11956 Health Library | Health and Wellness | Wellmont Health System
  • Clavicle Fracture

    (Broken Collarbone)

    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
    Distal Third Clavicle Fracture
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    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 either with 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.

    RESOURCES

    American Academy of Orthopaedic Surgeons http://www.aaos.org

    American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    Clavicle fracture. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated June 2009. Accessed July 21, 2009.

    Levy AM, Fuerst M. Sports Injury Handbook. New York, NY: John Wiley & Sons, Inc; 1993.

    Lenza M, Belloti JC, Andriolo RB, Gomes Dos Santos JB, Faloppa F. Conservative interventions for treating middle third clavicle fractures in adolescents and adults. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD007121.

    Shoulder trauma. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00394. Accessed July 15, 2008.

    Stegeman SA, de Jong M, Sier CF, et al. Displaced midshaft fractures of the clavicle: nonoperative treatment versus plate fixation (Sleutel-TRIAL). A multicentre randomised controlled trial. BMC Musculoskelet Disord. 2011 Aug 24;12:196.

    Vander Have KL, Perdue AM, Caird MS, Farley FA. Operative versus nonoperative treatment of midshaft clavicle fractures in adolescents. J Pediatr Orthop. 2010 Jun;30(4):307-312.

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