Clavicle Fracture (Broken Collarbone)

A broken collarbone can also be referred to as a clavicle fracture. This is a common fracture that takes place in people of all age groups. Dr. Weaver of Audrain Orthopaedics has a few tips for how to identify and correct a clavicle fracture.

Anatomy

The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body.

The clavicle is above several important nerves and blood vessels. Nevertheless, these important structures are rarely injured when the clavicle breaks, although the bone ends can shift whenever they are fractured.

audrain county missouri mexico clavicle fracture broken collarboneDescription

The clavicle is a long bone and the majority of breaks occur in the center of it. From time to time, the bone will break where it attaches at the ribcage or shoulder blade.

Cause

Clavicle fractures are often caused by a direct blow to the shoulder. This can happen during a fall to the shoulder or an automobile accident. A fall onto an outstretched arm could also result in a clavicle fracture. In infants, these fractures can take place during the passage through the birth canal.

Symptoms

Clavicle fractures can be extremely painful and may make it difficult to move your arm. Additional symptoms include:

•   Sagging shoulder (down and forward)

•   Lack of ability to raise the arm because of pain

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

•   A deformity or "bump" over the break

•   Bruising, swelling, and/or soreness over the collarbone

Doctor Examination

While in the evaluation, your physician will ask questions regarding the injury and how it took place. After talking about the injury and your symptoms, your doctor will look at your shoulder.

There is usually an evident disfigurement, or "bump," at the fracture site. Gentle pressure over the break brings about pain. Although a fragment of bone rarely breaks through the skin, it may push the skin into a "tent" formation.

Your physician will thoroughly look at your shoulder to make certain that no nerves or blood vessels were damaged.

In order to pinpoint the positioning and extent of the break, your physician will arrange an x-ray. X-rays of the whole shoulder are frequently done to check for additional injuries. If other bones are broken, your physician may order a computed tomography (CT or CAT) scan to view the fractures in better detail.

Nonsurgical Treatment

If the broken ends of the bones haven't shifted out of place and line up properly, you may not require surgery. Broken collarbones can heal with no surgery.

Arm Support

A simple arm sling or figure-of-eight wrap is generally used for comfort immediately after the break. These are worn to support your arm and help keep it in position while it heals.

Medication

Pain medication, like acetaminophen, can help alleviate pain as the fracture heals.

Physical Therapy

While you are wearing the sling, you will probably lose muscle strength in your shoulder. When your bone starts to heal, the pain will decrease and your physician may begin gentle shoulder and elbow exercises. These exercises will help prevent stiffness and weakness. More arduous exercises can gradually be started when the fracture is totally healed.

Doctor Follow-Up

You will have to see your physician regularly until your fracture heals. He or she will analyze you and take x-rays to ensure the bone is healing in good position. After the bone has healed, you'll be able to bit by bit go back to your normal activities.

Complications

The fracture can get out of place before it heals. It is important to follow up with your doctor as planned to make sure the bone stays in place.

If the fracture fragments do move out of place and the bones heal in that place, it's called a "malunion." Treatment for this is determined by how far out of place the bones are and exactly how much this affects your arm movement.

A large bump over the fracture site may develop as the fracture mends. This generally gets smaller with time, but a tiny bump might remain permanently.

Surgical Treatment

If your bones are out of place (displaced), your physician may recommend surgery. Surgery can align the bones exactly and hold them in good position as they heal. This can enhance shoulder strength when you have recovered.

Plates and Screws

During this operation, the bone fragments are first repositioned into their normal alignment, and then held in place with special screws or by attaching metal plates to the outer surface of the bone.

After surgery, you may notice a tiny patch of numb skin below the incision. This numbness becomes less noticeable with time. Because there's not a lot of fat over the collarbone, you might be able to feel the plate throughout your skin.

Plates and screws are often not removed when the bone has healed, unless they're causing discomfort. Problems with the hardware are not common, but sometimes, seatbelts and backpacks can aggravate the collarbone area. Should this happen, the hardware may be removed after the fracture has healed.

Pins

Pins are also used to hold the fracture in good position after the bone ends have been put back in place. The incisions for pin placement are usually smaller than those used for plates. Pins often irritate the skin where they have been inserted and are usually removed whenever the fracture has healed.

Rehabilitation

Specific exercises will help regain movement and strengthen your shoulder. Your physician may give you a home therapy plan or advise that you employ a physical therapist.

Therapy programs customarily start with gentle motion exercises. Your doctor will gradually add strengthening exercises to your program as your fracture heals.

Although it is a slow process, following your physical therapy plan is a key point in returning to all the activities you like.

Surgical Complications

People who utilize any sort of tobacco product, have diabetes, or are elderly are at an increased risk for complications during and after surgery. They are also more apt to have problems with wound and bone healing. Be sure to consult with your doctor about the risks and advantages of surgery for your clavicle fracture.

There are risks connected with any surgery, including:

•   Infection

•   Bleeding

•   Pain

•   Blood clots in your leg

•   Damage to blood vessels or nerves

•   Nausea

The health risks specific to surgery for collarbone fractures include:

•   Difficulty with bone healing

•   Lung injury

•   Hardware irritation

Outcome

Whether your treatment involves surgery or not, it can take several months for your collarbone to heal. It may take longer in diabetics or people who smoke or chew tobacco.

The majority of people go back to regular activities within 3 months of their injury. Your physician will tell you when your injury is stable enough to do so. Returning to typical activities or lifting with your arm before your physician suggests may cause your fracture fragments to move or your hardware to break. This might require you to start your treatment from the start.

Once your fracture has entirely healed, you can safely go back to physical activities.

What to Discuss With Your Orthopaedic Surgeon

1.   When will I be able to begin using my arm?

2.   When can I return to work?

3.   Do I have any specific risks for not doing well?

4.   If I have surgical treatment, what are the risks and benefits and how long will I be in the hospital?

5.   If I do not have surgery what are the risks and benefits?

6.   Is my bone weak?

7.   Should I be taking calcium and Vitamin D?

If you have a clavicle fracture and live in Columbia, Fulton, Jefferson City, Moberly, or Mexico, Missouri, call Audrain Orthopaedics today and arrange an appointment.

Thanks for your care in the past and especially during my knee replacement.  You made an operation that I dreaded much easier.

B.A. age 81