The clavicle or collarbone is a long bone that provides support between the shoulder blade and the sternum. Though many people refer to a singular collarbone, the body has two clavicles, on the left and right sides of the chest. It is fairly common for people, particularly active and athletic individuals, to fracture their clavicles. This can cause swelling, pain, and bruising. Minor fractures may only require arm support and physical therapy while more serious fractures require surgical intervention.
Though each broken collarbone varies from the next, around 80 percent of clavicle fractures occur near the middle of the bone -- the weakest point. The edges of the clavicle act as attachment sites for ligaments and powerful muscles such as the deltoids in the upper arms and the pectoralis major. These tissues provide support and protect the collar bone. In some instances, a clavicle may break where it attaches to the ribcage or a shoulder blade.
A clavicle can fracture in different ways. Physicians typically describe fractures based on their displacement, involvement with soft tissue, fracture pattern, and fragment level. Open fractures are among the most severe forms because the bone pierces the soft tissue of muscle and skin surrounding the bone. Doctors describe fractures where the bone remains connected as incomplete, while separated bones are complete fractures. A comminuted fracture occurs when the bone breaks into several pieces. Other fractures are less common for clavicle injuries, but still possible.
The symptoms of a broken collarbone vary depending on the severity of the fracture. Minor clavicle fractures may cause pain, swelling, bruising, and limited arm mobility. The arm’s weight may pull on a broken clavicle, giving the shoulder a sagging appearance. If the fracture is severe enough, a person may lose feeling in their arms or fingers. Alternatively, they may experience a tingling sensation along the arm. If the bone begins to push through the skin or a jagged-feeling bump appears, the fracture is serious and requires immediate medical attention.
Given the location of the clavicles, there are many different ways for them to break. More common fractures involve direct physical trauma; for example, a fall onto the shoulder or an outstretched hand. Athletic individuals, particularly people who play contact sports such as football, are prone to clavicle fractures. Vehicle accidents and vehicle-associated trauma also frequently cause broken collarbones.
During childbirth, various factors can lead to an infant breaking their collarbone. Infants that are statistically large may experience difficulties traveling through the birth canal. Alternatively, the mother's birth canal may be too narrow. It’s possible for the newborn’s shoulders to become stuck during delivery. Because a newborn’s bones are softer than an adult’s, a broken clavicle is a common result. Physicians may need to purposefully break the clavicle to ensure proper delivery.
Typically, the diagnosis of a clavicle fracture begins with identifying the symptoms. A physician who suspects a broken collarbone will primarily use x-rays to examine the fracture. X-rays can show the location of the break and determine how the bones have moved. The scans can also highlight other bones near the clavicle that were also fractured during the event. A doctor may use a CT or MRI scan if she desires a more detailed look at the fracture. In children, a simple ultrasound may be enough to identify breaks in the collarbone.
The majority of collarbone fractures do not require any surgical procedure. Treatment for minor clavicle fractures typically involves arm support using a sling or wrap. If a patient experiences notable swelling or pain, the doctor may recommend ice packs or cold compresses. For severe pain, a physician may prescribe painkillers or recommend over-the-counter medications. It is possible for the bone to experience malunion if the sling does not properly prevent arm movement. Malunion occurs when a bone heals from a fracture in an improper position, and this often requires additional treatment.
Severe collarbone fractures require more dramatic medical treatment. Surgery to repair complex breaks involves repositioning the bone and using metal screws, plates, or pins to hold the bone in place for proper healing. Technicians will perform scans throughout the healing process to ensure the fracture is healing acceptably. Once a patient recovers, a second surgery removes the pins and screws. Currently, surgeons are researching minimally invasive surgical options to allow for less traumatic procedures and faster healing.
The recovery period for a broken collarbone depends heavily on the severity of the fracture and the age of the affected person. Most adult bones take between six to eight weeks to heal fully. Adolescent bones may only require three to six weeks. During the healing process, it’s important for a person with a clavicle fracture not to perform strenuous activities or attempt to lift heavy objects. It can take several weeks for a person’s strength to fully return following a broken collarbone.
Some minor actions can help while recovering from a clavicle fracture. Ice packs and mild painkillers can help reduce the swelling and pain of the injury. If sleeping is uncomfortable or difficult, using pillows to keep the body in an upright position may provide minor relief. Many physicians recommend physical therapy at a certain point in the healing process. Therapy may include gentle exercises for the elbow, hand, and fingers, to begin recovering lost strength.
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