
• Automobile Accidents: Car accidents, particularly those involving a direct impact to the shoulder or chest area, can result in collarbone fractures.
• Childbirth: In some cases, collarbone fractures can occur during childbirth, particularly if the baby is large or the delivery is difficult.

Understanding these symptoms and causes can help in the early identification and appropriate management of collarbone fractures. Access Ortho can offer rapid appointments for injuries to the collarbone (clavicle).

Risk Factors for Collar Bone Fractures 

The following can increase the likelihood of experiencing a collarbone (clavicle) fracture:

1. Age:
   • Children: Their bones are still developing and are more susceptible to fractures from falls or accidents.
   • Older Adults: Bone density decreases with age, making fractures more likely, especially from falls.
2. Sports Participation: Engaging in high-impact or contact sports (e.g., football, rugby, hockey, cycling) increases the risk of collarbone injuries due to falls or direct blows.
3. Physical Activity Level: High levels of activity, especially in activities that involve falls or collisions, can increase the risk.
4. Bone Density: Conditions that affect bone density, such as osteoporosis, make bones more fragile and prone to fractures.
5. Previous Fractures: A previous collarbone fracture can weaken the area, making it more susceptible to future injuries.
6. Accidents and Trauma: High-risk activities or environments that involve potential falls or direct trauma (e.g., motor vehicle accidents, falls from heights) increase the likelihood of a fracture.
7. Gender: While both men and women can experience collarbone fractures, men are often at higher risk due to higher participation in high-impact sports and activities.
8. Inadequate Protective Gear: Not using proper protective equipment during sports or high-risk activities can increase the risk of fractures.

Understanding and managing these risk factors is important to reduce the likelihood of experiencing a collarbone fracture.

Potential Complications of Collar Bone Fractures 

Collarbone (clavicle) fractures can lead to several potential complications, depending on the severity and management of the injury. Therefore, it is essential to seek expert orthopaedic care to treat the clavicle fractures. These complications can include:

• Nonunion: This occurs when the fractured bone fails to heal properly, and the ends of the bone do not fuse together. It may require additional treatment or surgery.
• Malunion: This happens when the bone heals in an incorrect position, leading to a deformity or functional impairment. It might necessitate corrective surgery.
• Infection: If the fracture is an open (known as a compound fracture) where the bone has pierced the skin, there is a risk of infection. Proper wound care and antibiotics are necessary to prevent this complication.
• Nerve Injury: The collarbone is close to several important nerves, such as the brachial plexus. Severe fractures can sometimes injure these nerves. This can lead to symptoms in the arm and hand such as numbness, tingling, or weakness.
• Blood Vessel Injury: The subclavian artery and vein run near the collarbone. A severe fracture could potentially damage these blood vessels, leading to bleeding or circulation issues.
• Acromioclavicular Joint Injury: Fractures at the distal end of the collarbone can damage the acromioclavicular (AC) joint, leading to joint instability or arthritis.
• Shoulder Impairment: Inadequate healing or complications can result in reduced shoulder function, limited range of motion, or persistent pain.
• Post-Traumatic Arthritis: Damage to the joints or surrounding structures can lead to arthritis in the acromioclavicular joint or other related areas.

Early and appropriate treatment, including monitoring and follow-up care, can help minimise these risks and promote optimal recovery. Access Ortho will offer a rapid appointment to minimise risks associated with collarbone (clavicle) fractures. 

Diagnosing Collar Bone Fractures

Diagnosing a collarbone (clavicle) fracture requires a combination of medical history, examination, and imaging tests. Here’s how it’s typically done:

• Medical History: The medical team will ask about the mechanism of injury, the symptoms you’re experiencing, and any relevant medical history.
• Physical Examination: The medical team will assess for tenderness, swelling, deformity, and range of motion. They may also check for signs of nerve or blood vessel injury.
• Imaging Tests:
  • X-rays: This is the primary imaging test used to diagnose a collarbone fracture. X-rays help visualise the location and type of fracture (mid-shaft, distal, or proximal) and determine if there are any associated injuries to the acromioclavicular or sternoclavicular joints.
  • CT Scan: A computed tomography (CT) scan may be used if the X-ray results are unclear or if a more detailed view is needed. It helps assess the extent of the fracture and any potential complications.
  • MRI: Magnetic resonance imaging (MRI) is not frequently used for initial diagnosis but may be employed if there are concerns about soft tissue injuries, such as damage to muscles, tendons, or ligaments around the shoulder.
• Additional Tests:
  • Ultrasound: In some cases, an ultrasound may be used to assess soft tissue damage or to guide certain treatments.

