Clavicle Fracture

What is a clavicle fracture?

A clavicle fracture is a broken collarbone. The clavicle is part of the shoulder and can be found at the base of the neck, extending from the ribcage to the arm. A clavicle fracture occurs when this long, thin bone breaks from a fall, trauma, direct blow, work injury or from a sports collision. This type of fracture is fairly common and accounts for 5% of all adult bone fractures. Dr. Benedict Nwachukwu, orthopedic shoulder specialist serving Manhattan, New York City and the surrounding New York boroughs has extensive experience in treating this type of injury.

How are clavicle fractures classified?

Fractures of the collarbone are classified by its anatomical position:

• Midshaft – The most common type of clavicle fracture, occurs in the middle of the bone. Midshaft fractures can be treated without surgery if they remain in their correct position
• Lateral or Distal – Occur furthest away from the center of the body, near the extension at the top of the shoulder called the acromion. Bone placement will determine the need for surgery
• Medial – Fairly uncommon, occur closer to the neck and make up only 2-4% of all clavicle fractures.

What are the symptoms of a clavicle fracture?

Clavicle fracture symptoms vary depending on the severity of the injury. The most common symptoms are:

• Sharp pain, felt at the time of injury
• Pain when moving the arm
• Swelling, bruising and tenderness
• Difficulty in lifting or rotating the arm
• Stiffness in the shoulder
• Noticeable deformity or “bump” over the break
• Downward shoulder sag

Who is at risk for a broken collarbone?

Clavicle fractures almost always happen from a traumatic injury; a fall on an outstretched hand, a direct hit as seen in contact sports, or from a car, bike or other accident. The following groups of individuals are at the most risk for a broken collarbone:

• Children and teens – Children and teens between the ages of 10 and 19 run a higher risk of clavicle fracture, because the bones are still growing and are more susceptible to fracture. The lower density in their bones make them easier to break.
• Male athletes – Especially athletes who participate in contact sports, or high-impact activities. Athletes who are in higher impact sports are three-times more likely to suffer a broken collarbone.
• Older adults – Bone density decreases with age and a minor fall can cause a clavicle fracture in the older adult.

How is a clavicle fracture diagnosed?

Dr. Benedict Nwachukwu will obtain a patient history, including events which lead up to the injury. He will ask about symptoms, pain levels and will conduct a thorough examination of the shoulder. An x-ray will confirm the diagnosis and a CT scan, or an MRI scan may be ordered to provide Dr. Nwachukwu with more information on the overall condition of the shoulder and if any other shoulder structures were damaged during the injury.

How are clavicle fractures treated?

The decision for surgical intervention for a clavicle fracture depends on the type and severity of the break. If the broken ends of the bones do not shift out of place, surgery is not needed.

Non-surgical treatments:

• Rest
• Ice
• Immobilization – arm sling for comfort and to keep the shoulder in the correct position for healing.
• Medication – Pain medication, acetaminophen or other pain relievers may help relieve symptoms while the injury heals.
• Physical Therapy – Will help maintain arm motion and will progressively continue to restore strength to the arm and shoulder

If the broken ends of the bones have not significantly shifted out of place, you may not need surgery. Most broken collarbones can heal without surgery.

Surgical treatments:

For clavicle fractures that are not in their correct anatomical position, have broken through the skin, or are in several pieces, surgery may be necessary. Clavicle fracture surgery involves realigning the broken pieces of bone and holding them in place with special plates, pins, or screws.

How long does it take for a broken collarbone to heal?

Patients heal at different rates depending on their general health and underlying illnesses. Children can typically heal from a clavicle fracture in 3-6 weeks where it may take an adult 6-8 weeks. For patients in the New York area, Dr. Nwachukwu will confirm with an x-ray that the bone has completely healed. It is not unusual for patients to experience arm and shoulder weakness after a broken collarbone and it is important to follow physical therapy recommendations during and after healing.

For more information on clavicle fractures or a broken collarbone and the treatments available, please contact the office of Benedict Nwachukwu, MD, orthopedic shoulder specialist serving Manhattan, New York City and surrounding New York boroughs.