Clavicle Fracture

What is a Clavicle Fracture?

This medical condition is referred to as a broken collarbone and is one of the most common shoulder injuries. This is especially true of young people.

Anatomy

Your clavicle extends from your shoulder blade to your breastbone, also known as your sternum. It is seen just below your shoulder and neck. They are found on top of your chest and on both sides in front of your shoulders. It is the only link between your body and your shoulder. It also protects the blood vessels and nerves that go from your neck to the shoulder area. This bone is clearly visible and is only covered with skin so it has very little protection from being fractured.

Pictures – How does Clavicle Fracture look like?

Classification: Types of clavicle fractures

• Midshaft clavicle fracture — this occurs in seventy-five percent of clavicle fractures and is the most common. It can be as simple as being badly displaced to a simple crack in the bone. This fracture becomes concerning when there is significant separation or displacement, multiple breaks in the bone, or shortening of the length of the bone
• Distal clavicle fracture — this occurs in approximately twenty percent of clavicle fractures and occurs in close proximity to the end of your clavicle at your shoulder joint
• Medial clavicle fracture — this occurs in approximately five percent of clavicle fractures and often has a relationship to injury to your sternoclavicular joint, which is the connection of your sternum to your clavicle.

Symptoms

The pain most often associated foremost with a clavicle fracture is severe pain, especially on the front part of your upper chest or with upper extremity movements. Other symptoms may include:

• Having trouble moving the arm and shoulder
• Displacement or visible bulge in the collarbone
• If severe the bone may pierce the skin
• Tenderness
• Bruising due to possible ruptured blood vessels that overtime may extend down your armpit and chest
• If extreme pain you may experience dizziness and nausea
• Swelling
• After the swelling has gone down you may be able to feel the fracture through your skin
• Having sharp pain when you move it
• Dull to extreme ache in and around your clavicle area including the muscles

Some people who have a clavicle fracture may experience all of these symptoms while other with a less severe fracture may not has many or as severe symptoms.

Causes

A clavicle fracture can happen in many different ways but most often it is the result of a hard fall on your shoulder when you fall with your hand outstretched. Other ways a person can suffer a clavicle fracture can include:

• During birth when the baby is passing through the birth canal
• The clavicle does not mature in young children and teenagers until late adolescence
• Simple random fall while taking part in an activity like sports with athletes who participate in soccer, basketball, wrestling, and football being some of the ones who commonly have this type of fracture
• Being involved in a motor vehicle accident
• Getting hit on the outside part of your shoulder

Treatment

The best treatments that work to heal a clavicle fracture are conservative treatments but in order to restore normal functionality in a severe fracture you may need surgery. With conservative treatment methods these can include:

• Applying ice packs to help reduce the swelling
• Taking an over-the-counter or prescription pain reliever to help reduce the inflammation and discomfort
• Resting the arm and shoulder is normally mandatory
• Wearing a sling to immobilize the injured shoulder

Most clavicle fractures will only need to be treated with pain medication and immobilization. When using conservative treatment measures your progress will be monitored with an x-ray every two weeks.

Surgery

Having surgery to fix a clavicle fracture is usually only done when there is a severe break or when it will cause future problems. During the surgery you may need to have rods and screws inserted to help stabilize the bones while they are healing. It is considered a serious or severe clavicle fracture is when the bone is broken in more than one place or the bone is sticking out of your skin. If you have to have surgery it will be done using either local or general anesthesia. The surgeon then will make cuts or incisions in the skin to access the clavicle fracture. Before repairing your clavicle fracture the wound will be cleaned. At this time the surgeon will usually attach a steel or titanium plates to the fractured clavicle using pins or screws. These will stabilize the bone so it can heal faster better than if just a sling was used. If the recovery is good sometimes the plate can be removed during the post healing of the clavicle fracture but it is rarely required to remove it.

Healing time

It typically takes twelve weeks for the fractures to heal but some can return to their regular activities in six weeks. How long the recovery process takes also depends on your overall health and age. For example if you are in your twenties and in good health you will have a faster recovery than someone who is sixty and in fair health. Many times, in order to get complete strength back in your arm and shoulder, can take nine to twelve months. As the treatment progresses the pain you are feeling will decrease. If you are required to use a sling and immobilization instead of having surgery it can take a few months to completely heal.

Management

After surgery the incision is closed with sutures and then the surgeon will wrap a bandage around the area in order to prevent an infection. Until the condition is back to normal your arm will be put into a sling for three to four weeks

In addition there are certain things that you should not do such as:

• First four weeks—do not elevate the arm above seventy degrees for any plane
• First six weeks—do not live any object over five pounds, avoid repeated reaching
• Ice should three to five times a day for fifteen minutes each to help control inflammation and swelling
• After fourteen days you will have the sutures removed
• At one month, three months, and one year you will have the clavicle fracture checked to make sure that it is healing
• Exercise program three times a day

Complications

These complications do not necessarily happen after surgery. They can happen anytime you have a clavicle fracture. For example, if nerves or blood vessels become pinched by the broken bone you can develop serious complications. Some of the symptoms of this type of complication are tingling or numbness in your arm or hand. If you have this type of complication you will need to have surgery to repair any of those nerves or blood vessels. You could also develop difficulty in swallowing or breathing as a result of the clavicle fracture being near your sternum, which surgery is also required.

Prognosis

Many times when someone has undergone clavicle fracture surgery they will heal faster than those who do not and use other methods to treat their clavicle fracture. If immobilization is used as treatment you may have a visible bump in the area but if you had surgery to fix the clavicle fracture you will little to no visible bumps.