Clavicle Fracture Signs and Symptoms
A clavicle fracture is typically associated with extreme pain, and arm movement is difficult. The clavicle bone lies just beneath the skin, so a fracture usually causes an obvious protrusion or bump at the fracture site, along with swelling. (While the bump will diminish over time, a small bump may remain after the fracture heals.)
Other symptoms include:3
- Sharp pain felt at the time of injury; the injured person may feel pain when trying to move the arm.
- Stiffness in the shoulder that makes shoulder movement difficult or impossible.
- The affected shoulder sags, forward or downward.
- Swelling, tenderness and bruising occur over the collarbone.
- A grinding sensation when trying to lift the arm.
- The desire to hold the affected arm close to the body—supporting it with the hand of the healthy arm.
If a clavicle break is suspected because of a traumatic-related event, other injuries may be present. If possible, bystanders are advised to wait for medical personnel to move the injured person.
Occasionally, a person with a broken collarbone also experiences labored breathing, which may be a sign of an injured lung. Lung injuries are associated with clavicle fractures.
See a physician immediately if symptoms of a clavicle fracture are apparent.4
Diagnosing Clavicle Fractures
X-rays will be taken to determine the location and extent of the injury. In some cases, X-rays are necessary to distinguish between a clavicle fracture and an injury to the joint at the top of the shoulder, called the acromioclavicular joint. A CT scan may also be ordered for more detailed images.
During the physical examination, the physician may do the following:
- Note areas of tenderness
- Observe skin discoloration
- Look for deformities
- Address any open wounds
- Palpate (touch) the shoulder blade and ribs to determine if there is an accompanying injury
- Listen to the lungs with a stethoscope, and observe variations in breathing
- Evaluate the shoulder’s range of motion
A doctor may conduct a neurological examination to make sure that sensation and motor functions are normal.6 The clavicle is located near a series of nerves found based in the neck and shoulder called the brachial plexus. Injury to the brachial plexus is uncommon but can occur with a clavicle break.
The physician will also ask about the patient’s medical history, how the injury occurred, and any symptoms associated with it.
Treating a Clavicle Fracture
Whether or not surgery is required to repair a broken clavicle, the long-term treatment goal is to regain shoulder strength and mobility.
Nonsurgical Treatment for a Clavicle Fracture
Nonsurgical treatment for a broken clavicle can include the following:
- An arm sling or Clavicle Brace is typically worn after the break occurs. This helps prevent arm movement as the collarbone recovers.
- Pain medication, typically nonsteroidal anti-inflammatory drugs such as naproxen and ibuprofen, can be taken to reduce pain.
- Physical therapy exercises will be recommended once the collarbone begins to mend. The patient will begin with mild movements to ease stiffness. More intense exercises will be added after the bone recovers.
Surgical Treatment for a Clavicle Fracture
Clavicle surgery may be needed if the fractured bones if the fractured pieces of bone are not in their correct, anatomical location. (The medical term for this is a displaced fracture). In these cases, the bones need to be moved and secured in order to heal properly. Plates, screws, and pins are often used during the surgical process. Rehabilitation after surgery involves exercises that can be done at home or with a physical therapist.
The physician will provide specific post-surgery instructions to fit the patient’s individual needs and goals. General guidelines may include:
- Wearing a sling for 3 or 4 weeks after surgery.
- Icing shoulder several times a day to reduce swelling. Wrap the ice pack in a towel or cloth to prevent ice burn.
- Restraining from lifting objects weighing over five pounds during the first six weeks post-surgery.
- Following up with the physician and getting the appropriate x-rays to confirm healing.
- Participating in physical therapy when the physician advises to do so.
Generally, normal activity can be resumed 6 weeks after the clavicle break, but participation in contact sports should be postponed for 2 to 4 months. This provides time for the bones to heal. Healing may be slower in people who have diabetes or who use tobacco-based products since nicotine inhibits bone healing.