Broken Collarbone

Broken Collarbone

The collar bone (also known as clavicle) is an S-shaped bone that connects the breastbone (i.e. sternum) to the shoulder blade bone (scapular). The collarbone breaks most often in children.

Although in some cases, collarbone fracture may signify child neglect or abuse, it is usually common as a result of the normal activities of a toddler. Since young children may not be able to describe their pain, it is important to know the signs of a broken clavicle so that you can spot an injury in your child.

Causes of a Broken Collarbone

Collarbone fractures usually occur when the child falls on the side of the shoulder. They can also be a result of a direct blow to the collarbone. For instance, if the child is hit in front of the shoulder with a baseball or stick, it can lead to a broken collarbone. In rare cases, broken collarbones occur as a result of a fall on an outstretched arm.

Broken collarbones are mostly common in children that participate in football, soccer, and hockey or sports that have a high risk of falling, like biking. It is important to use adequate padding and also take measures to reduce the risk of collarbone fractures.

How Collarbone Fracture Occurs in a Newborn

A broken collarbone is the most common injury that newborns sustain during birth. It occurs as a result of trauma or difficult delivery. Some factors that increase the risk of a newborn sustaining a broken clavicle include the newborn’s large size, a narrow birth canal, the newborn’s shoulder getting stuck, and the use of tools to help in delivering the baby.

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.

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 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 be able to 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 be noticed after a few weeks and can be 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.

How long this will be worn will be determined by how severe the fracture is. 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.

The Treatment for a Broken Collarbone also known as a clavicle fracture in children:

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

Surgery may be required to treat a broken collarbone if:

• 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 to 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

These will be attached 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.

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.

What Can Be Done While Waiting for the Broken Collarbone to Heal?

The child should be able to 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 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. 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. Exercises should also be 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 a free 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 214-833-0917 to schedule an appointment at one of our four locations.