Alternative Names clavicle fracture, broken collarbone
Definition A collarbone fracture is a break that occurs in the collarbone, also called the clavicle. The collarbone is the bone that connects the breastbone, or sternum, to the shoulder blade.
What is going on in the body? The collarbone is a long, narrow, S-shaped, solid bone. Because of its location and shape, it can be injured if the arm, elbow or shoulder suffers any trauma. The collarbone is located in front of a number of important nerves and blood vessels. Rarely, these nerves and blood vessels may be injured when the collarbone is broken.
What are the signs and symptoms of the condition? Symptoms of a fractured collarbone may include:
pain, ranging from moderate to severe
swelling around the shoulder and collarbone
pain that increases with movement. To reduce pain, the person may prefer to hold his or her shoulder and arm close to the body with the arm supported.
inability to move the arm
a shoulder that flops down and forward
a noticeable deformity or bump that may be seen through the skin
a rubbing or grinding sensation when the arm is raised
numbness or tingling sensation in the shoulder, arm, or hand
weakness in the arm
What are the causes and risks of the condition? A collarbone fracture is often caused by a fall. Trauma may also occur during contact sports, such as ice hockey, football, or wrestling. Other causes may include:
a tumour in the collarbone
conditions, such as osteoporosis, that cause weak bones
Newborns can have their collarbone broken during birth as they go through the birth canal.
What can be done to prevent the condition? A person can prevent some injuries by following sports safety guidelines for children, adolescents, and adults. A healthy diet with adequate calcium can help prevent some fractures caused by bone weakness.
How is the condition diagnosed? After doing a complete history and physical examination, the doctor may order:
x-rays to locate the break and its severity
imaging tests, such as MRI, if a tumour is suspected
blood tests, including a full blood count (FBC), to rule out infection
a biopsy of any fluid or growths to check for infection or tumours
What are the long-term effects of the condition? Long-term effects will depend on the extent of the fracture and the success of treatment. If a person was involved in sports or heavy lifting before the injury, his or her normal range of motion in the shoulder may be decreased. Chronic pain or soreness in the shoulder and collarbone may also occur. Damage to the nerves and blood vessels is also possible, which can cause decreased sensation and tissue damage.
What are the risks to others? A collarbone fracture poses no risk to others.
What are the treatments for the condition? Minor to moderate injury may require "RICE" therapy:
rest or reduced activity
applying ice or cold packs to the shoulder, for 15 minutes every 2 hours
compression of the affected area, such as with a special splint called a figure-of-8 splint or a sling
elevation
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, may be recommended to reduce inflammation and discomfort.
After a few days to weeks, the initial pain and swelling will begin to subside and the bone will start to heal. At this time, Physiotherapy or strength training exercises may help to increase the strength of the tendons and muscles. Ultrasound may also be used to warm the muscles and improve blood flow.
Rarely conservative treatment is not successful, surgery may be needed. Sometimes a bone graft may be needed to promote healing.
What are the side effects of the treatments? There may be stomach upset, ulcers, or allergic reaction to NSAIDs. Splints or slings can cause muscle tightening as well as skin irritation. Treatments that require surgery pose a risk of bleeding, infection, and allergic reaction to anaesthesia.
What happens after treatment for the condition? In some situations, no further treatment is needed. physiotherapy and daily exercises may be advised to strengthen the muscles and help the bone continue to heal. Complete recovery from the fracture may take several months.
How is the condition monitored? Any new or worsening symptoms should be reported to the doctor.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
