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Clavicle (Collarbone) Fractures
Dr Kau Chung Yuan (许医生)
MBBS (S’PORE)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
What are Clavicle Fractures?
Clavicle fractures, commonly known as collarbone fractures, are frequent injuries resulting from a direct impact on the shoulder area or a fall on an outstretched arm. The clavicle serves as a vital support structure for the shoulder, making it susceptible to fractures. These injuries can vary significantly in severity from minor cracks to complex fractures.
Given its location, a fractured clavicle often affects the ability to move the arm and shoulder, leading to a noticeable impact on daily activities and, in some cases, requiring surgical intervention to ensure proper healing and function restoration.
Causes and Risk Factors
Causes and risk factors of clavicle fractures may be attributed to multiple factors such as:
Direct Impact
A direct blow to the shoulder, often from sports injuries, falling on an outstretched arm, or vehicle accidents, is a common cause of clavicle fractures.
Osteoporosis
Reduced bone density can make the clavicle more susceptible to fractures even with minor trauma.
Genetic Factors
Some individuals may have a predisposition to bone fractures, including the clavicle, due to inherited bone conditions.
Symptoms of Clavicle Fractures
Common symptoms of clavicle fractures include the following:
- Pain that increases with shoulder movement, making it difficult to move the arm.
- Swelling and bruising around the area of the fracture, are visible soon after the injury occurs.
- Tenderness over the collarbone area, making it uncomfortable to touch.
- A noticeable deformity or bump at the fracture site indicates displaced bone fragments.
- A grinding sensation when trying to raise the arm, is caused by the bone fragments moving against each other.
- Limited range of motion in the shoulder, affecting the ability to lift the arm or carry objects.
Diagnosis of Clavicle Fractures
Diagnosing clavicle fractures involves a comprehensive approach and usually includes:
- Physical Examination
Assessment of symptoms, examining the shoulder area for tenderness, swelling, and deformity, and comparing the injured side to the uninjured side. - X-rays
A primary imaging test is used to confirm a clavicle fracture, showing the location and extent of the break. Different angles may be used to fully understand the fracture’s complexity. - CT Scan
In cases where the X-ray results are inconclusive or to evaluate complex fractures more thoroughly, a CT scan can provide detailed images of the bone and surrounding structures. - MRI
Although not commonly used for initial diagnosis, MRI may be recommended to assess damage to surrounding soft tissues, such as ligaments and tendons, especially in severe fractures.
Non-Surgical Management
Non-surgical treatment methods for clavicle fractures focus on supporting the bone’s natural healing process through the following:
Arm Support
Using a sling or figure-of-eight brace to immobilize the arm and shoulder, helps to reduce movement and aid in the healing process.
Pain Relief
Over-the-counter pain medications, such as acetaminophen or NSAIDs (non-steroidal anti-inflammatory drugs), can be used to manage pain and reduce inflammation.
Ice Application
Applying ice packs to the injured area for the first few days post-injury can help minimize swelling and discomfort.
Physical Therapy
After the initial healing phase, physical therapy may be recommended to restore movement, strength, and functionality to the shoulder and arm.
Activity Modification
Avoid activities that could exacerbate the injury or delay healing until the fracture has sufficiently healed.
Surgical Treatment
Surgery is considered for complex fractures with significant displacement, multiple fragments, or if the fracture has failed to heal with non-surgical treatment.
- Open Reduction and Internal Fixation (ORIF)
This procedure involves realigning the bone fragments to their normal position and securing them with plates and screws. - Intramedullary Fixation
A less invasive option where a rod is inserted into the marrow canal of the clavicle to stabilize the fracture. - Minimally Invasive Plate Osteosynthesis (MIPO)
Similar to ORIF but uses smaller incisions and minimizes soft tissue damage.
Dr. Kau Chung Yuan
MBBS (S’pore)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
- Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
- Master of Medicine (Orthopaedics), Singapore (MMed) 2013
- Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
- Bachelor of Medicine and Surgery (MBBS, Singapore) 2004
Prevention of Clavicle Fractures
Preventive measures for clavicle fractures aim to minimize the risk of injury through multiple strategies including:
- Wear Protective Gear: Utilizing protective equipment, such as padded clothing or shoulder pads, especially in contact sports or activities with a high risk of falls.
- Strengthening Exercises: Engaging in exercises to strengthen the muscles around the shoulder and upper body can provide better support to the clavicle.
- Practice Safe Techniques: In sports and physical activities, learning and applying proper techniques to fall safely and avoid direct impacts to the shoulder.
- Maintain Bone Health: Ensuring a diet rich in calcium and vitamin D, along with regular exercise, to maintain strong bones and reduce the risk of fractures.
- Environmental Modifications: Reducing hazards that can lead to falls, such as securing rugs, improving lighting, and using handrails on stairs.
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Frequently Asked Questions (FAQs)
Can a clavicle fracture heal without a cast?
Yes, clavicle fractures typically do not require a cast. Instead, arm support like slings or braces is used to immobilize the area, allowing the bone to heal naturally.
How long does it take for a clavicle fracture to fully heal?
The healing time for a clavicle fracture can vary, ranging from 4 to 8 weeks for minor fractures and up to several months for more severe or surgically repaired fractures. The exact timeline depends on the fracture’s severity, the treatment method, and the individual’s overall health.
Will I need physical therapy after a clavicle fracture?
Physical therapy is often recommended after a clavicle fracture, especially if there is significant immobilization. Therapy helps restore range of motion, strength, and function to the shoulder and arm.
Is there a risk of complications after a clavicle fracture?
While most clavicle fractures heal without significant issues, complications can occur, such as delayed union, non-union, or malunion of the bone, as well as nerve or vascular injury. Following medical advice and treatment plans is crucial to minimize these risks.