What is a clavicle (collar bone) fracture?
A fracture or break in a bone generally occurs secondary to trauma from a fall, commonly during sports such as cycling, and following a direct impact to the shoulder. These fractures can be simple two-part fractures, but in some instances, the bone can fracture in multiple places.
What are the symptoms of a clavicle fracture?
Patients develop immediate pain and swelling and there can be a visible deformity or prominence of the fracture end under the skin. There can be associated grazing of the skin over the clavicle. The patient will have limited use of the arm in the acute phase and continued pain and potentially poor function until the fracture heals.
How is it diagnosed?
It is diagnosed by taking a careful history and performing a detailed examination. There can also be other associated injuries of the shoulder, including scapula fractures, which can occur with trauma in this area, and the clinician will carefully exclude.
Shoulder X-ray and CT imaging in selected cases can be useful to exclude other potential injuries and to further assess the fracture, particularly in cases where surgical management is required. The investigations will help to inform the clinician regarding treatment plans.
How is it treated?
Treatment begins with symptomatic management using pain killers, and a sling for support and immobilization of the fracture.
The position of the fracture, and the degree of trauma associated, help to guide the patient and clinician with regards to the need for surgery. The demands of the patient both for their occupation and for sporting activities are a key component of making this decision. Surgery can provide the patient with a more predictable and earlier return to work and sporting activities and leads to a healing rate of around 99% of fractures at one year.