45
By Madison Argo, and Michael Khazzam, MD
stopsportsinjuries.org
The clavicle, also commonly known as the
“collarbone,” is one of the most frequently
fractured bones in the human body. This “S” shaped bone lies horizontally and extends from the midline of the neck to the top of the shoulder. One can easily feel their own clavicle bone, evidence that it is fairly exposed to the environment and thus susceptible to injury. Most fractures typically occur from direct trauma such
as recreational activities, motor vehicle collisions, falls onto an outstretched hand, or even during childbirth. The majority of these fractures occur at the middle of the bone, the weakest region, and are easily seen or felt. In addition, there may be tenderness at the site accompanied with difficulty moving or raising the arm. The clavicle serves multiple purposes, including maintaining the position of the arm at the side of the chest and allowing for one to fully raise the arm above the head and create a complete circular motion. There are six muscles in the
chest, neck, shoulder, and upper back that attach to this bone’s flat surface and rely on this anchor for stability. The collarbone also overlies and protects important blood vessels and nerves, which can be at risk during injury.
Treatment
Treatment for a simple, minimally displaced collarbone fracture, includes a sling to support the arm’s weight which provides pain relief and comfort during the healing process. This is followed by 6–12 weeks of restricted weight bearing (3–6 weeks in children) and a follow-up exam with the physician to ensure proper healing. During this period, physicians generally prescribed daily elbow range of motion to prevent stiffness. Surgery may be necessary when the ends of thefracture are not aligned, the fractureinvolves several fragments, or the bonehas punctured the skin. Surgical repair
involves placing a plate secured with screws along the fracture site. With any
period of prolonged immobility, muscles
begin to weaken. Physical therapy and
gradual strengthening exercises are encouraged to restore full
function. For non-operative
clavicle fractures, the
healing process requires
time to heal before
strenuous exercises are
pursued. This differs
in surgically repaired
fractures that rely
on hardware for
support,
allowing
earlier initiation
of shoulder range
of motion.
Return to Play
Fortunately, the prognosis for
collarbone fractures is very
good. Following healing, approximately 2–3 months later, the majority of patients return to full mobility whether this is the vigorous activity of a professional athlete or a child simply riding their bike. Complications may arise for particular fracture patterns and it’s important to follow your physician’s recommendations for treatment and healing.