Broken Collarbone

QUESTIONS AND ANSWERS

Diagnosis

If you think your child has broken his or her clavicle, it is important to seek medical attention immediately. The medical practitioner will:

• Examine the affected area
• Take X-rays of the injury to determine if there’s a fracture. The X-rays will also help the doctor know the exact location of the break, how severe it is, and if other bones have also broken.

If the doctor thinks a joint or artery has been damaged, he will request more tests like:

• Arteriogram/ Arteriography: This uses X-rays and dyes to see the inner parts of the arteries.
• CT scans: They provide more detailed pictures than X-rays.
• Ultrasound: This uses sound waves to create an image of what’s going on in the body.

Common Areas for Collarbone Breaks

When considering where a collarbone might break, there are three primary locations, each with unique implications for treatment and recovery:

• Middle (Mid-Clavicle): This is the most frequent break point. Fractures at this location cause difficulity in aligning the bone due to the natural curvature and movement of the collarbone, often requiring careful assessment to determine if surgery is necessary.
• Distal End: Located at the shoulder end of the collarbone, breaks here can vary in severity. In some cases, they might be displaced and often occur in individuals who frequently use their arms for overhead activities, such as athletes in throwing sports. It’s possible that surgical intervention may be required for full recovery, especially if there is significant misalignment.
• Medial End: This location is at the junction where the collarbone connects to the sternum. Fractures here are relatively rare and are commonly treated without surgery. The need for operative treatment is minimal, as these fractures tend the bone to align easily.

Understanding the location of a fracture can provide insights into its stability and guide treatment approaches.

Symptoms of a Broken Collarbone

The signs and symptoms of a broken collarbone in children include:

• Pain at the top of the shoulder or the clavicle, especially when the child moves the shoulder
• Difficulty in moving the arm or shoulder
• Bruising or weakness
• Lump in the affected area
• Weakness, tingling, or numbness in the shoulder or arm
• Deformed collarbone
• The child supports the arm with the other hand to reduce the pain

The commonest sign of a broken collarbone in a newborn is crying with the movement of the affected arm as a result of pain in the collarbone. The newborn will feel pain when he or she is lifted under the arms. The baby may not move the injured arm as much as the arm that is not injured.

If the injury has affected the nerves of the arm, the newborn may find it difficult to move the arm and the arm may hang limply at his or her side. The injured shoulder will appear slightly lower than the other shoulder. The healing process of the bone may cause a lump to develop at the spot of the fracture (this will appear after a few weeks and felt when you touch the area).

Treatment for Broken Collarbone

It is important to restrict the movement of any fracture to help in healing. To restrict the movement of a broken collarbone, the child will need to wear an arm sling. The length of time that the child will wear the sling will depend on the severity of the fracture. Bone union takes about three to six weeks for children. A collarbone fracture in a newborn will heal with only pain control and by carefully handling the baby.

How Clavicle Fracture Location Influences Stability and Treatment

The location of a clavicle fracture plays a crucial role in determining both its stability and the required treatment approach. Here’s a deeper look into how these factors interconnect:

• Medial Fractures: These fractures occur near the center of the body. They are quite uncommon and generally have a stable nature. As a result, they are typically managed without surgical intervention.
• Mid-Clavicle Fractures: Found along the length of the clavicle, these fractures can often be displaced, meaning the bone ends are misaligned. This misalignment can compromise stability and may necessitate surgical treatment to ensure proper healing and function.
• Distal Clavicle Fractures: Occurring near the shoulder, these fractures vary in severity. While some appear stable and heal without surgery, there is a higher likelihood of displacement, especially in individuals who use the area extensively, such as athletes. This increased displacement risk often leads to surgical consideration, particularly if the fracture affects the dominant or “throwing” arm.

Understanding the classification of a clavicle fracture is essential for determining whether a conservative or surgical treatment path is best. Each type has unique characteristics influencing the overall management plan.

Medications

The doctor may recommend an over-the-counter pain reliever to reduce inflammation and pain. If the pain is severe, the child will need a prescription medication that contains a narcotic for some days.

Therapy

Therapy starts after Treatment for a Broken Collarbone. It is usually important to start some motion to reduce stiffness in the shoulder while the child is still wearing a sling. After removing the sling, the doctor may recommend other physical therapies to improve the strength of the muscle, joint motion, and flexibility.

Surgery

The doctor will recommend surgery for the following reasons:

• Nerves or blood vessels are injured
• The broken bones break through the skin
• Pieces of the broken collarbone are in a critical position

The surgery for collarbone fracture is referred to as open reduction and internal fixation. The operation will put pieces of the broken collarbone back in their position (reduction). The process involves the use of metal devices to keep the bones in place (fixation). The orthopedic surgeon may perform the surgery using the following:

Plates and screws

The doctor will attach plates and screws to the external surfaces of the bone. They are not removed until after the bone heals. They are only removed if they cause discomfort (usually at least a year after the surgery).

Pins or screws

These are removed once the injury has healed.

When Can the Child Go Back to Sports?

The doctor will have to see the child again to know if he or she is in good condition to go back to sports. The child can go back to sports when the following are noticed:

• There is no pain when the collarbone is pressed
• The strength of the shoulder is normal, and
• The child can move and use the arm and shoulder without feeling any pain.

Generally, kids can resume non-contact sports (like swimming or running) after 6 weeks and contact sports (like hockey, football, and lacrosse) within 8 to 12 weeks.

