Out of the many bones in the body, the easily fractured bone is the collar bone, known as the clavicle. Immediately following the fracture of the collarbone, the patient experiences severe pain and swelling with visible deformity in some cases.

A physical examination and X-rays can quickly diagnose a clavicle fracture. The clavicular fracture has three sites of incidence, namely :

1) Near the sternum (least common)

2) Near the AC joint (second most common)

3) In the middle of the bone between the sternum and AC joint (most common).

Our expert doctors at Hyderabad Shoulder Clinic will give you the best treatment options for clavicle fractures, and for most patients, there are no limitations once the fracture heals.

The clavicle

The clavicle connects the breastplate, i.e., the sternum, to the shoulder. This solid S-shaped bone is easily visible to many people. The clavicle connects to the sternum at a joint called the sternoclavicular joint. At the other end, the bone meets the shoulder blade (scapula) called the acromion. The end of the joint containing cartilage is called the acromioclavicular joint.

One can understand the critical location of the clavicle. By falling directly onto the shoulder or by falling on an outstretched arm, the severe force gets transferred to the clavicle. As a result, the collarbone is one of the most commonly broken bones in the body.

How to detect a clavicle bone fracture?

The first symptom is swelling due to the bleeding from the blood vessels in and around the bone. There will be a lot of pain, too, due to damage to microscopic nerve endings around the bone. If an angle gets created between the broken ends, the bone also gets deformed. The patient cannot move the affected arm. If there is a break in the skin over the fracture, it indicates that the ends of the bones may have punctured the skin. In such cases, you may need surgery to clean out any dirt or debris. If there is tingling, numbness, or weakness in the hand or arm, it may be a severe injury. If the injury is near the sternum, the patient will also have shortness of breath or difficulty in swallowing.

What are the best treatment options for clavicle fractures?

Seek medical treatment right away by contacting an emergency facility. They will immobilise the arm and shoulder by holding the arm close to the body with the other arm or in a sling. Apply ice on the injured area for 20 to 30 minutes at a time, but do not freeze the skin. 

Treatment options

Immobilisation: The most common treatment option for fractures in the middle of the clavicle is immobilisation with either a sling or a special bandage called a figure-of-8 splint. Such fractures heal quickly and nicely with a sling, just like a figure-of-8 splint. The latter is uncomfortable and challenging to wear nonstop for six or eight weeks. With a figure-of-8 splint, there can be skin problems, and the patient smells as if it should not be removed to wash the armpit. 

However, some orthopaedics strongly prefer a figure-of-8 splint as it can produce an acceptable result.

Pain relief: Pain relief can be achieved with cold therapy and pain medication. Ice should be applied for 15 to 20 minutes every two hours for as long as necessary to decrease the pain and swelling. Do not apply heat. Pain medication may be needed for several weeks, significantly to help you sleep. While recovering, most patients have to sleep in a sitting position. 

Movement and exercise: After a few days of the fracture, one must move fingers, wrist, and elbow without too much discomfort. As the pain lessens, you should start moving the shoulder joint slightly to prevent joint tightening. As the pain begins to subside, it is acceptable to begin moving the shoulder. Your treating doctor may show you the motions and will ask you to visit a physical therapist. Do not start exercising without your physician’s go-ahead. One can walk or exercise by biking after a few weeks with the permission of your physician.

Surgical Options:Open reduction and internal fixation (ORIF) is performed to stabilise and heal your broken collarbone (clavicle).Surgical options are not always suggested. Below are the conditions when surgery is opted such as:

• After fracturing your clavicle are significantly out of alignment
• The clavicle broke and pierced out of the skin
• The clavicle broke into several small or large  pieces

Through the ORIF surgery the surgeon can position your bones back into their proper configuration. Once the bones are in the proper place the chances of healing improve drastically. We at Hyderabad Shoulder Clinic will talk to you about the risks and benefits of ORIF.

ORIF is done as an emergency or urgent procedure. Before the surgery the medical team will take your medical history and do a physical exam followed by an X-ray of your clavicle. Openly inform your doctor about all the medicines you take, including over-the-counter medicines and blood thinners. Another important detail to inform is the time of your last meal.

ORIF is also done as a planned procedure. In such cases you should stop taking any medicines ahead of time, like blood thinners. The doctors will advise you not to take any food and drink after midnight the night before your procedure.

ORIF Procedure:

• The patient is given general anaesthesia. Your vital signs, such as your heart rate and blood pressure, are monitored during the operation. A breathing tube is placed down your throat during the operation to help you breathe.
• The area is cleaned and your surgeon will make an incision through the skin and muscle near your clavicle.
• Expert surgeons like Dr.Chandra Sekhar, will bring the pieces of your clavicle back into alignment (reduction).
• Reduction is followed by securing the pieces of clavicle to each other (fixation) by using screws, metal plates, wires, and pins. 
• After the bone is in its place, your surgeon will surgically close the layers of skin and muscle around your clavicle.

Healing time from clavicle fracture: Age, the location of the fracture, and how many pieces it is broken into determine the healing time. If the fracture happens in children younger than eight years old, then it may heal in four or five weeks, whereas the same might take six to eight weeks in adolescents. Healing time is 10 to 12 weeks in adults or teenagers who have stopped growing. For anyone, the maximum time taken to heal is four months. If the clavicle is broken into more pieces, it takes longer than the ones with fewer fragments.

What result can be expected once a clavicle fracture heals?

After complete healing, motion is generally not restricted. But please wait a few months before playing sports. Only after the fracture is healed should strengthening of the shoulder and arm be done. If the fracture does not heal after six months, surgery may also be necessary. Surgery is needed to reduce a visible deformity of the fracture, but it results in a scar. 

We at Hyderabad Shoulder Clinic have successfully treated countless clavicle fracture cases. there is a good recovery rate as well. For more information, please visit our website https://hyderabadshoulderclinic.com/ or contact us at +91 9959588389 or

shoulderandsportsclinic@gmail.com.