Clavicle Fracture (Broken Collarbone):
A clavicle fracture is a break in the collarbone, which is one of the shoulder’s primary bones. This is a rather common fracture, accounting for around 5% of all adult fractures. A fall onto the shoulder or outstretched arm, which causes the bone to snap or break, is the most prevalent cause of a broken clavicle. A broken collarbone can cause lots of pain, making arm movement difficult. The most common treatment for clavicle fractures is to use a sling to keep the arm and shoulder immobile while the bone heals.
The shards of bone in some clavicle fractures, on the other hand, travel significantly out of place when the injury occurs. For these more difficult fractures, surgery to relocate the collarbone may become necessary. The clavicle is a bone that connects the ribs (sternum) to the shoulder blade (scapula). The bone that connects the arm to the rest of the body is the ulna. A clavicle is located above a number of vital nerves and blood arteries. When a fracture occurs, however, these critical structures are rarely harmed.
Broken Clavicle Effects and Causes
Clavicle fractures affect persons of all ages and are rather prevalent. The Center section of the bone called the shaft, is where the majority of fractures occur. The bone might shatter where it joins to the ribs or shoulder blade on occasion. Clavicle fractures come in a variety of shapes and sizes. The bone might either crack slightly or shatter into countless pieces (comminuted fracture). The shattered bone fragments may line up straight or maybe crooked (displaced fracture). A direct impact on the shoulder is the most common cause of clavicle fractures. This can occur as a result of a fall on the shoulder or a car accident. A broken clavicle can also occur by a fall onto an outstretched arm. During a baby’s journey through the birth canal, a clavicle fracture can occur.
The pain from a clavicle fracture can become excruciating, and it might become difficult to move an arm. Symptoms are as follows:
Difficulty in bending the shoulder downward and forward
Inability to elevate the arm due to pain
A grinding feeling while trying to raise the arm
A bump or malformation over the break.
Bruising, swelling, and/or tenderness around the collarbone are other signs and symptoms of a fracture.
Doctor Examination – Physical Examination
Your doctor will want to hear how the injury happened and what symptoms your child is experiencing. He or she will then perform a thorough examination of your child’s shoulder. There is frequently a visible deformity, or bump, at the fracture site in a clavicle fracture. Pain will occur if you apply gentle pressure on the break. Although a bone fragment breaking through the skin is uncommon, it can cause the skin to develop a tent shape. The shattered ends of the bone in a clavicle fracture can induce tenting of the skin over the fracture site.
Your doctor will also conduct tests to confirm that no nerves or blood vessels were harmed as a result of the fracture. Dense structures, such as bone, are visualized using X-rays. An x-ray will be ordered by your doctor to help locate the location of the fracture and determine the severity of the break. He or she may also request x-rays of your child’s complete shoulder to rule out any other ailments. Your doctor may arrange a computerized tomography (CT) scan to observe the fractures in greater detail if other bones are damaged.
Broken Clavicle Treatment
Your child may not need surgery if the shattered ends of the bones have not shifted much out of place. The majority of fractured collarbones mend without the need for surgery. Treatment options that aren’t surgical include:
A basic arm sling is commonly used for immediate relief and to hold the arm and shoulder in place while the injury heals. Medication. Pain relievers, such as acetaminophen, can aid with pain relief as the fracture heals. Physical and occupational therapy. Although some pain will exist, it is critical to keep the arms moving to avoid stiffness. Patients frequently begin doing elbow mobility exercises as soon as the problem occurs.
It’s usual to lose some shoulder and arm strength after a collarbone fracture. The pain will subside as the bone heals, and your doctor may recommend gentle shoulder exercises. These exercises will avoid stiffness and weakness. Once the fracture has healed fully, patients will perform new physical therapy exercises.
Doctor Appointments after the initial treatment.
Until the fracture heals, your child will need to see your doctor on a regular basis. During these appointments, he or she will take X-rays to ensure that the bone is healing properly. Your child will gradually resume his or her normal activities once the bone becomes healed.
