Broken collarbones (also called clavicle fractures) are fairly common, representing about 5 percent of all adult fractures. Clavicle fractures are even more common in children, representing between 8 and 15 percent of all child fractures.
A 2016 Swedish study found that 68 percent of clavicle fractures occurred in males. The 15- to 24-year-olds represented the largest age group among males, at 21 percent. But in people older than 65, more women than men had broken collarbones.
Each fracture is different, but 80 percent of them occur in the middle part of the collarbone, which isn’t strongly attached by ligaments and muscles.
Sports injuries, falls, and traffic accidents are the most frequent causes of broken collarbones.
When you break your collarbone, you’re likely to be in a lot of pain and have trouble moving your arm without causing more pain. You may also have:
- inability to move your shoulder
- a bump or raised area over the break
- grinding or crackling noise when you move your arm
- forward sagging of your shoulder
The most frequent cause of broken collarbones is a direct blow to the shoulder that snaps or breaks the bone. This can occur in a downward fall landing on your shoulder, or falling onto an outstretched arm. It can also happen in a car collision.
Sports injuries are a common cause of broken collarbones, especially in younger people. The clavicle doesn’t fully harden until you’re about 20.
Contact sports like football and hockey can lead to shoulder injuries, as can other sports where a fall usually happens at high speeds or on a downward trajectory, such as skiing or skateboarding.
Newborns can have their clavicle fractured during delivery. It’s important for parents to notice if your baby has any of the symptoms of a broken collarbone, such as crying when you touch their shoulder.
Your doctor will ask you about your symptoms and how the injury occurred. They’ll also examine your shoulder, and likely ask you to try to move your arm, hand, and fingers.
Sometimes the location of the break will be evident, because your bone will be pushing up under your skin. Depending on the type of break, the doctor may want to check to see if nerves or blood vessels were also damaged.
The doctor will order shoulder X-rays to show the exact location of the break, how much the bone ends have moved, and whether other bones are broken. Sometimes they’ll also order a CT scan to look at the break or breaks in more detail.
Treatment for a broken collarbone depends on the type and severity of your fracture. There are risks and benefits to both nonsurgical and surgical treatments. It’s best to fully discuss your treatment options with your doctor.
In the past, nonsurgical treatment for a break in the middle part of the clavicle was thought to be best. But in the last several years, a 2016 study reported, surgical treatment became predominant.
A 2015 meta-analysis of surgical and nonsurgical treatment noted that complication rates were 25 percent, no matter which treatment was chosen. Both studies called for more research to determine what kinds of breaks benefit most from surgery.
Conservative, nonsurgical treatment
With nonsurgical treatment, here’s what you can expect:
- Arm support. Your injured arm will be immobilized in a sling or wrap to keep the bone in place. It’s important to restrict movement until your bone has healed.
- Pain medication. A doctor may prescribe over-the-counter drugs such as ibuprofen or acetaminophen.
- Ice. A doctor may recommend ice packs to help with pain for the first few days.
- Physical therapy. A doctor or a physical therapist may show you gentle exercises to prevent stiffness as your bones are healing. Once your bones have healed, your doctor can advise a rehabilitation program to help your arm gain strength and flexibility.
One complication of conservative treatment is that the bone may slip out of alignment. This is called malunion. You may need further treatment, depending on how malunion affects your arm function.
In some cases, you may have a bump on your skin above the break. The bump usually gets smaller in time.
If your broken collarbone is fragmented, fractured in more than one place, or badly aligned, surgery may be recommended. Typically, treating complex breaks involve:
- repositioning your collarbone
- placing metal screws and a metal plate or pins and screws alone to hold the bone in place so that it heals properly
- wearing a sling after surgery to immobilize the arm for a few weeks
- taking painkillers as prescribed after surgery
- having follow-up X-rays to monitor healing
Pins and screws are removed once the bone has healed. Metal plates are typically not removed unless there is irritation of the overlying skin.
There may be surgical complications, such as problems with the bone healing, irritation from the inserted hardware, infection, or injury to your lung.
Doctors are currently researching minimally invasive arthroscopic surgery for broken collarbones.
Broken collarbone in children | Treatment for children
Broken collarbones in children usually heal without surgery. There are few reports of complications in medical literature.
In the first four to six weeks, you shouldn’t lift anything heavier than five pounds or try to raise your arm above shoulder level.
Once the bone has healed, physical therapy to get your arm and shoulder back to normal function will likely take another few weeks. In general, people can get back to regular activities in three months.
Sleeping with a broken collarbone may be uncomfortable. Remove the sling at night, and use extra pillows to prop yourself up.
Use over-the-counter painkillers to manage pain. Ice packs may also help.
Stick with a gentle physical therapy routine to keep your arm from stiffening while it’s healing. This may include some soft tissue massage, squeezing a ball in your hand, and isometric rotation. You may move your elbow, hands, and fingers as it becomes comfortable to do so.
Once the break has healed, your doctor or physical therapist can give you exercises to strengthen your shoulder and arm. These may include range-of-motion exercises and graduated weightlifting.
Your doctor will assess when you go back to your normal activities. They’ll also advise when you can begin specific training for a return to sports. For children, this can be in six weeks for non-contact sports and eight to 12 weeks for contact sports.
Broken collarbones are fairly common and usually heal without complications. Each case is unique. Discuss with your doctor whether surgical or nonsurgical treatment might be best for you.
It’s important to stick with a physical therapy routine to regain full use of your arm and shoulder.