These diagnostic tools help guide treatment plans and monitor the healing process. Access Ortho will provide a rapid assessment and order the required radiology to form a detailed assessment of the injury to ensure an appropriate treatment plan. 

Specific Considerations for Collar Bone Fractures 

When managing collarbone (clavicle) fractures, several specific considerations come into play to ensure effective treatment and recovery:

1. Fracture Type and Severity:
   • Simple vs. Compound Fractures: Simple fractures generally heal well with conservative treatment, while compound (open) fractures require careful management to prevent infection.
   • Displaced vs. Non-Displaced: Displaced fractures may require realignment or surgery, whereas non-displaced fractures often heal with immobilisation and rest.
2. Age and Activity Level:
   • Children: Pediatric fractures typically heal faster, but there is a need to monitor for growth-related issues, such as potential impacts on bone growth.
   • Adults: Recovery may be slower and more complicated by factors like bone density and overall health.
   • Active Individuals: Rehabilitation and a gradual return to activity are crucial for athletes or those engaged in physical activities to prevent re-injury.
3. Associated Injuries:
   • Nerve and Blood Vessel Damage: Careful assessment for possible nerve or blood vessel injury is essential, especially in severe fractures.
   • Joint Injuries: Fractures involving the acromioclavicular (AC) or sternoclavicular (SC) joints may require additional treatment to address joint instability or arthritis.
4. Treatment Approaches:
   • Immobilisation: For most non-displaced fractures, a sling or figure-of-eight bandage may be used to immobilise the shoulder and promote healing.
   • Surgery: Severe or displaced fractures might require surgical intervention to realign and stabilise the bone using plates, screws, or pins.
   • Rehabilitation: Physical therapy is often recommended to restore strength, range of motion, and function. Rehabilitation programs need to be tailored to the individual’s needs and recovery progress.
5. Infection Control:
   • Wound Care: For compound fractures, proper wound care and antibiotics are vital to prevent infection.
6. Monitoring and Follow-Up:
   • Regular Check-ups: Appointments are important to monitor the healing process, assess for potential complications, and adjust treatment as needed.
7. Pain Management:
   • Pain Relief: Adequate pain management is important for comfort and to facilitate movement and rehabilitation.

Access Ortho considers all these aspects to ensure that collarbone (clavicle) fractures are treated effectively and that the patient recovers fully while minimising the risk of complications.

Managing and Treating Collar Bone Fractures 

Managing and treating collarbone (clavicle) fractures involves a non-surgical or surgical approach depending on the type and severity of the fracture. Access Ortho can advise on the best care for your injury. Here’s a comprehensive overview of the treatment options:

Non-Surgical Treatment

8. Immobilisation:
   • Sling: A shoulder sling is commonly used to immobilise the arm and support the shoulder, reducing movement and promoting healing.
   • Figure-of-Eight Bandage: This may be used to stabilise the shoulder and help align the bone during healing.
9. Pain Management:
   • Medications: Over-the-counter pain relievers (e.g., ibuprofen, acetaminophen) or prescribed medications can help with pain management and to reduce inflammation.
10. Ice Therapy:
    • Application: Applying ice packs to the area can help reduce swelling and pain. Ice should be applied for 15-20 minutes every few hours during the first 48 hours.
11. Rest and Activity Modification:
    • Avoiding Strain: It is crucial to rest the shoulder and avoid activities that could stress the fracture site. A healthcare provider should guide the gradual reintroduction of activities.
12. Physiotherapy:

Rehabilitation Exercises: Once healing progresses, physiotherapy may include exercises to restore movement, strength, and function. This helps in recovering full use of the shoulder.

Surgical Treatment

Surgery may be necessary for:

1. Displaced Fractures: When the fractured bone ends are significantly out of alignment and cannot heal correctly with immobilisation alone.
2. Comminuted Fractures: When the bone has fractured into several pieces.
3. Compound Fractures: When the bone has pierced the skin.
   • Surgical Options:
4. Open Reduction and Internal Fixation (ORIF):
   • Procedure: The bone fragments are realigned, and hardware such as plates, screws, or pins are used to stabilise the bone. This is done through an incision.
5. Intramedullary Pin:
   • Procedure: A pin is inserted into the centre of the bone to stabilise it from within.