Complications of a Broken Collarbone

Broken collarbones usually heal without any difficulty. If complications occur, they might include:

Blood vessel or nerve injury

The rough ends of the broken collarbone may injure nerves and blood vessels in their vicinity. If you notice coldness or numbness in your child’s arm, seek immediate medical help.

Delayed healing

A collarbone that is severely broken may not heal quickly. The bone may also become short as a result of the poor union of the bones while healing.

A lump in the bone

The area where the bone joints together usually form a bony lump (this is part of the healing process). Most of them disappear with time while some are permanent.

Recovery

When it comes to recovering from a collarbone fracture, the timeline can vary significantly between athletes and non-athletes.

For Athletes:

• Quicker Recovery Demands: Athletes often push for a faster recovery to return to their sport as soon as possible. This urgency might lead to surgical intervention over conservative treatment, aiming to restore function rapidly.
• Intensive Rehabilitation: Post-surgery, athletes usually undergo rigorous rehabilitation. This targeted therapy helps regain strength and flexibility sooner, potentially reducing overall downtime.

For Non-Athletes:

• Flexible Recovery Pace: Non-athletes typically have the luxury of a less pressured recovery. Many opt for conservative management, such as wearing a sling, and allow their body’s natural healing processes to take the lead.
• Gradual Return to Activity: The emphasis tends to be on gradual resumption of daily activities rather than rapid performance recovery, which may extend the healing period compared to athletes.

Ultimately, recovery is personalized, considering the individual’s lifestyle and physical demands, with athletes often experiencing an accelerated and structured path back to full activity.

How Long Does it Take a Broken Collarbone to Heal?

How long it takes a broken clavicle to heal depends on a series of factors. These include the age of the child, the location of the fracture, and the number of pieces the bone breaks into. Collarbone fractures in children below the age of 8 years may heal within 4 or 5 weeks. Broken collarbones in adolescents may take up to 6 and 8 weeks to heal.

However, clavicle fractures in adults or teenagers that have stopped growing may take about 10 to 12 weeks to heal (it can also take longer). Most broken collarbones heal completely within four weeks in adults. Collarbone that breaks into more pieces usually takes longer to heal than those with a few fragments.

Reinjury is a significant concern following a collarbone fracture, especially for athletes eager to return to their activities. When a fracture is healing, the initial bone formation occurs within 6-8 weeks. At this stage, the new bone is still fragile and susceptible to damage. It requires additional time to strengthen into mature bone capable of enduring high stress.

If an athlete returns to physical activities prematurely, the fracture repair site may become the weak point, increasing the risk of reinjury. Doctors may recommend surgical intervention to potentially accelerate recovery and rehabilitation, allowing for a safe return to sports. However, adequate healing time is crucial, as rushing this process can compromise the bone’s integrity, leading to setbacks in the recovery journey.

During the Collarbone Healing Process?

The child should move his or her fingers, wrist, and shoulder without too much pain within a few days of sustaining the injury. As the pain in the collarbone area reduces, the child should start moving the shoulder joint a little to prevent the joint from tightening up. As the pain starts subsiding, it is required to start moving the shoulder to prevent a frozen shoulder (a condition where the shoulder gets stiff). The doctor may show you the motions of the shoulder. The shoulder motion does not prevent the broken collarbone from healing once the injury has started healing.

After an X-ray confirms a fracture, the doctor will immobilize the colorbone using a sling or other method for up to six weeks. During this period, doctors may prescribe pain medication to manage discomfort. Once the initial immobilization phase is complete and as the pain continues to decrease, it’s important to avoid shoulder stiffness through deliberate arm movements.

Here are some steps to consider:

• Avoid Lifting: Refrain from lifting any objects that could strain the healing area.
• Monitor Pain Levels: Begin range-of-motion exercises as the pain subsides and the sling is no longer needed.
• Seek Professional Guidance: A physical therapist can recommend specific exercises tailored to the child’s recovery needs.

If the fracture involves the middle-third of the clavicle with minor displacement, doctors my not need to conduct surgery. As recovery progresses, ensure the child’s shoulder joint stays flexible with the recommended exercises. Once the fracture has completely healed, motion is not restricted. You should only try to strengthen the arm and shoulder after the fracture has healed. The child should conduct exercises as directed by the physician.

Request an Appointment

A broken collarbone is a painful injury. In most cases, patients don’t need surgery, while some require an operation to arrange the pieces of the collarbone back in their position. Physical therapy is also required to help the child resume daily activities. If you notice any sign of a broken collarbone in your child (or other forms of fracture), talk to the orthopedic experts at Medical City Children’s Orthopedic and Spine Specialists.

We will examine the child to know what the problem is. We will also provide the Treatment for a Broken Collarbone and suggest exercises that will reduce pain and stiffness and restore strength. Our board-certified physicians and fellowship-trained orthopedic surgeons are skilled in treating children and teenagers with broken collarbones. Contact us today to schedule an appointment.

We Can Help!

Finally, our doctors at Medical City Children’s Orthopedics and Spine Specialists understand the importance of maintaining your child’s health. In addition, our experts and specialists have the training, knowledge, and experience required to take care of a sprained or broken ankle that is causing pain to your child. If your child experiences any form of ankle pain, don’t hesitate to call our office at 214-556-0590 to schedule an appointment at one of our four locations — Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX. 

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American College of Orthopaedic Surgeons: Broken Collarbone