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A clavicle fracture is a break in the clavicle bone (also called the collarbone). It connects the sternum (breastplate) to the shoulder.
The clavicle can fracture in 3 different places:
- Middle third—the middle portion of the clavicle, which is the most common site for a clavicle fracture
- Distal third—the end of the clavicle connecting to the shoulder
- Medial third—the end of the clavicle connecting to the sternum
|Distal Third Clavicle Fracture|
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A clavicle fracture is caused by trauma to the clavicle bone. The trauma is usually caused by:
- Direct blow to the clavicle
- Falling on an outstretched arm or on the point of the shoulder
- Newborn babies can break a clavicle passing through the birth canal
A risk factor is something that increases your chance of getting a disease, condition, or injury.
- Increased age, because of the increased risk of falling
- Certain congenital bone conditions
- Participating in contact sports
- Large newborns have a higher risk of fracture during birth
- Pain, often severe
- Sagging shoulder, down and forward
- Inability to lift the arm because of pain
- A lump or visible deformity over the fracture site
- Tenderness and swelling of the affected area
The doctor will ask about your symptoms, physical activity, and how the injury occurred. The injured area will be examined.
Images may be taken of your bodily structures. This can be done with:
Treatment will depend on the severity of the injury. Treatment may involve:
- Putting the pieces of the bone back in position, which may sometimes require anesthesia and more rarely surgery
- Keeping the pieces together while the bone heals itself
- Newborns and most children do not usually need to have the pieces of the bone put back in position unless the broken ends are very far apart
Brace or Sling
Most clavicle fractures can be treated either with a figure-of-eight strap, which is wrapped around the body and the shoulders, or with the arm in a sling. These devices help hold the shoulder in place while the clavicle heals. The doctor may prescribe pain medication.
Surgery may rarely be needed to set the bone. The doctor may insert pins or a plate and screws in the bone to hold it in place while it heals. A sling or figure-of-eight strap will be needed while you heal.
A physical therapist can help with shoulder range-of-motion and strengthening exercises.
- A child may heal as quickly as 3-4 weeks.
- An adolescent may take 6-8 weeks to heal.
- An adult may require 8-10 weeks to heal.
- A lump at the fracture site may persist for years.
To help prevent clavicle fractures:
- Do not put yourself at risk for trauma to the clavicle bone.
- Eat a diet rich in calcium and vitamin D.
- Build strong muscles to prevent falls and to stay active and agile.
American Orthopaedic Society for Sports Medicine
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Clavicle fracture—emergency management. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T903976/Clavicle-fracture-emergency-management . Accessed August 24, 2017.
Lenza M, Belloti JC, Andriolo RB, Gomes Dos Santos JB, Faloppa F. Conservative interventions for treating middle third clavicle fractures in adolescents and adults. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD007121.
Shoulder trauma. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00394 . Updated September 2007. Accessed August 24, 2017.
Stegeman SA, de Jong M, Sier CF, et al. Displaced midshaft fractures of the clavicle: nonoperative treatment versus plate fixation (Sleutel-TRIAL). A multicentre randomised controlled trial. BMC Musculoskelet Disord. 2011 Aug 24;12:196.
Vander Have KL, Perdue AM, Caird MS, Farley FA. Operative versus nonoperative treatment of midshaft clavicle fractures in adolescents. J Pediatr Orthop. 2010 Jun;30(4):307-312.
8/20/2013 DynaMed's Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114297/Buckle-fracture-of-distal-radius : Joshi N, Lira A, Mehta N. Diagnostic accuracy of history, physical examination, and bedside ultrasound for diagnosis of extremity fractures in the emergency department. Acad Emerg Med. 2013 Jan;20(1):1-15.
- Reviewer: EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
- Review Date: 09/2018
- Update Date: 08/20/2013