Post-Surgery Care:

6. Wound Care:
   • Monitoring: Keeping the surgical site clean and dry to prevent infection. Follow-up appointments are necessary to check the surgical site and remove stitches or staples if needed.
7. Pain Management:
   • Medications: Pain relief may be provided through prescription medications or over-the-counter options as needed.
8. Rehabilitation:
   • Physiotherapy: Continued physiotherapy is often required to regain strength, flexibility, and function after surgery.

Long-Term Considerations

9. Follow-Up:
   • Monitoring: Multiple visits with a healthcare provider are required to monitor the healing process through physical exams and possibly additional imaging.
10. Activity Modifications:
    • Gradual Return: A gradual return to normal activities, including sports or heavy lifting, should be supervised by a healthcare provider to avoid re-injury.
11. Complication Management:
    • Addressing Issues: Early detection and management of any complications, such as infection, nonunion, or malunion, are essential for a successful recovery.

Effective management of collarbone fractures involves a tailored approach based on the individual’s specific needs and the nature of the fracture. This ensures optimal recovery and minimises the risk of long-term complications. Access Ortho can provide expert care for clavicle fractures. 

Preventing Collar Bone Fractures and Strategies to Reduce the Risk of Collar Bone Fractures 

Preventing collarbone (clavicle) fractures involves taking steps to reduce the risk of injury. Here are some strategies to help minimise the risk:

General Prevention Strategies

12. Use Protective Gear:
    • Sports Equipment: Wear appropriate protective gear such as shoulder pads, helmets, and elbow guards during high-impact or contact sports.
    • Safety Gear: Use protective equipment when cycling, skating, or participating in activities where falls are common.
13. Improve Bone Health:
    • Nutrition: To support strong bones,a diet rich in calcium and vitamin D is needed. Foods like dairy products, leafy greens, and fortified cereals can help.
    • Supplements: If dietary intake is insufficient, consider calcium and vitamin D supplements, especially for older adults or those at higher risk of osteoporosis.
14. Exercise Regularly:
    • Strength Training: Engage in weight-bearing exercises to improve bone density and strength. 
    • Balance and Coordination: Improve balance and coordination through activities like yoga to reduce the risk of falls.
15. Fall Prevention:
    • Home Safety: Reduce tripping hazards at home by securing loose rugs, improving lighting, and installing handrails where needed.
    • Footwear: Wear non-slip shoes to reduce the risk of falls, particularly on slippery surfaces.
16. Proper Technique:
    • Sports Techniques: Learn and use proper techniques in sports and physical activities to minimise the risk of falls and collisions.
    • Safe Practices: Avoid risky activities or behaviours that increase the likelihood of injury.

For Specific Groups

17. Children:
    • Supervision: Supervise children during play and sports to ensure they use safety equipment and follow safe practices.
    • Education: Teach children about safe falling techniques and how to avoid risky behaviour.
18. Older Adults:
    • Bone Density Screening: Regularly check bone density and address any signs of osteoporosis or bone weakness.
    • Exercise Programs: Engage in exercise programs tailored to older adults that are designed to improve strength, balance, and flexibility.
19. Athletes:
    • Warm-Up and Stretching: To reduce muscle and joint injuries, incorporate proper warm-up and stretching routines before engaging in sports.
    • Conditioning: Maintain overall fitness and conditioning to improve resilience against injuries.

By following these strategies, individuals can reduce their risk of collarbone fractures and promote overall bone health and safety. 

Outlook and Prognosis for Collar Bone Fractures 

The outlook and prognosis for collarbone (clavicle) fractures are generally positive, but they vary depending on the type and severity of the fracture, the treatment approach, and individual factors. Here’s what you can typically expect:

General Prognosis

20. Healing Time:
    • Non-Displaced Fractures: Usually heal well with conservative treatment (e.g. sling and rest) within 6 to 8 weeks.
    • Displaced Fractures: These may take longer, especially if surgery is required. Healing can take up to 12 weeks or more.
21. Recovery:
    • Function Restoration: After treatment, most people regain movement and strength in the shoulder and arm. Physiotherapy can aid in a full recovery.
    • Residual Pain: Some individuals may experience mild discomfort or stiffness in the shoulder for a few months after the fracture has healed.
22. Return to Activities:
    • Gradual Return: Full return to sports or heavy lifting should be gradual and guided by a healthcare provider. Most people can resume their normal activities once healing is complete.