Your doctor may consider surgery if the shattered ends of the bones have shifted significantly out of place. Typically, surgery entails repositioning the shattered bone fragments and keeping them from migrating out of place until they recover. When your child has recovered, the surgical procedure will have enabled your child to strengthen his or her shoulders.
Internal fixation and open reduction:
This is the most common method for treating clavicle fractures. The bone fragments are initially moved (reduced) into their proper alignment throughout the process. Special metal gear is then used to hold the bone fragments in place. Surgeons will insert Internal fixation in a variety of ways, including:
Screws and plates:
The bone pieces are secured in place with specific screws and metal plates added to the outside surface of the bone once they have been restored to their usual alignment. You may detect a little patch of numb skin beneath the incision after surgery. With time, the numbness will become less noticeable. A parent can feel the plate through the skin because the clavicle is right beneath the skin. After the bone has healed, plates and screws are rarely removed unless they are causing pain. Hardware issues are uncommon, however, some patients report that seat belts and backpacks itch their collarbones. A surgeon can remove the hardware after the fracture has healed if this happens.
Pins or screws:
After the bone ends have been reattached, pins or screws can keep the fracture in place. Pin and screw installation incisions are frequently smaller than plate incisions. Pins and screws irritate the skin where they are put, therefore they are usually removed when the fracture heals.
Your child will have some discomfort following surgery. During the healing period, this is a very normal occurrence. Many individuals discover that applying cold and taking non-prescription pain relievers is all they need to feel better. If the pain is severe, your doctor may recommend taking a prescription-strength medicine for a few days, such as an opioid. Although opioids can aid with pain relief after surgery, they will only be taken for a short period. Opioid addiction and overdose have become major public health concerns. As a result, opioids are usually only prescribed for a limited duration. It’s critical to follow your doctor’s instructions when using opioids. Your child should stop using opioids as soon as the pain starts to improve.
Specific exercises can help regain movement in your child’s shoulder and strengthen it. Your doctor may recommend that your child work with a physical therapist or provide you with a physical therapy plan to conduct at home. The majority of therapy programs begin with modest motion exercises. As the fracture heals, your doctor will progressively add strengthening activities to the Program. Following the physical therapy plan is a key part of your child returning to all of the things he or she enjoys, even if it is a slow process.
A broken clavicle might migrate out of place before it heals in some instances. It’s critical for your child to see your doctor on a regular basis to ensure the bone stays in place. A malunion occurs when the fracture pieces shift out of place and the bones recover in that condition. The extent to which the bones are out of place and how much this impairs arm movement determines the treatment. As the fracture heals, a big bump may form over the fracture site. This normally fades with time, but a little lump may persist for a long period.
Any sort of surgery comes with its own set of dangers. These include: Infection, Bleeding, Wound healing issues, Pain, Blood clots, Damage to blood vessels or nerves and anesthesia reactions Difficulty with bone healing, lung injury, and hardware irritation are all risks associated with surgery for a broken clavicle. Smokers, tobacco users, diabetics, and the elderly are at a higher risk of complications during and after surgery. They’re also more prone to suffer wound and bone healing issues. Your doctor will explain each of the risks to both parents prior to surgery and will take special precautions to avoid complications.
To care for your kid and support the family, our well-trained pediatric orthopedic surgeons collaborate with nurses, nurse practitioners, physical and occupational therapists, orthotic and prosthetic specialists, social workers, and child life specialists in a family-centered environment. In addition, your child has access to medical city Children’s Orthopedists and Spine Specialists, ensuring that his or her medical needs are met.
The doctors and staff at Medical City Children’s Orthopedics and Spine Specialists with offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX. understand your concerns regarding your child’s comfort, function, self-esteem, and school experience as a result of his or her injury or orthopedic condition, and we adopt a holistic approach to care planning. We communicate with your child as well as you when we explain what we’re going to do and what you and your child need to do afterward, so he or she is aware of the care we’ll provide. Our pediatric orthopedists are available to you and will schedule an appointment as soon as possible — usually within a week of your call, if not sooner.