Medicine (Baltimore). A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder. J Shoulder Elbow Surg 2010; 19: 1049-55.

Fractures of the medial third are usually the result of direct trauma to the anterior chest (such as in a motor vehicle accident), and can be associated with neurovascular, pulmonary and cardiac (rare) injuries. Your doctor may provide you with a home therapy plan or suggest that you work with a physical therapist.

Most people return to their regular activities within 3 months of their injury. B) The posterior dislocation (red arrow) is more evident on CT scan. Clavicle fractures are fairly common and occur in people of all ages. Contact sports and activities should be avoided for approximately six weeks post removal of sling. Advise to give regular analgesia as required, If <11 years and undisplaced, follow-up by a GP or fracture clinic is usually not required. Occasionally, the bone will break where it attaches at the ribcage or shoulder blade. Stuart Hershman, MD, is a board-certified spine surgeon. What are the potential complications associated with this injury? 2017;88(4):434-439. doi:10.1080/17453674.2017.1321351, Murray IR, Foster CJ, Eros A, Robinson CM. Fractures of the clavicle can be classified by its anatomical location (Table 1): Table 1: If your pain is severe, your doctor may suggest a prescription-strength medication, such as an opioid, for a few days. clavicle shaft fractures are common traumatic injuries seen in young adults that occur in the middle third of the clavicle treatment is controversial but may be nonoperative or operative based on the degree of displacement and patient factors.
Thank you, {{form.email}}, for signing up. Common methods of internal fixation include: (Left) X-ray shows a displaced clavicle fracture (arrow). Recent studies have found that the risk of nonunion of a fracture (lack of healing) is high when the fracture is poorly aligned. Lenza M, Belloti JC, Andriolo RB, Gomes Dos Santos JB, Faloppa F. Conservative interventions for treating middle third clavicle fractures in adolescents and adults. Pain from the fracture and restriction of movement are usual for 2-3 weeks and will require regular analgesia.

Risk factors for nonunion after nonoperative treatment of displaced midshaft fractures of the clavicle. The clavicle, aka collarbone, sits at the front of the shoulder joint. To provide feedback, please email rch.orthopaedics@rch.org.au, 50 Flemington Road Parkville Victoria 3052 Australia, Site Map | Copyright | Terms and Conditions, A great children's hospital, leading the way. Displaced lateral and medial third fractures require orthopedic referral for assessment. Clavicle fractures are very common injuries in adults (2–5%) and children (10–15%) and represent the 44–66% of all shoulder fractures.

The clavicle is important in helping to support normal shoulder function and is the attachment point for several important muscles including the deltoid and pectoralis muscles. Infection after surgical reconstruction of a clavicle fracture using a reconstruction plate: a report of seven cases. Content developed by Victorian Paediatric Orthopaedic Network. When a clavicle fracture occurs, it is common to have pain and swelling at the site of the injury. Traditionally, these fractures have been treated nonsurgically.

Returning to regular activities or lifting with your arm before your doctor advises may cause the fracture fragments to move or the hardware to break. Most fractures occur in the middle portion, or shaft, of the bone. Your doctor will gradually add strengthening exercises to your program as your fracture heals. Most often, a plate and screws are placed along the bone to hold it in position, and these can typically be felt under the skin. Major nerve damage is very uncommon, but the skin nerves that provide sensation just below the collarbone are often damaged at the time of surgery. Many people who have clavicle fracture surgery will notice a patch of numbness or tingling just under their incision. All material on this website is protected by copyright. Your doctor will order an x-ray to help pinpoint the location of the fracture and to learn more about the severity of the break. If the broken ends of the bones have significantly shifted out of place, your doctor may recommend surgery. Copyright ©1995-2020 by the American Academy of Orthopaedic Surgeons. Other signs and symptoms of a fracture may include: Your doctor will want to know how the injury occurred and will ask about your symptoms.

For these more complicated fractures, surgery may be needed to realign the collarbone. While surgery has advantages in these situations, there are also risks of clavicle fracture surgery that should be considered. These should be referred to the orthopaedic service as a matter of urgency.

You will need to see your doctor regularly until your fracture heals. For the vast majority of clavicle fractures that are not out of place, or only minimally out of place, the safest and most effective treatment is with the use of a sling. McKee RC, Whelan DB, Schemitsch EH, McKee MD: Operative versus nonoperative care of displaced midshaft clavicular fractures: A meta-analysis of randomized clinical trials. The risk of non-union per fracture: current myths and revised figures from a population of over 4 million adults. Healing may take longer in diabetics or in people who smoke or use tobacco products. Indications for prompt consultation include: Congenital pseudoathrosis of clavicle - multiple previous fractures in same location, Broad arm sling to support limb for 2 weeks or until comfortable, No evidence to support Figure of 8 bandage or brace, If displaced, urgent referral to the nearest orthopaedic service on call. Fractures are painful.

Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on the bone that it snaps or breaks.

In a clavicle fracture, there is usually an obvious deformity, or "bump," at the fracture site.

It is important to follow up with your doctor as scheduled to make sure the bone stays in position. Specific exercises will help restore movement and strengthen your shoulder. The clavicle lies above several important nerves and blood vessels. Benson M, Fixsen J, Macnicol M, Parsch K (Eds). Gentle pressure over the break will bring about pain. This information is provided as an educational service and is not intended to serve as medical advice. Clavicle fractures vary. Because the metal hardware is close to the skin, the chance of infection is not insignificant. Young SJ, Barnett PL, Oakley EA.
This is difficult to see on x-ray.

When a fracture is displaced (the ends of the broken bone are not touching) and there is a higher risk of nonunion, surgery can lead to more reliable healing of the fracture. doi:10.1097/MD.0000000000012729. The broken pieces of bone may line up straight or may be far out of place (displaced fracture). Reduction of the middle third is almost never required.


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