Fracture of the collar bone

Diagnosis: FRACTURE OF THE COLLAR BONE
(FRACTURA CLAVICULA)


Anatomy:
The collar bone (clavicula) forms a joint with the breastbone and the shoulder blade’s upper bone projection (acromion). Amongst other functions the collar bone acts as the anchor for many shoulder and chest muscles.

  1. Clavicula 

SKELETON

Cause: A fracture of the collar bone can occur in cases of a direct fall on the shoulder, or fall upon an outstretched arm; this is one of the most common fractures (5-10% of all fractures). The ligaments holding the collar bone in place may also rupture.

Symptoms: Pain in the collar bone and upon movement of the shoulder joint. In cases of a fracture with displacement of the bone, a bump is often visible on the collar bone.

Examination: Sudden, powerful pain in the shoulder with constriction of movement after a fall should always lead to acute medical examination. The fracture is usually visible on x-rays and on the basis of the type of fracture, the treatment can be determined.

Treatment: Depending on the type of fracture, rest and possibly a sling may be employed until pains decrease after a couple of weeks. In some instances, a sling is chosen to fixate the fracture (Madsens figure-8 bandage). In more complex fractures, and fractures with ruptured ligaments a surgical fixation of the fracture is most often chosen. In some cases it is an option to fixate certain fractures with a plate, which allows a faster return to sports, but the operation has a relatively high risk of complications (article).

Rehabilitation: When the pain has diminished (after 2-3 weeks) physical fitness training in the form of running may be commenced, and retraining according to the guidelines under rehabilitation of children and adolescents in general. After 4-6 weeks careful muscle training of the shoulder muscles may be started. Participation in contact sports will be possible after a couple of months have elapsed.

Complications: In the vast majority of the cases the fracture will heal without complications, although some suffer long-term discomfort, even if the fracture heals. Some fractures form a false joint (pseudoartrosis), which requires (renewed) surgery.