A clavicle fracture is more commonly known as a broken collarbone. People of all ages can get a clavicle fracture, though it’s particularly common in children and young adults. It is often very painful and can make moving the arm or shoulder difficult, making daily activities nearly impossible. Serious complications can also occur with a broken collarbone. That’s why you should see one of the experienced and highly-trained shoulder specialists at the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado, for treatment of a clavicle fracture before it has a negative impact on your life.

OVERVIEW

The collarbone (also called the clavicle) is the bone that connects the breastbone to the shoulder. A broken collarbone (also called a clavicle fracture) is when this bone breaks. The clavicle is one of the most fractured bones in the body, making up about 5% of all bone fractures. Teenagers and children are at higher risk than adults, typically occurring in those younger than 25. That’s because the collarbone doesn’t completely harden until around age 20. Because they are most likely to play high-impact sports, young men and teenage boys are at the most risk for clavicle fractures. Men are nearly 3 times more likely to sustain a clavicle fracture than women.

ABOUT THE CLAVICLE

There are two clavicles, long, slender, S-shaped bones that run horizontally between the top of the breastbone (sternum) and the shoulder blade (scapula). By serving as a strut to the shoulder, it helps keep the arm in the right position for overhead activity and allows the muscles to be under the correct tension to maintain strength. The clavicle is the first bone to start to ossify in the fifth week of fetal life and the last to conclude the growth through its growth center as late as age 25. It is a very prominent structure with only skin and “supraclavicular” skin sensory nerves crossing its surface. That’s why the clavicle can be felt by touching the area between the neck and shoulder.

WHAT IS A CLAVICLE FRACTURE?

A clavicle can crack in one place or break into several pieces (comminuted fracture). The broken pieces may still line up or end up out of place (displaced fracture). Clavicle fractures are divided into three types based on location:

1. Near the sternum (breastbone)– the least common
2. Near the AC joint (the AC joint is where the clavicle bone meets the big bone behind the shoulder that also forms part of the shoulder joint)—second most common
3. In the middle of the shaft of the bone, approximately halfway between the sternum and the AC joint—the most common

Even if the broken bones aren’t perfectly lined up, the body can usually make them straight again. That’s because the collarbone has a thick outer layer that doesn’t break and acts like a sleeve to hold the bone together while it heals.

CAUSES

Some causes of a clavicle fracture include;

• Falling hard onto the shoulder or an outstretched hand
• Traffic accidents from a car, motorcycle, or bike crash
• Sports injuries from football, lacrosse, rugby, wrestling, hockey, skateboarding, skiing, and snowboarding
• Birth injury, usually from a difficult vaginal birth
• It can also happen when a young child falls from playground equipment or out of a bed or crib

SYMPTOMS

Symptoms of a clavicle fracture include:

• Snapping or grinding noise when the bone breaks
• Sharp pain, which gets worse when trying to move that area
• Shoulder slumping down or forward because the bone no longer supports it
• Difficulty moving or lifting the arm, with a possible grinding feeling when doing so
• Bruising, swelling, or tenderness in the area
• A bulge or “tenting” of the skin above the break
• Numbness or “pins and needles” (less often)
• Bone poking through the skin with bleeding (rarely)

NON-SURGICAL TREATMENTS

Most clavicle fractures don’t need surgery. If the broken parts of the bone are in a good position to heal, a doctor may recommend:

• Icing: to decrease pain and swelling
• Arm support: a sling or shoulder immobilizer that can be removed during bathing and sleeping
• Medication: over-the-counter medications such as acetaminophen or nonsteroidal drugs may be used, but they generally will not be adequate by themselves, in which case stronger drugs such as opioids may be cautiously prescribed only if necessary
• Physical therapy: specific exercises can improve motion in the arm, strengthen the shoulder, and prevent stiffness

WHEN IS SURGERY INDICATED?

The decision for surgical versus conservative management is complex and based on several factors, including patient expectations, the severity of the injury, fracture pattern, and associated injuries. Surgeons may recommend an operation to fix a clavicle fracture if it is broken into many pieces, if the bones are far apart if the bone sticks out through the skin, or if the nerves or blood vessels are injured. Clavicle fractures can be fixed with plates and screws or pins. Surgery can often take less than an hour and can be done on an outpatient basis.

GETTING THE RIGHT DIAGNOSIS. GETTING THE RIGHT DOCTOR.

When it comes to clavicle fractures, it is important to choose your surgeon wisely. No one delivers a higher quality of care than the orthopedic specialists at the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado. After a detailed examination, they will take X-rays of the injured area to confirm a broken bone. X-rays can also show where the break is, how bad it is, and whether any other bones have also broken. Should your surgeon think there is damage to a joint or artery, more tests may be ordered, such as CT scans, ultrasounds, or arteriography/arteriograms, which use X-rays and dye to see inside the arteries. Scrutiny of the lung fields and the ribs may be performed to avoid missing associated rib or thoracic injuries. Many surgeons may not be as thorough as those at CCOE. Their extensive experience and expertise can help avoid complications and give you the best pain-free positive results. Schedule an appointment with a shoulder specialist today.