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Collarbone Fractures

(Clavicle Fractures)

By Danielle Campagne, MD, Assistant Clinical Professor, Department of Emergency Medicine, University of San Francisco - Fresno

Fracture of the collarbone (clavicle) is a break in the long bone that runs horizontally from the top of the breastbone (sternum) to the top of the shoulder blade (scapula).

  • Collarbone fractures often occur after a fall on an outstretched arm or a shoulder or after a direct blow.

  • These fractures cause pain, swelling, and sometimes a bulge or bump where the bone is broken.

  • Doctors can usually identify collarbone fractures based on a physical examination, but x-rays are taken to pinpoint the fracture's location and determine the extent of the injury.

  • Most collarbone fractures require only a sling, but some types of fractures require surgery.

Collarbone fractures are a common fracture, particularly among children.

Fracturing the Collarbone

In some collarbone fractures, the broken pieces stay in place (called a nondisplaced fracture).

Collarbone fractures often occur after a fall on an outstretched arm or a shoulder or after a direct blow. Most occur near the middle of the bone. The broken pieces of bone may stay in place (called a nondisplaced fracture) or be out of place (called a displaced fracture). In some collarbone fractures, the main ligaments that hold the collarbone to the shoulder bone are torn.

Symptoms

The area is painful and swollen, and pain may extend into the shoulder. People may sense that the bone is moving and unstable.

Because the collarbone lies just under the skin and has little muscle over it, people may see a bulge or bump where the bone is broken. The broken bone rarely breaks through the skin, but it may push the skin out. This effect is called tenting because it resembles a tent pole holding up a tent.

Diagnosis

  • X-rays

  • Occasionally other imaging tests, such as computed tomography

If people think they may have fractured their collarbone, they should see a doctor as soon as possible.

Even though doctors can usually identify collarbone fractures based on a physical examination, x-rays are taken to pinpoint the fracture's location and determine the extent of the injury (see Overview of Fractures : Diagnosis).

Occasionally, other imaging tests, such as computed tomography (CT) are needed. CT combines x-rays with computer technology to produce a more detailed, three-dimensional image of the injured area.

Treatment

  • Usually, a sling

  • Occasionally surgery

Most collarbone fractures can be treated by immobilizing them with a sling for 4 to 6 weeks (see Figure: Commonly Used Techniques for Immobilizing a Joint). A sling may be all that is needed.

Occasionally, when the broken pieces are far apart, the skin is tented, or a ligament is torn, surgery is needed.

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