A broken collarbone (fractured clavicle) is a common injury among two very different groups of people: children and athletes. Many babies are born with collarbones that broke during the passage down the birth canal. A child's collarbone can easily crack from a direct blow or fall because the collarbone doesn't completely harden until a person is about 20 years old. An athlete who falls may break the collarbone because the force of the fall is transmitted from the elbow and shoulder to the collarbone.
The collarbone is considered part of the shoulder and helps connect the arm to the body. It lies above several important nerves and blood vessels. However, these vital structures are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle section.
Signs of a break
Sagging shoulder (down and forward).
Inability to lift the arm because of pain.
A grinding sensation if an attempt is made to raise the arm.
A deformity or "bump" over the fracture site.
Although a fragment of bone rarely breaks through the skin, it may push the skin into a "tent" formation.
Diagnosis
Although a broken collarbone is usually obvious, your orthopaedist will do a careful examination to make sure that no nerves or blood vessels were damaged. An X-ray is often recommended to pinpoint the location and severity of the break.
Treatment
Most broken collarbones heal well with conservative treatment and surgery is rarely necessary.
A simple arm sling can usually be used to immobilize the arm. A child may have to wear the sling for 3 to 4 weeks; an adult may have to wear it for 6 to 8 weeks.
Depending on the location of the break, your physician may apply a figure-of-eight strap to help maintain shoulder position.
Analgesics such as acetaminophen or nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen will help reduce pain.
A large bump will develop as part of the healing process. This usually disappears over time, but a small bump may remain.
Range of motion and strengthening exercises can begin as soon as the pain subsides. However, you should not return to sports activities until full shoulder strength returns.
In rare cases, depending on the location of the break and the involvement of shoulder ligaments, surgery is needed. Surgery usually gives good results.
* Materials borrowed from the AmericanAcademy of Orthopaedic Surgeons. More information can be found at www.aaos.org.
