Common Shoulder Injuries: Part 2 Broken Collar Bone

A broken collarbone (broken clavicle) is a common shoulder injury, which frequently occurs when someone falls onto an outstretched hand. The collarbone is attached centrally to the sternum (breastbone) and at its outer side to the shoulder complex. This arrangement means that when a person falls onto an outstretched hand, the force is transmitted up the arm resulting in a collarbone fracture. Sometimes a direct blow to the clavicle can also result in a broken collarbone.

With broken collarbones in children, there is usually little displacement of the two fracture fragments and subsequent healing occurs quickly over a period of 2 to 3 weeks. In older individuals, where more force is applied to produce a broken collarbone, the two fragments often become displaced and are prominent through the skin. Once the fractured bone has been reduced back into place by the treating doctor it will usually heal in about 6 weeks.

Occasionally there are complications with this type of fracture, including a fragment of bone causing damage to blood vessels in the chest, or imperfect union of the two fracture fragments which leads to a prominent notch once healing has taken place.

Broken Collarbone Signs & Symptoms

Because the collarbone is so close to the surface of the skin, the fracture is usually characterised by the protruding fracture fragments. As with any fracture there is considerable pain, and bruising may be visible. The patient will hold the arm immobile in an attempt to relieve the pain.

Broken Collarbone Treatment

Treatment of a broken collarbone is dependent upon the degree of displacement of the fracture fragments. If the two pieces of bone are reasonably well aligned, it will usually be sufficient to immobilise the affected arm in a sling or a figure-of-eight harness.

Where there is excessive displacement that prevents fracture union and healing, the orthopaedic consultant may choose to repair the fracture surgically using screws. However, this situation is rare as the clavicle has a very good capacity to heal.

After a few weeks shoulder range of movement exercises can be progressed to gradually increase available shoulder movement. These exercises may be a little uncomfortable, but with some encouragement from a Chartered Physiotherapist this discomfort should quickly resolve as normal movement returns. Shoulder strengthening should then begin using resistance bands to regain full function.

Once full range of movement and shoulder strength has been achieved, unrestricted shoulder motion is permitted. A return to sport should be granted by the orthopaedic consultant, based on functional ability and x-ray evidence.

Broken Collar Bone Prevention

Because of the traumatic nature of a broken collarbone, prevention strategies are limited. Care should be taken to avoid falls onto an outstretched arm, especially where weather conditions make the surface extra slippery.