Collarbone Fracture

Overview, Causes, & Risk Factors

A collarbone fracture is a break that occurs in the collarbone, also called the clavicle. The collarbone is the bone that connects the breastbone, also called the sternum, to the shoulder blade.

What is going on in the body?

The collarbone is a long, narrow, S-shaped, solid bone. Because of its location and shape, it can be injured when the arm, elbow, or shoulder suffers any trauma. The collarbone is located in front of a number of key nerves and blood vessels. Rarely, these nerves and blood vessels may be injured when the collarbone is broken.

What are the causes and risks of the condition?

A collarbone fracture is often caused by a fall. Trauma may also occur during contact sports, such as ice hockey, football, or wrestling. Other causes may include:

a tumor in the collarbone

conditions that cause weak bones, such as osteoporosis

physical abuse, including child abuse or elder abuse

A newborn's collarbone may be broken during birth as the child travels through through the birth canal.

Symptoms & Signs

What are the signs and symptoms of the condition?

Symptoms of a fractured collarbone may include:

a visible deformity or bump that may be seen through the skin

a rubbing or grinding sensation when the arm is raised

a shoulder that flops down and forward

inability to move the arm

numbness or tingling sensation in the shoulder, arm, or hand

pain, ranging from moderate to severe

pain that increases with movement

a preference for holding the shoulder and arm close to the body with the arm supported

swelling around the shoulder and collarbone

weakness in the arm

Diagnosis & Tests

How is the condition diagnosed?

After doing a complete medical history and physical exam, the doctor may order:

a biopsy of any fluid or growths to check for infection or tumors

a nerve conduction test, also called an NCV, to measure nerve damage from the injury

blood tests to rule out infection, including a complete blood count

imaging tests, such as MRI, if a tumor is suspected

X-rays to locate the break and its severity

Prevention & Expectations

What can be done to prevent the condition?

A person can prevent some injuries by following sports safety guidelines for children, adolescents, and adults. A healthy diet with adequate calcium can help prevent some fractures caused by bone weakness.

What are the long-term effects of the condition?

Long-term effects will depend on the extent of the fracture and the success of treatment. If a person was involved in sports or heavy lifting before the injury, his or her normal range of motion in the shoulder may be decreased. Chronic pain or soreness in the shoulder and collarbone may also occur. Damage to the nerves and blood vessels is also possible. This damage can lead to decreased sensation and other tissue damage.

What are the risks to others?

A collarbone fracture poses no risk to others.

Treatment & Monitoring

What are the treatments for the condition?

Minor to moderate injury may require "RICE" therapy:

R = rest or reduced activity

I = ice or cold packs applied to the shoulder, for 15 minutes every 2 hours

C = compression of the affected area, such as with a special splint called a figure-of-8 splint or a sling

E = elevation of the shoulder or affected arm

Nonsteroidal anti-inflammatory drugs, also called NSAIDs, may be recommended to reduce inflammation and discomfort. Examples of NSAIDs are ibuprofen and naproxen.

After a few days to weeks, the initial pain and swelling will begin to subside, and the bone will start to heal. At this time, physical therapy or strength training exercises may help to increase the strength of the tendons and muscles. Ultrasound may also be used to warm the muscles and improve blood flow.

If conservative treatment is not successful, surgery may be needed. Sometimes, a bone graft may be needed to promote healing.

What are the side effects of the treatments?

There may be stomach upset, ulcers, or an allergic reaction to NSAIDs. Splints or slings can cause muscle tightening as well as skin irritation. Treatments that require surgery pose a risk of bleeding, infection, and allergic reaction to anesthesia.

What happens after treatment for the condition?

In some situations, no further treatment is needed. Physical therapy and daily exercises may be advised to strengthen the muscles and help the bone continue to heal. Complete recovery from the fracture may take several months.

How is the condition monitored?

Any new or worsening symptoms should be reported to the doctor.