The Fractured Collarbone

updated on May 5, 2008 9:52 PM PDT

Portions Taken from "Holland Fractures Collarbone...Again"

The Fractured Clavicle

This injury is very common and can be a real pain in the ass if it doesn't heal right. As is the case with all fractures this fracture needs to be immobilized so it can heal properly, surgery on clavicle (collarbone) fractures is rare, but the results are very good. This injury usually occurs when someone falls onto an outstretched hand or onto the point of their shoulder. Most people know that they have broken a bone because they often hear the sound of the bone cracking, and there is a lot of pain at the site of the fracture. Also, because the clavicle is very close to the skin, the swelling and the bruising that is a natural part of every broken clavicle can easily be seen.

More than eighty-five percent of clavicle fractures occur in the middle of the bone. This type of fracture rarely ever needs surgery, except in special circumstances. Instead, the bone is allowed to heal on its own, and your doctor will be able to suggest ways in which you can ease the pain and discomfort. This will usually include wearing a sling or a "figure of eight" bandage for one to two weeks, applying ice packs to the area of the break, and taking mild pain pills. Most people find that a sling is more comfortable than a "figure of eight" splint, so doctors recommend this type of bandage more often.

For more detailed info on this injury this was taken from the AAOS Website:

A broken collarbone (fractured clavicle) is a common injury among two very different groups of people: children and athletes. Many babies are born with collarbones that broke during the passage down the birth canal. A child's collarbone can easily crack from a direct blow or fall because the collarbone doesn't completely harden until a person is about 20 years old. An athlete who falls may break the collarbone because the force of the fall is transmitted from the elbow and shoulder to the collarbone.

The collarbone is considered part of the shoulder and helps connect the arm to the body. It lies above several important nerves and blood vessels. However, these vital structures are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle section.

Signs of a break

* Sagging shoulder (down and forward).

* Inability to lift the arm because of pain.

* A grinding sensation if an attempt is made to raise the arm.

* A deformity or "bump" over the fracture site.

* Although a fragment of bone rarely breaks through the skin, it may push the skin into a "tent" formation.

Diagnosis

Although a broken collarbone is usually obvious, your orthopaedist will do a careful examination to make sure that no nerves or blood vessels were damaged. An X-ray is often recommended to pinpoint the location and severity of the break.

Treatment

Most broken collarbones heal well with conservative treatment and surgery is rarely necessary.

Surgery Indications: (from ShoulderSolutions.com)

There are a few types of fractures and certain circumstances in which fractures of the clavicle may need to be treated with surgery. One such reason for operating on a broken clavicle is an "open fracture," where the ends of the bone have come out through the skin. Many times the bones will only poke through the skin at the time of the original injury and then pop back inside once the patient gets up. For this reason, if you have broken your clavicle and you have a cut in the area of the break, you should see a doctor right away. Dirt, grass, and other debris can contaminate open fractures, and a surgery can be required in order to prevent an infection from occurring.

Fractures that occur very near the A/C joint are also a special type of a break. Sometimes these fractures heal so slowly that surgery is often preferred. Surgery is an option for some of these fractures, and your doctor will discuss whether or not you have this type of fracture and may need surgery. Fortunately, this type of a broken clavicle is very rare, occurring less than 10% of the time.

If the fracture does not heal by itself, doctors describe the situation as a "non-union," which means that the bones have not grown back together. When this happens after a clavicle fracture, the patient may experience long lasting pain and discomfort. In this situation, surgery may be offered as a way to realign the ends of the bone and encourage them to heal by holding them there with a plate and screws. Your doctor will be able to discuss the advantages and disadvantages of this type of surgery with you.