The clavicle, commonly known as the collarbone, is a slender bone that connects the breastbone (sternum) to the shoulder blade (scapula). It plays an important role in stabilizing the shoulder and allowing arm movement. Because of its location and exposure, the clavicle is one of the bones most likely to break, especially during falls, sports injuries, or vehicle accidents.
Understanding how these injuries happen, their symptoms, and the best treatment options is key to ensuring proper recovery.
How Clavicle Fractures Happen
The collarbone is vulnerable to injury because it lies just beneath the skin with little soft tissue protection. Most clavicle fractures occur from:
- Falls onto an outstretched arm or shoulder – A common cause in both adults and children
- Sports injuries – Especially contact sports like football, hockey, rugby, and cycling accidents
- Direct trauma – Such as being struck on the shoulder or chest during an accident
- Birth injuries – Occasionally, newborns can sustain clavicle fractures during delivery
Types of Clavicle Fractures
Clavicle fractures are classified based on their location and pattern:
- Midshaft fractures
These occur in the middle portion of the collarbone and are the most common type. - Distal fractures
These happen near the shoulder joint where the clavicle meets the acromion. - Medial fractures
These occur near the sternum and are less common but can be associated with other injuries.
Fractures can also be non-displaced, where the bone pieces remain aligned, or displaced, where the bone fragments shift out of position. Severe cases may involve the bone breaking through the skin (open fracture).
Symptoms to Watch Out For
A clavicle fracture typically causes immediate discomfort. Common symptoms include:
- Sudden pain at the site of injury
- Swelling, tenderness, and possible bruising around the collarbone
- A visible bump or deformity over the fracture site
- Difficulty moving the arm or shoulder without pain
- Grinding or crackling sensations with shoulder movement
In displaced fractures, the shoulder may appear to sag or be pushed forward due to loss of support from the clavicle.
How Clavicle Fractures Are Diagnosed
An orthopaedic specialist will perform a physical examination to check for tenderness, swelling, and arm mobility. Imaging tests are then used to confirm the fracture:
- X-rays – The primary tool to determine the location and severity of the break
- CT scans – Occasionally used for complex or multi-fragment fractures
- Evaluation of nearby structures – To ensure there is no nerve, blood vessel, or lung injury in severe cases
Treatment Options
The treatment of a clavicle fracture depends on the type of fracture, the degree of displacement, and the patient’s age and activity level.
Non-Surgical Treatment
Most clavicle fractures, especially non-displaced or minimally displaced ones, heal without surgery. Non-surgical care typically includes:
- Arm sling or figure-of-eight brace to immobilize the shoulder while the bone heals
- Pain management with medications and ice therapy
- Physiotherapy after initial healing to restore movement and strength
Healing usually takes 6 to 12 weeks, depending on the patient’s age and overall health.
Surgical Treatment
Surgery may be recommended for:
- Severely displaced or shortened fractures
- Open fractures where the bone pierces the skin
- Fractures associated with nerve or blood vessel damage
- Multi-fragment (comminuted) fractures
Surgical procedures often involve using plates and screws or pins to stabilize the bone. After surgery, a structured rehabilitation plan is essential to ensure proper healing and shoulder function.
Recovery and Rehabilitation
Recovery from a clavicle fracture involves several stages:
- Immobilization Phase – Lasts a few weeks for non-surgical cases or until the surgeon clears movement for surgical cases.
- Early Rehabilitation – Gentle range-of-motion exercises start once initial healing occurs to prevent stiffness.
- Strengthening Phase – Physiotherapy focuses on rebuilding shoulder and arm strength to restore normal function.
Most patients recover fully and return to daily activities in 3 to 4 months, although athletes may need a longer time before resuming high-impact sports.
Possible Complications
While most clavicle fractures heal well, potential complications can include:
- Delayed union or non-union if the bone does not heal properly
- Mal-union where the bone heals in a misaligned position
- Nerve or blood vessel injury in severe fractures
- Shoulder stiffness or weakness if rehabilitation is delayed
Prompt evaluation and adherence to the treatment plan greatly reduce the risk of complications.
Preventing Clavicle Injuries
Not all fractures can be prevented, but steps to reduce risk include:
- Wearing protective gear during contact sports or cycling
- Practicing safe falling techniques in activities like skiing or skateboarding
- Maintaining bone health with proper nutrition and weight-bearing exercise
- Avoiding high-risk activities without proper safety measures
When to See an Orthopaedic Specialist
Any suspected clavicle fracture should be evaluated immediately. If you experience sudden shoulder pain after a fall, visible deformity, or difficulty moving your arm, seek medical attention promptly by an orthopaedic surgeon. With timely diagnosis, proper treatment and dedicated rehabilitation, most people make a full recovery and return to their normal activities without long-term limitations.