Potential Complications

• Nonunion: There are occasions a fracture does not heal properly, in this case it may require additional treatment or surgery. This is less common but can occur, especially with severe fractures.
• Malunion: If the bone heals in an improper position, corrective surgery might be necessary to realign the bone.
• Infection: For compound (open) fractures, there is a risk of infection, this can be managed with proper wound care and antibiotics.
• Nerve or Blood Vessel Injury: Although rare, severe fractures can sometimes damage nearby nerves or blood vessels, potentially causing long-term issues.
• Arthritis: Injuries to the acromioclavicular (AC) or sternoclavicular (SC) joints can lead to arthritis in these joints over time.

Generally, most people with collarbone fractures can expect a good recovery with appropriate treatment and follow-up care, allowing them to return to their usual activities and functions. It is essential to get specialist orthopaedic care for your injury. Access Ortho can provide a rapid appointment for assessment and management.

What to Expect After a Collar Bone Fracture and Recovery Time for Collar Bone Fractures 

What to Expect After a Collarbone Fracture

• Initial Recovery:

• Pain Management: Expect some pain and discomfort immediately after the injury, which is usually managed with pain medications and ice therapy.
• Immobilisation: You’ll likely use a sling or figure-of-eight bandage to keep the shoulder stable and reduce movement, promoting healing.
• Healing Phase:

• Rest and Rehabilitation: Rest is crucial during the initial healing phase. After a few weeks, once the pain decreases, physiotherapy may begin to restore range of motion and strength.
• Follow-Up Appointments: Schedule regular check-ups with your healthcare provider to monitor healing progress and adjust the treatment plan as needed.
• Gradual Return to Activities:

• Activity Modification: You may need to modify activities to avoid strain on the healing bone. Gradual reintroduction of activities is recommended.
• Physical Therapy: Exercises will help regain full shoulder function. Adherence to the rehabilitation program is important for optimal recovery.
• Long-Term Outlook:

• Full Recovery: Most people regain full function and strength, although some may experience mild stiffness or discomfort for a while.
• Possible Residual Effects: In some cases, minor, long-term effects may occur, such as minor discomfort or occasional stiffness, especially if the fracture was severe or involved the joints.

General Recovery Times for Collarbone Fractures

• Non-Displaced Fractures:

• Healing Time: Typically 6 to 8 weeks.
• Treatment: Conservative management with rest, immobilisation, and pain management.

23. Displaced Fractures:
    • Healing Time: Approximately 8 to 12 weeks or more, depending on the need for surgical intervention.
    • Treatment: This may involve surgery for realignment and stabilisation, followed by rehabilitation.
24. Surgical Cases:
    • Healing Time: Surgery may extend the overall recovery time to 12 weeks or longer, with additional time needed for rehabilitation.
    • Recovery: Post-surgical care includes wound care, pain management, and physical therapy.

In general, most individuals experience a positive recovery outcome with proper treatment and follow-up care, leading to a return to normal activities and functionality within a few months.

When to Seek Medical Attention for a Suspected Collar Bone Fracture 

You should seek medical attention for a suspected collarbone (clavicle) fracture if you experience any of the following:

Symptoms Indicating a Collarbone Fracture

• Severe Pain: Intense pain around the collarbone, especially if it worsens with movement.
• Visible Deformity: A noticeable bump, bulge, or abnormal shape along the collarbone.
• Swelling and Bruising: Significant swelling and bruising seen around the collarbone and shoulder area.
• Limited Mobility: Difficulty moving the shoulder, or inability to move the arm.
• Numbness or Tingling: Lack of feeling or sensations of tingling in the arm or hand could indicate nerve involvement.

