What are the other Names for this Condition? (Also known as/Synonyms)

• Broken Clavicle
• Broken Collarbone
• Collarbone Fracture

What is Clavicle Fracture? (Definition/Background Information)

• The area surrounding the clavicle consists of many vital nerves and blood vessels. However, these critical structures are seldom damaged when the clavicle gets fractured
• A Clavicle Fracture is a break or crack that involves the clavicle bone, which lies between the sternum (ribcage) and scapula (shoulder blade)
• A Clavicle/Collarbone Fracture is usually caused by a high-energy impact that results from an athletic sport, motor vehicle accident, or a fall
• Overall, men are twice as likely to sustain a Broken Clavicle than women
• Treatments associated with a Clavicle Fracture include nonsurgical and surgical methods

There are 3 different types of Clavicle Fracture:

Proximal Clavicle Fracture: (Type A)

• Proximal Clavicle Fracture are fractures that occur on the inner third of the clavicle
• This type of fracture occurs in 5% of the cases
• Displaced Proximal Fractures require close examination for neurovascular compromise, and usually require reduction (surgical procedure)
• Non-displaced Proximal Fractures are treated conservatively with a sling to restrict movement. Physical therapy exercises are then used to improve flexibility and decrease stiffness

Midshaft Clavicle Fracture: (Type B)

• Midshaft Clavicle Fractures are fractures that occur in the middle of the clavicle
• This type of fracture occurs in 80% of the cases
• Diagnostic methods associated with such fractures usually are a thorough physical examination and radiology imaging
• Treatment associated with a Midshaft Clavicle Fracture involves restoring normal function, decreasing pain, and quickly return an individual to daily activities

Distal Clavicle Fracture: (Type C)

• Distal Clavicle Fractures are fractures that occur on the outer third of the clavicle, to the coracoclavicular ligaments
• Such fractures occur in 15% of the cases
• Distal Clavicle Fractures usually require internal fixation devices to stabilize the fracture

Who gets Clavicle Fracture? (Age and Sex Distribution)

• Clavicle Fractures are non-specific injuries, and as such, may occur in individuals of any age, race, ethnic group, and gender
• Overall, men are twice as likely to sustain a Fractured Clavicle, than women
• Children and adolescents are higher prone, due to an underdeveloped bone and a higher participation rate in sports
• Occasionally, overweight infants may also suffer a Clavicle Fracture, during the delivery process

What are the Risk Factors for Clavicle Fracture? (Predisposing Factors)

Common risk factors associated with Clavicle Fractures include:

• Elderly individuals have a higher risk, due to decreasing strength/density of bones
• Children and adolescents, due to underdeveloped bones and higher physical activity involvement/participation rate in sports
• Participation in any rough or high-impact sport
• High birth weight infants

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Clavicle Fracture? (Etiology)

Some of the causes associated with a Fracture of the Clavicle include:

• Falls: Falling hard, directly onto one’s shoulder, or with an extended hand, is a common cause
• Taking part in any rough or high-impact sport
• Birth-related injury: Clavicle Fractures are frequent during childbirth, when the babies are overweight, or at an advanced gestational age

What are the Signs and Symptoms of Clavicle Fracture?

Signs and symptoms of a Clavicle Fracture include:

• Increased pain in the shoulder associated with movement
• Swelling, tenderness, and bruising of the shoulder
• Visible enlargement of the shoulder muscle
• Shoulder stiffness
• Noticeable shoulder deformity at the site where the injury occurred

How is Clavicle Fracture Diagnosed?

Diagnostic methods that a physician may use to help diagnose a Clavicle Fracture include:

• Physical examination: A thorough physical examination is important in identifying any noticeable deformities, swelling, contusions, within the shoulder. Individuals are also expected to provide an explanation of the circumstances that caused the injury. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
• X-ray of shoulder: X-rays are common methods in evaluating a fracture, including if the bone has been displaced. This diagnostic test will provide a clear image of the bone, identify the exact location of the injury, and determine the extent of the fracture
• Computerized tomography (CT) scan: A CT scan takes a series of x-ray images from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues within the shoulder. This diagnostic test helps a physician evaluate the severity of the injury

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Clavicle Fracture?

Common complications associated with a Clavicle Fracture include:

• Permanent damage to nerves and blood vessels
• Poor or delayed healing of the clavicle
• A visible bump may develop directly over the fracture site
• The immobilization required to heal Clavicle Fracture may occasionally result in painful shoulder inflammation, stiffness, and reduced range of motion (termed frozen shoulder)
• Infection of the bone (osteomyelitis)
• If the acromioclavicular (shoulder blade) or sternoclavicular (sternum) joint is involved in the fracture, degenerative joint disease may develop (osteoarthritis)

How is Clavicle Fracture Treated?

A Clavicle Fracture may be treated using nonsurgical and/or surgical treatment methods.

The nonsurgical treatment methods include:

• Applying ice to the shoulder can help reduce pain and swelling
• Complete immobilization of the shoulder with a cast, may be required to restrict movement
• Non-steroidal anti-inflammatory oral medications, such as indomethacin and naproxen may be used to treat a Clavicle Fracture. These medications can help decrease the pain and swelling
• Individuals are likely to need physical therapy exercises after the cast is removed. The goals of these exercises are to strengthen the shoulder muscles, improve flexibility, and decrease stiffness. It may take several months for an individual to complete the physical therapy programand regain full strength and functionality
• If an infant sustains a Clavicle Fracture during childbirth, healing usually occurs automatically within a few weeks, without the need for elaborate medical treatment measures. In the meantime, the child has to be handled carefully

The surgical treatment methods include:

• Closed reduction: Closed reduction is a surgical treatment that involves realigning the fractured bone back to its original position, without making an incision at the fracture site. This procedure is usually performed under a general anesthesia, or by conscious sedation using muscle relaxants
• Open reduction and internal fixation (ORIF): Open reduction is a surgical procedure to realign the fractured bone, to its original position. Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bone under the skin

How can Clavicle Fracture be Prevented?

To prevent a Clavicle Fracture, individuals should be careful and consciously aware, while performing any physical activities, such as sports, or even some normal daily activities that could lead to situations involving accidents. Children must be provided a safe environment to work, study, or play. Any possible dangers should also be anticipated and appropriate safety measures adopted.

A few ways to further help prevent unwanted injuries or a Clavicle Fracture include:

• Individuals, who participate in any high-risk sports, such as football, should wear appropriate safety equipment to help prevent the possibility of such fractures
• Wearing appropriate footwear (such as the proper shoe size) may help prevent accidents
• Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. Regular diet with appropriate calcium-intake is recommended, even after a Clavicle Fracture
• Perform weight-bearing exercises to strengthen bones

What is the Prognosis of Clavicle Fracture? (Outcomes/Resolutions)

• The long-term prognosis of Clavicle Fractures is usually good, in a majority of the individuals. Generally, such fractures require about 3 months to heal
• In individuals with diabetes, it may take a longer time to heal (due to decreased functionality of the immune system)
• Individuals, who smoke or chew tobacco, may also take longer to heal (due to the constriction of the blood vessels). Nicotine-intake slows down the body healing process
• When properly treated, usually under the guidance of a physiotherapist and specialist, a high percentage of individuals regain full strength and range of motion
• There are usually no complications associated with Clavicle Fracture in a newborn, and full recovery is expected without any treatment

Additional and Relevant Useful Information for Clavicle Fracture:

The majority of Clavicle Fractures in newborns occur accidentally, during childbirth. It is difficult to predict and avoid such an occurrence, during the delivery period.