Fractured clavicle

The clavicle or collarbone is the bone that connects the chest to the upper arm. Together with the humerus (arm bone) and the scapula (shoulder blade) it makes up the shoulder joint. The clavicle can be broken during a fall where the person lands on the side. This commonly happens during contact sports, cycling and winter sports. Babies are also subject to this type of fracture during childbirth as they pass through the birth canal and children, because of the softness of their bones, may also break their clavicle during a fall.

Symptoms of this type of injury include:

• A downward and forward sagging of the shoulder
• Pain that makes it difficult to raise the arm
• A grinding sensation when attempting to raise the arm
• A deformity or "bump" over the site of the fracture
• Pain when the area is touched

A fracture may be simple or compound and this will determine the treatment method that will be employed. Fortunately, most fractures heal by themselves without surgery. All that may be needed for a simple fracture is to immobilise the arm in a sling for 3-4 weeks in the case of a child, and 6-8 weeks in the case of an adult. Pain medication can be used during the acute stage. Once the pain subsides, we would begin passive range of motion to prevent stiffness and promote range of motion. Strengthening exercises will follow to restore proper joint function.

Where a compound fracture has occurred, the ligament ruptures and the middle of the clavicle displaces upwards. This type of fracture often requires surgery which involves lining up both ends of the bone and fixing them together with pins or plates. Physiotherapy begins immediately after surgery to promote the healing process. We would perform passive range of motion, followed by active range of motion when pain subsides. Strengthening exercises and activities of daily living make up the latter part of the program. The fracture should be completely healed after two or three months. You should not return to sporting activities until then.