When to Seek Immediate Medical Care

• Open Fracture: If the bone has pierced through the skin, immediate medical care is necessary to prevent infection and manage the injury. You should attend the emergency department if you have an open fracture. 
• Severe Trauma: If the fracture follows a severe trauma, such as a car accident or a high-impact fall, prompt medical evaluation is crucial to assess for other possible injuries. If there is a chance of head injuries or abdominal injuries, you should attend the emergency department. 
• Signs of Nerve or Blood Vessel Injury: If you experience severe pain, numbness, or weakness in the arm, or if there is a risk of damage to nearby blood vessels.

When to See Access Ortho

Persistent Symptoms: If you have symptoms consistent with a fracture but aren’t sure, or if the pain, swelling, or bruising persists despite initial home care.

Limited Improvement: If symptoms do not improve with rest and over-the-counter pain medications, or if there are concerns about the alignment or healing of the fracture.

Follow-Up Care: After an initial assessment with your GP or Emergency department, follow up with Access Ortho to monitor healing and adjust the treatment plan as needed.

Seeking timely medical attention ensures proper diagnosis, treatment, and monitoring of collarbone fractures, which can help prevent complications and promote a better recovery outcome. Access Ortho offers rapid appointments for clavicle fractures.

Frequently Asked Questions

Is the collarbone and clavicle the same bone?

Yes, the collarbone and clavicle refer to the same bone. The term “collarbone” is a common name, while “clavicle” is the anatomical term. It’s a long, slender bone that connects the sternum (breastbone) to the scapula (shoulder blade), playing a significant role in stabilising the shoulder and facilitating arm movement.

How do I know if I’ve fractured my collarbone?

If you have any of the following symptoms, you should get medical care to determine if you have fractured your collarbone (clavicle):

•  Sharp pain at the site of the collarbone
• Visible deformity or bump
• Significant swelling and bruising 
• Limited shoulder movement 
• Numbness or tingling in the arm or hand.

An X-ray or other imaging tests are needed for a definitive diagnosis.

Can a collarbone fracture heal without surgery?

Yes, many collarbone fractures, especially non-displaced or minimally displaced ones, can heal without surgery. Treatment typically involves rest, immobilisation with a sling, and pain management. However, surgery may be required for displaced fractures or severe cases to realign and stabilise the bone. Access Ortho can assess the need for surgery and find a surgeon if necessary. 

How long does it take for a collarbone fracture to heal completely?

Generally, non-displaced fractures heal in about 6 to 8 weeks. Displaced or more severe fractures might take 8 to 12 weeks or longer, especially if surgery is involved. Full recovery, including restoring strength and function, may take additional time.

What is the best sleeping position with a fractured collarbone?

It’s often recommended to sleep on your back or the uninjured side. Use pillows to support your arm and shoulder in a comfortable position. Avoid sleeping on the injured side, as it can cause pain and interfere with healing.

Can I drive with a broken collarbone?

No, you can’t drive with a broken collarbone. You cannot operate a vehicle safely. Check with your medical team to determine when you can return to driving. 

Will a collarbone fracture affect shoulder movement long-term?

Most people regain full shoulder movement and function after proper treatment and rehabilitation. However, some may experience minor stiffness or discomfort, especially if the fracture was severe or involved joint injuries. Adhering to a physiotherapy regimen can help minimise long-term effects.

Are collarbone fractures common in newborns?

Yes, collarbone fractures can occur in newborns, particularly during a difficult delivery or when the baby is large. These fractures usually heal quickly with minimal intervention and are generally not a cause for long-term concern. If you have concerns, you should consult your paediatrician after delivery.

How soon can I return to sports after a collarbone fracture?

Return to sport depends on the fracture’s severity and your recovery progress. Typically, you should wait until you have full range of motion, strength, and the fracture has healed. This can take several weeks to months. Consult with your healthcare provider before resuming sports to ensure you’re ready.

What’s the difference between a collarbone fracture and shoulder separation?

A Collarbone Fracture involves a break in the collarbone (clavicle) itself.

A Shoulder Separation is an injury involving damage to the acromioclavicular (AC) joint. This is the point where the collarbone meets the shoulder blade. It involves damage to the ligaments holding the joint together, not a fracture of the collarbone itself.

Can a collarbone fracture cause nerve damage?

Yes, in severe cases, a collarbone fracture can potentially injure nearby nerves, such as the brachial plexus, leading to symptoms like numbness, tingling, or weakness in the arm or hand. If you experience any of these seek medical attention promptly.