(collar bone)
The collarbone, also called the clavicle, is the bone over the top of your chest.
It connects your sternum (breast bone) to your scapula (shoulder blade). It is an easy to feel and prominent bone.
When a bone breaks, it is called a fracture.
Clavicle fractures are the most common acute shoulder injury. About 2-5% of all adult fractures are of the clavicle. It is the most common fracture in children.
Symptoms
A broken collar (clavicle) bone can be very painful and you will find it is difficult to move the arms. Besides that, you will may experience any of these symptoms:
- Swelling and bruising around the broken bone
- Pain and grinding sensation in attempting to lift the arms
- A “bump” over the broken bone
- Tenderness on gentle pressure of the bump.
Causes
The most common cause of a broken collar bone is trauma / an accident. This can involve falling down, being hit on the shoulder or being in a car accident.
Some people are prone to break their bone without any trauma. These people usually have weak bones usually due to osteoporosis.
Risk Factors
There are a few factors which may put you at higher risk of a broken collar bone. These include:
- Age – people both very young and old are at a higher risk as their bones are not as strong as in teenage and adult years.
- Sports – sports such as football, basketball, wrestling, rugby, hockey, skiing and snowboarding can increase the risk of a clavicle fracture. Sport injuries are among the most common causes of a broken collar bone.
- Osteoporosis – Osteoporosis can weaken the strength of bones leading to an increased risk of fractures.
Investigations
The doctor will ask about the injury and how it happened. Then, the doctor will examine your shoulder carefully, to make sure that there is no damage to the nerves or blood vessels of the arm.
The doctor will order an X-ray to investigate further the location and severity of the break. If he or she cannot find any broken bone despite the pain, a CT or MRI may then ordered to investigate the fracture further. In most cases, only an X-ray is required.
Complications
Malunion – this is when the fracture heals in an abnormal way, such that the normal structure of the bone is disrupted. This may lead to a lump that may be felt over the clavicle at the site of the fracture. Usually this does not cause any pain or disability. In severe cases, the malunion may cause problems that may require further treatment. It is important to follow the advise of your doctor, surgeon and physiotherapist to minimise the risk of developing this complication.
Non-union – this is when the two ends of the fracture fail to heal together. It is rarely seen with fractured clavicle.
Deformity – there may be a lump of bone around the fracture site that you can feel and see. It may require removal if it results in a pressure point on the skin.
Damage to blood vessels – very large blood vessels lie behind the clavicle, and can be damaged in severe fractures. Whilst this is a life-threatening complication, it is very rare.
Treatment
Non-surgical
Most fractures of the collar bone can be treated without surgery. Recovery will usually take 6 – 8 weeks during which time the shoulder needs to be protected. Usually non-surgical treatment involves:
- Arm support – A simple sling to take the weight of the arm off the collar bone is the most important measure to ensure proper healing of the fracture.
- Pain medication may be prescribed in the early stages of the recovery.
- Physiotheraphy may be necessary to preserve the strength of the shoulder muscles and ensure a return to normal movements.
Surgical
If the fracture is very severe and the broken ends of the collar bone are not stable, then a surgical procedure may be required to ensure the bone heals. The surgeon may need to use plates, screws and pins to support the bones.
Seeking Advice
Your Family Doctor (GP)
Your Family Doctor is a great place to start to to diagnose and help treat your problem. He or she will be able to
- tell you about your problem
- advise you of the best treatment methods
- prescribe you medications
- and if necessary, refer you to Specialists (Consultants) for further treatment
Emergency Department
If you cannot see your Family Doctor, the doctors in the Emergency Department can diagnose and treat clavicle fractures. If the pieces of broken bone aren’t lined up properly to allow healing with a sling, you may be referred to an Orthopaedic Surgeon.
Bring along information about yourself
It can be a great help for your doctor if you bring along the following information about yourself
- A list of your medications, including the name and dosage.
- Information about your medical problems and past treatment
- Previous investigation results, such as xrays and blood tests.
Prevention
The best prevention of collar bone fractures is to avoid falls or accidents. Make sure the home environment is safe and free of hazards. When playing contact sports, ensure the appropriate safety equipment is used.
If you have been diagnosed with Osteoporosis, make sure you follow up with your Family Doctor to ensure the condition is well treated and any further damage to your bones avoided.
F.A.Q. | Frequently Asked Questions
Will the doctor take the plates and screws out if my bone when the fracture has completely healed?
These plates and screws are not usually removed after the bone has healed, unless they are causing discomfort or become infected.