The clavicle is your collarbone. It connects your arm to the rest of the skeleton. It is S-shaped and extends from the sternum (sternoclavicular joint) to the shoulder blade (acromioclavicular joint). It is right under the skin and can be very prominent in some people. Each of us has 2 collarbones, one on each side. A broken collarbone is a very common injury.
Broken collarbones are very common. A fall or direct blow to the shoulder is a typical mechanism of injury. Fractures of the clavicle can also happen after a fall on the outstretched hand, or during childbirth in babies. The middle third of the clavicle is usually involved.
• Sharp pain upon moving the arm
• Inability to lift the arm overhead
• Swelling and bruising
• Prominent bone edges right under the skin (tenting)
• Numbness and tingling (rare)
• Bone edges sticking out of skin (rare)
The doctor will take a detailed history and examine you carefully. An x-ray is usually enough to confirm the diagnosis. Your arm will be placed in a sling for comfort.
Most clavicle fractures can be treated without surgery, in a sling for a few weeks. They typically need 6-8 weeks to heal in children and 3-4 months in adults. You may feel a bump in the area of the fracture, that may reduce in size with time, as your fracture heals. Some fractures, however, especially those accompanied by shortening, displacement and comminution may need surgery to heal properly. Surgery is done with general anesthetic +/- nerve block, in the beach chair or supine position. The surgeon will perform an incision over the clavicle, find, clean and reduce the broken pieces and hold them together with a construct of plates and screws. The soft tissues and skin are then closed, and the arm is placed in a sling. Recovery involves early gentle mobilization as pain allows.
After surgery, some patients may experience numbness around the scar area. As the collarbone is under the skin without much muscle cover, the plate and screws may be felt under the skin, especially while wearing a bra or backpack. If that’s the case, the bothersome plate and screws may be removed after a few months, when the fracture has healed.
Dr Panagopoulos has extensive experience in upper limb trauma and will discuss all options with you during your visit in the office. In clavicle fractures, surgery and nonoperative treatment have similar outcomes. Surgery, however, demonstrates better union rates and faster time to union.
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