Clavicle fracture

What is a clavicle fracture?

The collar bone, also known as the clavicle, is the bone that spans from the tip of the shoulder to the base of your throat. Clavicle fractures are most often caused by a direct blow to the shoulder. This can happen if you fall directly onto the shoulder or onto an outstretched arm. It can also happen during a collision.

Symptoms

A clavicle fracture can be painful and it may be hard to move your arm. Other signs and symptoms of a fracture may include:

• sagging of the shoulder downward and forward
• inability to lift the arm because of pain
• a grinding sensation when you try to raise the arm
• a deformity or bump over the break
• bruising, swelling and/or tenderness over the collarbone.

Treatment

The treatment is most commonly non-surgical but for some cases surgery may be required.

You may not need surgery if the broken ends of the bones have not significantly shifted out of place. Nonsurgical treatment may include:

• arm support: immediately after the break, a simple arm sling is usually used for comfort and to keep your arm and shoulder in position while the injury heals. You will wear the sling for a week or two (for more information, please see the fact sheet on slings.)
• medication: pain medication, including paracetamol, can help relieve pain as the fracture heals
• physical therapy: although there will be some pain, it is important to maintain arm motion to prevent stiffness. Often, patients begin exercises for elbow motion immediately after the injury
• surgical treatment: may be needed if fractured bone is pushing into the skin, there is too much movement, or the break is at either end of the bone. You may be referred to an orthopaedic surgeon for further management, if required.

After a clavicle fracture, it is common to lose some shoulder and arm strength. Once the bone begins to heal, your pain will decrease, and your doctor may suggest gentle shoulder exercises. These exercises will help prevent stiffness and weakness. More strenuous exercises will be started gradually when the fracture is completely healed.

Follow-up care: you will need to see your doctor regularly until your fracture heals. During these visits, they will take X-rays to make sure the bone is healing in a good position. After the bone has healed, you will be able to gradually return to your normal activities.

Home care

While each break will behave differently, when recovering from a broken collarbone you may find it helpful to:

• use ice packs and painkillers if pain and swelling continue while your arm is in a sling
• as soon as it is comfortable to do so, move your elbow, hand and fingers regularly
• remove the sling for short periods of time if it is not too painful or when you think the fracture has started to heal
• do not play contact sports for at least 10 to 12 weeks after the injury. Your doctor will tell you when you can go back to work and resume normal activities.

Sleep

Even when you have good pain relief medication the first night is usually the worst for discomfort. Often sleeping while sitting up will help. Arrange pillows under and around your chest to allow your arm to hang in a controlled way. It also stops you from rolling over onto the broken side. After the first 24 to 48 hours the discomfort and unpleasant catching sensation will decrease.

What to expect

The bone will take eight weeks to fully remodel, however you will feel much better after two to three weeks and will be able to use your arm for most daily tasks. But do not lift heavy objects.

Returning to contact sport is something you need to discuss with your doctor and physiotherapist.

See your doctor immediately if you:

• have shortness of breath or suddenly feel very unwell or faint
• feel tingling or weakness in your arm which is new and not known to your treating clinician
• feel bones have moved a lot and could be pointing under the skin.

Seeking help

In a medical emergency call an ambulance – dial triple zero (000). If you have any concerns, see your local doctor or healthcare professional. If this is not possible return to the emergency department or urgent care centre.

For more information

Ask your local doctor or healthcare professional. You can also call healthdirect 24 hours a day on 1800 022 222 or visit healthdirect.gov.au.