The shoulder is made of 3 bones: the upper arm bone (humerus), the shoulder blade (scapula) and the collarbone (clavicle). The clavicle sits between the ribcage and the shoulder blade and connects the arm to the body. In addition, the shoulder soft tissues, including the cartilage, labrum, ligaments, and tendons, provide dynamic stability for the shoulder joint.
What is a clavicle fracture?
A broken collarbone is the most common type of shoulder fracture, accounting for about 5% of all adult fractures, and 10-15% of childhood fractures. It is usually caused by a fall on the shoulder or an outstretched arm, or a traumatic accident that causes a direct blow to the shoulder. Almost 80% of clavicle fractures occur in the middle of the bone. Less commonly, the medial aspect of the bone (near the sternum) or the lateral aspect of the bone (near the AC joint) may fracture. The fracture may be just a crack or broken into several pieces. Moreover, the fracture may be well-aligned or not well-aligned (displaced).
Clavicle fractures are common in young adults, with a higher prevalence in males than females. Athletes who play football, hockey, soccer skating, skiing, bicycling, mountain biking and horseback riding are at risk. Specifically, fractures from a skiing or biking injury may cause multiple fractured fragments. The break may be an isolated injury or involve injuries to the other areas.
What are the symptoms of a clavicle fracture?
- Sharp pain, bruising and swelling
- A bump on the shoulder where the fracture is pushing against the skin
- An inability to lift the arm because of pain
- A shoulder that sags down and forward
- Movement generates pain and a grinding sensation
- If the bone protrudes from the skin, it is called an open fracture
How is a clavicle fracture diagnosed?
Dr. Godin will conduct a comprehensive physical examination of the collarbone, shoulder and upper chest looking for bruising, tenderness and swelling; and gently feel the area to determine the location and position of the break. He will also check for damage to the blood vessels and nerves. X-rays will confirm the diagnosis. Other imaging studies may be recommended to assess for concomitant soft tissue damage.
What are the treatment options?
Certain clavicle fractures can be treated with non-surgical intervention. If the fracture alignment and displacement are within certain parameters, the arm will be immobilized with a sling to support the arm while the break heals.
Early mobilization, while the shoulder is healing, is important to reduce pain, improve range of motion and allow for faster recovery. Restoration of full range of motion and strength will require physical therapy. About eighty percent of shoulder fractures are non-displaced. Almost 100% of collarbone fracture heal completely within 4-6 months. However, when the injury involves a displaced fracture,, surgical intervention may be recommended.
Surgical Treatment of Clavicle Fractures
The procedure is called an open reduction and surgical fixation, which is the most common surgical procedure for this type of fracture.
The procedure involves an incision over the broken bone. Dr. Godin will place the bone back in the correct position, and the fragments will be fixed with a plateand screws to keep the bone in place while the fracture heals. If needed, any soft tissue injury is also repaired. Pain management will keep the patient comfortable while the bone heals. Physical therapy will be necessary to restore range of motion and strength.
Dr. Jonathan Godin is a shoulder expert who will provide you with the most advanced treatment available for your needs, that will allow the quickest possible recovery and return to your active lifestyle.