Clavicle Fractures (Broken Collarbone)
by Dr Marcus Chia - Shoulder and Elbow Surgeon
Most present with pain, swelling and deformity (a lump over the collarbone). There may be tenting of the skin over the fracture. There may be bruising or a graze over the shoulder. Shoulder movements are painful, particularly above shoulder level. Rarely, clavicle fractures are associated with damage to the blood vessels and nerves that supply the arm.
Xrays are necessary to assess the need for surgery. In some cases a CT scan may be required.
The majority of clavicle fractures heal over time with the use of a sling and avoidance of activities for 6 to 10 weeks. The use of ice and simple analgesics is helpful to reduce pain and swelling. There may be a noticeable bump where the fracture has healed.
If the clavicle fracture does not line up well, is short or in multiple fragments (‘comminution’), surgery may be recommended. Clavicle fractures may be fixed with a plate and screws or the use of a long pin (‘intramedullary nailing’). Dr Chia’s preferred method of treatment, in the majority of cases, is with the use of a plate and screws. This involves a minimally invasive incision just below the clavicle which is usually less than half of the length of the plate. Surgery does not speed up the healing process but rather ensures that the bone heals correctly.
Post-operatively the shoulder will be placed in a sling for comfort which can be removed as needed. Ice is encouraged to control pain and swelling. All activities above shoulder level are to be avoided for the first 6 weeks. Return to contact sports is allowed once bony union has occurred, generally by 10 weeks. Plate removal is not routinely necessary due to Dr Chia’s use of the new pre-contoured, low profile plates.
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