A broken collarbone is a break in the clavicle, the bone in the upper chest that connects the breastbone to the shoulder blade. Such breaks are relatively common, especially in babies, adolescents, and athletes. A broken collar bone can occur in several ways, but the most common involves some kind of trauma, such as falling, being hit directly on the shoulder itself, or involvement in an automobile accident.

Cause

Clavicle fractures are often caused by a direct blow to the shoulder. This can happen during a fall onto the shoulder or a car collision. A fall onto an outstretched arm can also cause a clavicle fracture. In babies, these fractures can occur during the passage through the birth canal.

Symptoms

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

• 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 break
• Bruising, swelling, and/or tenderness over the collarbone

Diagnosis

During the evaluation, your doctor will ask questions about the injury and how it occurred. After discussing the injury and your symptoms, your doctor will examine your shoulder.

There is usually an obvious deformity, or “bump,” at the fracture site. Gentle pressure over the break will bring about pain. Although a fragment of bone rarely breaks through the skin, it may push the skin into a “tent” formation.

Your Great Lakes Orthopedics & Sports Medicine orthopedic surgeon will carefully examine your shoulder to make sure that no nerves or blood vessels were damaged.

In order to pinpoint the location and severity of the break, your doctor will order an x-ray. X-rays of the entire shoulder will often be done to check for additional injuries. If other bones are broken, your doctor may order a computed tomography (CT or CAT) scan to see the fractures in better detail.

If your bones are out of place (displaced), your doctor may recommend surgery.

Procedure

Surgery can align the bones exactly and hold them in good position while they heal. This can improve 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 and/or by attaching metal plates to the outer surface of the bone.

After surgery, you may notice a small patch of numb skin below the incision. This numbness will become less noticeable with time. Because there is not a lot of fat over the collarbone, you may be able to feel the plate through your skin.

Plates and screws are usually not removed after the bone has healed, unless they are causing discomfort. Problems with the hardware are not common, but sometimes, seatbelts and backpacks can irritate the collarbone area.

If this happens, the hardware can 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 once the fracture has healed.

Rehabilitation

Specific exercises will help restore movement and strengthen your shoulder. Your doctor may provide you with a home therapy plan or suggest that you work with a physical therapist.

Therapy programs typically 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 an important factor in returning to all the activities you enjoy.