Overview
what it is and why it mattersThe clavicle, your collarbone, is the bone you can feel running across the top of your chest from your shoulder to your throat. Clavicle fractures make up about 5% of all broken bones, most often in young men and athletes who took a direct hit to the shoulder or fell hard on an outstretched arm. About 80% happen in the middle third of the bone; the ends (close to the shoulder or close to the throat) break less often. Most heal well in a sling without surgery. But fractures where the broken ends have shifted significantly or shortened the bone have a higher chance of healing crooked, and surgery is becoming more common for those.
Symptoms
what patients describeA broken collarbone usually happens in an instant: a direct blow to the point of your shoulder in a collision, a fall from a bike, or a hard landing on an outstretched arm. You will feel a sharp crack or pop, and pain will immediately prevent you from raising the arm on that side. Most people instinctively cradle the injured arm against their body for support, and any attempt to move the shoulder or take a deep breath will sharpen the pain.
Swelling develops rapidly over the fracture site, and you can often see or feel the deformity: a visible bump where the broken ends have shifted apart or ridden over each other, or a drooping shoulder that looks lower than the uninjured side. Bruising spreads across the upper chest and shoulder within a day or two. In displaced fractures the skin over the bump may be stretched thin and tenting. If you see skin blanching white over the break, that is a reason to be seen the same day.
Diagnosis
exam first, imaging secondPain, swelling, and often a bump you can see or feel where the bone has shifted. A standard shoulder X-ray confirms the fracture. A second angled X-ray view helps your surgeon judge how much the fragments have displaced. A CT scan is added for fractures at the outer end, near the AC joint.
How We Treat It
most heal in a slingMost clavicle fractures, especially the common midshaft breaks where the ends have not shifted far, heal reliably without surgery. The goal early on is simply to support the arm and let the bone knit, then gradually rebuild motion and strength as healing X-rays allow.
1
Sling Immobilization
A simple sling for the first several weeks while the bone knits back together: the standard treatment for most midshaft fractures. As X-rays start showing healing, your surgeon will progressively add motion and strength work. The vast majority heal reliably this way.
2
Figure-of-Eight Brace
A figure-of-eight brace pulls the shoulders back to keep the broken ends better aligned. There is some evidence it improves alignment, but for most patients the final outcome ends up similar to a sling.
Surgical Options
if non-operative care isn't enoughSurgery is required when there is an open fracture (the bone broke through the skin), the skin over the fracture is being stretched so thin it is about to tear, an injury to the blood vessels nearby, or a floating shoulder (a clavicle fracture combined with a scapula fracture). Surgery is also considered, though not strictly required, when the bone has shortened a lot, when the broken ends are completely overlapped, or when an active athlete wants the faster, more predictable recovery surgery offers.
Providers Who Treat Clavicle Fracture
fracture care team
Frequently Asked
questions we hear in clinicDo I need surgery for a broken collarbone?
Usually no. Most clavicle fractures heal well in a sling without surgery, especially the common midshaft breaks where the ends have not shifted far. Surgery becomes more likely when the broken ends have shifted significantly or the bone has shortened, which raises the chance of healing crooked.
How is a clavicle fracture diagnosed?
From the exam first: pain, swelling, and often a bump you can see or feel where the bone has shifted. A standard shoulder X-ray confirms the fracture, and a second angled view helps your surgeon judge how far the fragments have displaced. A CT scan is added for fractures at the outer end, near the AC joint.
How common are clavicle fractures, and where does the bone usually break?
They make up about 5% of all broken bones, most often in young men and athletes after a direct hit to the shoulder or a fall onto an outstretched arm. About 80% happen in the middle third of the bone; the ends, closer to the shoulder or the throat, break less often.
When should I be seen the same day?
If the skin over the bump looks blanched white, that is a reason to be seen the same day. In displaced fractures the skin over the bump can be stretched thin and tenting, and that needs prompt attention.
When is surgery actually required?
Surgery is required when there is an open fracture where the bone broke through the skin, skin over the fracture stretched so thin it is about to tear, an injury to nearby blood vessels, or a floating shoulder (a clavicle fracture combined with a scapula fracture). It is also considered, though not strictly required, when the bone has shortened a lot, when the broken ends are completely overlapped, or when an active athlete wants the faster, more predictable recovery surgery offers.
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: