Clavicle Fracture Treatment in Adelaide
Dr Arthur Turow, Shoulder SurgeonA clavicle fracture, commonly called a broken collarbone, makes it painful to lift your arm, sleep comfortably or manage everyday tasks. Many fractures heal without surgery. Some fractures benefit from fixation. Dr Arthur Turow assesses and treats clavicle fractures in Adelaide, helping you understand the injury, your treatment options and your steps towards returning to work, sport and to things you love doing.
An X-Ray of a mid-shaft fracture with multiple fragments (also known as a comminuted fracture).
A clavicle fracture is a broken collarbone, usually caused by a fall, sporting injury or accident
Pain, swelling, bruising and a visible bump are common symptoms
Many fractures heal without surgery, using a sling for initial support and then followed by rehab
Surgery may be needed for fractures that are unstable, widely displaced or unlikely to heal without surgery
Surgical fixation uses a plate with screws to hold the bone in position while it heals
Returning to heavy work or sport often takes 3 months; sometimes longer depending on your bone healing
What is a clavicle fracture?
The clavicle provides an important link between your chest and your arm. It supports the position of your shoulder and helps transfer forces between your arm and body.
A clavicle can fracture/ break at different locations:
- Mid-shaft fracture: A break through the middle third of the collarbone. This is the most common location.
- Distal or lateral fracture: A break near the shoulder or AC joint. This is less common than mid-shaft fractures. Some patterns are unstable because of their relationship to the supporting ligaments. Some lateral fractures can be associated with an AC joint injury.
- Medial fracture: A break close to your sternum (breastbone). This fracture is least common.
A fracture is described as displaced when the fracture ends have moved out of alignment. Comminuted means that the clavicle has broken into more than two fragments. These features are important when assessing your fracture as they can help guide your treatment.
Symptoms of a broken collarbone
Clavicle fractures happen after a fall onto your shoulder, a cycling accident, a football tackle or another direct impact.
Symptoms include:
-
Pain over the collarbone
-
Swelling & bruising
-
Difficulty lifting or using your shoulder & arm
-
A visible bump or change in your shoulder shape
-
A grinding sensation around the fracture when you lift your arm or position yourself
A fall onto your shoulder can also cause an AC joint injury or a shoulder dislocation.
You should get your fracture assessed promptly. An open wound over the fracture, skin stretched over a sharp fragment, a cold or numb arm, or breathing difficulty requires urgent medical attention.
How is a clavicle fracture diagnosed?
Assessment includes how you injured yourself, examination of your shoulder and imaging.
X-rays are usually sufficient to identify the fracture, the position of the fragments and whether you injured any other structures. A CT scan is usually not needed, but may be useful for some complex injuries.
Follow-up appointments and X-rays help to assess how your clavicle is healing.
Clavicle fracture treatment
Treatment without surgery
Many fractures can be managed without surgery: sling, pain relief and gradual rehab. If your fracture is non-displaced or minimally displaced, your fracture should heal well with supportive care.
You generally should wear a sling during the first several weeks to support your arm during the painful early period. Shoulder movement & strengthening are introduced later, as your fracture starts to heal and has some early stability.
Follow-up remains important even when pain improves. A fracture can occasionally move further out of place or not heal/ unite.
An X-Ray of mid-shaft clavicle fracture. The fracture fragments are mildly displaced but are still in contact with each other.
Follow-up X-Ray of the same mid-shaft fracture, two months after injury. The fracture was treated without surgery and the bone shows good fracture healing.
An X-Ray of a fixed clavicle; using a metal plate and several screws, restoring clavicle length and alignment.
When might surgery help?
Clavicle fracture fixation involves realigning the broken bone & holding it with a plate and screws. Surgery may be considered when:
- The fracture is substantially displaced or unstable
- The fracture has a pattern associated with a higher risk of poor healing
- A bone fragment threatens the skin, or the fracture is open
- Associated injuries affect the stability of your shoulder
- Your fracture has not healed and is causing you persistent symptoms
Shortening, multiple fragments and your functional demands also contribute to this decision.
For displaced mid-shaft fractures in adults, surgery can reduce the risk fracture non-union; however, many patients also recover well without surgery. While surgery can improve the healing rate it does not guarantee a better long-term functional result. Dr Turow will explain the benefits & disadvantages for your specific fracture.
Recovery after a clavicle fracture
Recovery depends on bone healing. Regaining shoulder movement and strength are also important aspects of your rehab. Pain improves before your fracture is strong enough for heavy lifting or sports.
For treatment without surgery, you frequently need to wear a sling for 2-6 weeks. The exact timing depends on your fracture pattern and recovery on follow-up.
After surgical fixation, the following stages provide a guide to rehab. Sling use, exercises and strengthening are tailored according to your fracture, stability of the fixation & your progress on follow-up X-rays.
First 6 weeks
- In the first six weeks your fracture still needs some protection
- You can start to wean out of your sling after two weeks
- Avoid lifting and weight bearing through your arm
Weeks 6 to 12
- The main aim during this time is range of motion
- You should still avoid heavy lifting and sports
- A follow-up X-Ray will be arranged for you during this time
From 12 weeks
- The next three months you focus on strengthening and endurance
- Resistance training is increased
- You can return to swimming
Around 3 to 6 months
- Your fracture should be fully united by this stage (this can depend on your specific injury, though)
- Generally return to heavier work, gym training and sports
Clavicle fracture assessment in Adelaide
Dr Arthur Turow is an Australian-trained orthopaedic surgeon whose practice focuses on shoulder and upper limb conditions. His qualifications include FRACS (Orth) and FAOrthA.
Your consultation will consider your fracture pattern, the likelihood of healing and the demands of your work or sporting ambitions. Bring any existing X-rays, reports and information about treatment you have already received.
Consultations are available in Adelaide CBD and at regional locations across South Australia, including Yorke Peninsula, Gawler and Mt Barker.
Book an appointment or call (08) 8236 4179.
Frequently Asked Questions
Does a displaced clavicle fracture always need surgery?
No. Some displaced fractures heal without surgery. The decision depends on your fracture pattern, stability, skin condition, likelihood of healing and your functional demands. Surgery can reduce non-union risk in some fractures. Surgery does have some risks such as infection & plate irritation.
Will the bump over my broken collarbone disappear?
The bump may either be the position of your fracture or new bone forming during healing. While it can become less prominent over time, some change in shape can persist.
How should I sleep with a broken collarbone?
A slightly upright position tends to be more comfortable, especially in the early stages. You can use pillows to support your arm. This can also help preventing you from rolling onto the broken clavicle. Wearing your sling at night can also help keeping you more comfortable.
Will the plate and screws need to be removed?
Not routinely. The metalwork can remain in place, unless it causes you persistent irritation; for example, aching or an uncomfortable feeling when you wear clothing or backpacks over your clavicle plate. Removal is another operation & carries risks, including a small chance of re-fracture.
Further Reading
Information for patients:
- Broken collarbone: AAOS OrthoInfo
An illustrated explanation of symptoms, diagnosis, sling treatment, surgery and recovery
Interested in more scientific information? The following research papers examine treatment outcomes & return to sport after clavicle fractures:
For Patients
If you have injured yourself, it is important to get your injury evaluated and to perform appropriate diagnostic tests. Dr. Arthur Turow can assess your injury, provide you with an accurate diagnosis and suggest appropriate treatment options specific for your individual needs.