Clavicle Fractures

A clavicle fracture is a break in the collarbone, the long, slender bone that runs across the front of the chest from the breastbone to the shoulder. It usually happens suddenly, from a fall, a collision, or a direct blow to the shoulder, and causes immediate pain and difficulty moving the arm. Most clavicle fractures heal well without surgery, knitting back together over several weeks while supported in a sling.

A clavicle fracture usually happens in an instant. Common symptoms include:

• Immediate pain that prevents raising the arm on that side
• Pain that sharpens with any attempt to move the shoulder or take a deep breath
• Swelling over the fracture, with a visible bump or a shoulder that droops lower
• Bruising across the upper chest and shoulder within a day or two

Diagnosis begins with the history and a physical examination: tenderness directly over the bone, a visible deformity, and swelling all point to the collarbone. A standard shoulder X-ray confirms the fracture and shows where it occurred, and an angled view helps judge how far the pieces have shifted. A CT scan is added for fractures at the outer end near the shoulder joint.

Most clavicle fractures, especially midshaft breaks that have not shifted far, heal without surgery:

• A sling to support the arm and keep the shoulder comfortable while the bone heals
• Over-the-counter anti-inflammatory medication for pain and swelling in the early weeks
• A progressive program of motion and then strengthening once the bone shows healing

Surgery is considered when the bone has shortened significantly, the broken ends overlap, the fracture is at the outer end with the supporting ligaments torn, or the skin over the bump is close to tearing. A plate and screws restore length and alignment.

For a fuller explanation, including anatomy, diagnosis, and the full range of treatment:

• Clavicle Fracture (Broken Collarbone) — AAOS OrthoInfo