Where is the clavicle?
The clavicle is the collar bone, and it connects your shoulder blade to your breastbone. You can feel both of your clavicles very easily because they are right under your skin. The bone bends like an S as if goes from the center of your chest to your shoulder blade.
How do clavicle fractures occur?
Most clavicle fractures occur after direct impact on the side of the shoulder. Bike riders often crash and fall over their handle bars and land directly on the shoulder. People often crash on the ski slopes and land directly on their shoulders, which results in a broken clavicle. Other high energy accidents, such as a car accident, can result in a clavicle fracture.
How do you diagnose a clavicle fracture?
The most common symptom after a clavicle fracture is severe pain after an injury. The clavicle fracture will cause a deformity over the shoulder and there will be swelling and black and blue areas the next day. Your doctor can confirm the diagnosis with an xray.
How is a clavicle fracture treated?
Most clavicle fractures will heal as long as the arm is immobilized in a sling. When the clavicle heals, there will be a bump around the fracture, but the strength and motion of the arm will be normal. The fracture needs 12 – 16 weeks of healing before the patient can use it for full activity.
Some fractures will heal better if they are fixed with surgery. This depends on the location of the fracture, the amount of displacement between the ends of the broken bone, and the number of pieces that have broken. Your surgeon can make that decision after looking at the xray.
What can the patient do to make the clavicle fracture heal better?
Smoking is the worst thing a patient can do while the clavicle is trying to heal. The carbon monoxide in the smoke keeps the microscopic blood vessels from delivering oxygen to the fracture. Without enough oxygen, the fracture will not heal. Early use of the arm before the doctor allows the sling to be taken off, will also delay or inhibit healing.
What do I need to know about surgery for clavicle fractures?
Surgery can be done to repair displaced clavicle fractures. The decision to have early surgery for a clavicle fracture depends on many factors, and the patient should understand the risks and the benefits of surgery before making a decision to have surgery for a clavicle fracture.
The benefits of surgery include a higher healing rate by 10-20%, twenty percent less pain after the fracture heals, and earlier healing time by two weeks. The risks of surgery include, infection, wound healing problems, irritation of the hardware that is used to fix the clavicle, need for a second surgery to remove the hardware if it is painful, and injury to the nerves and blood vessels under the clavicle during the surgery.
Before the surgery, patients get a nerve block to numb up the shoulder so that patients will have minimal pain when they wake up from anesthesia. Surgery to repair the clavicle starts with an incision over the clavicle that is about 5-10 cm long. The surgeon will carefully put the pieces of bone back where they belong and hold them in place with a metal plate and screws. The skin is closed and a waterproof dressing is placed over the clavicle. When patients wake up, they will have their arm in a sling, and they must keep the arm in the sling for 6 weeks. If xrays look good at 6 weeks, the doctor will stop using the sling and allow very light activity with the arm. Three months after surgery, xrays are taken to confirm healing of the fracture and the patient can gradually return to normal activity.