Clavicle Fracture Surgery

What is a clavicle fracture?

A clavicle fracture – also known as a broken collarbone – is a break in the bone that attaches the shoulder to the chest. Clavicle fractures account for up to 5 percent of all adult broken bones. These types of injury typically occur when someone falls onto the shoulder or onto an outstretched hand. A broken collarbone will often be very painful, and patients will report feeling a pop as the bone breaks. Dr. Benedict Nwachukwu, orthopedic shoulder surgeon, treats patients in Manhattan, Brooklyn, New York City and the surrounding New York boroughs who are experiencing pain associated with a fractured or broken clavicle.

How do I know if I have a clavicle fracture?

Patients who have a clavicle fracture will often have pain in the collarbone area and will report difficulty with moving the arm. Commonly, there may be a droop associated with the side of the shoulder where the clavicle is broken. In general, symptoms of a broken clavicle in include:

• Sagging of the shoulder downward and forward
• Inability to lift the arm because of pain
• A grinding sensation when you try to raise the arm
• A deformity or “bump” over the break
• Bruising, swelling, and/or tenderness over the collarbone

How is a clavicle fracture diagnosed?

Dr. Benedict Nwachukwu is a clavicle fracture expert and sees a high volume of these injuries in the New York City, Brooklyn and New Jersey area. He will often have an index of suspicion for the injury based on your story of events leading up to the fracture and your symptoms. In the office, he will obtain an X-Ray of the clavicle to confirm the diagnosis. If you have had an x-ray in the Emergency Room or at an Urgent Care – you should bring this to your visit. This is helpful in allowing Dr. Nwachukwu to evaluate the state of the fracture and if it has moved or shifted.

Can I treat my clavicle fracture without surgery?

The majority of clavicle fractures can indeed be treated without surgery. When you are evaluated by Dr. Nwachukwu in the office, he will make an assessment regarding the displacement of your fracture (how far apart the bones are) as well as the fracture stability (how likely it is to stay unmoved and heal). If there is not a lot of displacement and the fracture is stable, non-operative treatment is preferred. In these patients, Dr. Nwachukwu will place them in a sling with repeat x-rays several days afterward to confirm bone healing. Once there has been enough bone growth (3-4 weeks of immobilization), Dr. Nwachukwu will allow you to start gentle physical therapy with progression in therapy as the pain allows. For most patients, it takes 6-8 weeks for bone to heal.

When does a clavicle fracture need surgery?

There are several instances when a clavicle fracture requires surgical intervention. Surgical repair of the clavicle should be considered when:

• A large degree of displacement (bones have moved far apart)
• Shortening of the clavicle (fracture ends have overlapped)
• If there is a compromised nerve (numbness or tingling)
• If there is concern about the cosmetic appearance of the collarbone

What does Clavicle fracture surgery involve?

Dr. Nwachukwu performs clavicle fracture surgery (clavicle fixation) as an outpatient procedure in which patients come in for surgery in the morning and go home the same day. A nerve block is used to provide pain relief. A small incision is made over the area of the fracture and plates and screws are placed to hold the fracture together. Depending on the type of fracture more/less screws & plates may be required. In general, Dr. Nwachukwu prefers a minimally invasive approach to his collarbone surgery and he will use a low-profile plate where possible.

Pre-operative image of a clavicle fracture that was left unattended for 6 months. It never healed and Dr Nwachukwu was able to repair the fracture with plates and screws. The bottom X-ray is taken at 3 months after surgery and shows excellent healing of the fracture.

How quickly will I recover after clavicle fracture surgery?

Patients find that after clavicle fracture fixation, their shoulder feels more stable and the pain from the broken bones is gone. In general, it takes 4-6 weeks for the bone to have enough healing strength after application of a plate. Dr Nwachukwu will allow patients to participate in early physical therapy, however the first 6 weeks weight bearing on the affected extremity is not allowed (no push-ups!) By 3 months post-op most patients are feeling very well and are able to resume their more vigorous sporting activities

For more information on clavicle fracture surgery, a broken collarbone, or to talk about the treatment options available for your shoulder pain, please contact the office of Benedict Nwachukwu, MD, orthopedic shoulder surgeon serving Manhattan, New York City and surrounding New York boroughs.