Fracture of the collar bone

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.

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.