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The clavicle or "collar bone" connects the scapula bone in the shoulder to the sternum in your chest. It functions to hold the shoulder upward and backward.
Clavicle fractures are common bone injuries. A break in the clavicle bone is usually a closed fracture that normally takes approximately 6 weeks to heal in an adult, 4 weeks in a child. The injury rarely requires surgery.
There are some common causes of a fractured clavicle. It may be due to a birth injury, as the clavicle may fracture during passage through the birth canal. The fracture is frequently not noticed until the healing bone callus is noticed as a hard lump. It usually needs no treatment and the lump will disappear as the baby grows.
In older children and adults, accidents such as falls against the shoulder or on an outstretched hand are a common cause of fractures of the clavicle. These fractures are also sometimes a result of a blow from a blunt object or a collision of some sort.
The symptoms of a fractured clavicle are pain, swelling, tenderness, bruising, and a deformity or bump at the fracture site. Patients with a broken clavicle cannot lift their arms without extreme pain.
When a patient presents with a fractured clavicle, the attending physician will examine the fracture site for neurovascular damage and take x-rays of the injured area, including the joints above and below the primary injury site.
A patient with a broken clavicle will have to wear a simple arm sling for about 6 weeks. Children with broken clavicles are often fitted with a figure-8 clavicle strap to keep their clavicle immobilized until it heals, usually in 3 to 4 weeks. Most adult fractures are treated with a figure-8 splint or strap and will have to sleep in a chair or in bed with extra pillows because the fracture takes a week or two to set and it is vital to prevent rolling onto the bone during sleep. Usually patients will be able to start exercising their shoulders after three weeks of immobilization.
Healing is considered complete when there is no motion at the fracture site and x-rays reveal complete bone union.
A less common injury is separation of the acromoclavicular, or AC joint, where the clavicle meets the acromion process of the scapular. It is a bony protuberance on the top of the shoulder. The ligaments of this joint can be injured by falling onto the shoulder, elbow or an outstretched arm. Symptoms can range in severity from slight pain to a complete rupture of the joint resulting in a lump where the collar bone sticks up out of the neck.
Symptoms include pain and tenderness the end of the collar bone, as well as pain upon moving the shoulder joint, especially when raising the arm above the shoulders.
If the injury is a minor partial separation, it can be treated with ice compresses and rest. However, more serious separations may need to be taped down in order to heal. A complete separation will require orthopedic surgery. AC joint injuries should be evaluated by a physician, as if this injury is neglected and allowed to heal out of place it will increase the wear and tear on the joint causing future shoulder problems.
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