Treatment for Clavicle Fractures

What is it?

The clavicle (collar bone) is one of the most commonly broken bones in the body. It is usually broken from a fall onto the shoulder. It can occur in patients of any age but commonly affects younger and more active patients.

The clavicle serves as a strut for the upper body keeping the shoulder girdle in the proper position. Clavicle fractures are most commonly broken in the middle third of the bone. Occasionally they are broken on the outer third of the bone, and rarely are they broken on the medial third.

What factors are considered when determining treatment?

Clavicle fractures can be treated with or without surgery. Different factors help a surgeon to decide whether or not your particular fracture needs surgery including some of the following factors:

  • Patient age
  • Expected activity level
  • Amount of fracture displacement
  • Amount of fracture shortening
  • Patient's overall health

What are the risks?

The surgery itself is generally very safe in most healthy patients. There are the general risks of anesthesia and also those risk associated with the surgery.

Risks of Non-operative Treatment:

  • Stiffness
  • Loss of Function
  • Non-union or mal-union of the fracture
  • Cosmetic deformity (bump) at fracture site
  • Long term shoulder fatigue

Risks of Fixing the Fracture:

  • Stiffness
  • Loss of Function
  • Numbness around the incision
  • Hardware Complications

What type of clavicle fractures are there?

Mid-shaft clavicle fractures: Midshaft clavicle fractures occur in the middle third of the collar bone. These are the most common type of clavicle fractures. Many of these fractures can heal without surgery or significant long term disability. Some fractures may be better treated with surgery if they are significantly displaced or shortened in an active patient.

Lateral (distal) clavicle fractures: Lateral third clavicle fractures can behave differently than mid-shaft fractures. This is because lateral fractures can potentially involve injury to the coracoclavicular ligaments. If the injury involves these ligaments, the fracture is more prone to displacement and non-union (failure of the bone to heal)

What are the treatment options?

Non-Operative Management: Many clavicle fractures can be managed without surgery. This is particuarly true for patients who do not have much displacement or shortening of their fracture. Until more recently, the majority of fractures were managed in this manner and most people had satisfactory results with this treatment.

Fixing the Fracture: Fractures can also be fixed using plates and screws, and more rarely, a pin. This helps secure the bone fragments in an anatomic position so that they heal appropriately. This is typically the best option for patients with significantly

displaced fractures to optimize long-term function.

What is the recovery like?

Recovery from treatment of a clavicle fracture can vary depending on how severe the fracture is and what treatment is undertaken. In general there will be a period of immobilization in a sling (2-4 weeks) followed by range of motion exercises and progressive strengthening. Most patients are back to functional use of their arm with some limitations by 2 months with full recovery expected around 4 months.