The collarbone fracture or clavicle fracture is one of the most common, but at the same time one of the most harmless fracture injuries. When you break your collarbone, the clavicle (collarbone) breaks. This is the connecting bone that connects the shoulder blade and thorax. A fall onto an extended arm or shoulder is the most common cause of this fracture injury.
What is a broken collarbone?
The clavicle fracture is also commonly known as a broken collarbone. A tubular bone, about as long as a hand, connects the shoulder blade to the thorax on the breastbone. This bone is called the collarbone or clavicle. It is very common for this bone to break. See biotionary for What does SBS stand for.
Of the broken bones, only the radius fracture is more common. In most cases, children and young people are affected. The collarbone can break in different ways and in different places. Accordingly, collarbone fractures are classified into four types.
Type 1 stable fractures that lie outside the ligaments are referred to. Type 2 are unstable fractures located between the outer ligaments with the inner fragment protruding upwards. In type 3, the break is outside the outer ligament attachments. In type 4, the outer and soft bony mantle is merely displaced, but not severed. This type of collarbone fracture only occurs in children.
Causes
A broken collarbone is always accompanied by a certain amount of violence. By far the most common causes are falls. Usually a fall onto the shoulders or onto an outstretched arm. In particular, falls on the outstretched arm often occur in sports.
In addition to falls, a fracture of the clavicle can also occur as a result of direct trauma. Blows to the front shoulder area can cause a fracture.
But fractures of the clavicle also occur in traffic accidents, since the seat belt exerts strong pressure on the shoulder area during the impact. It can happen that a baby’s collarbone is broken due to an unfavorable position during birth.
Symptoms, Ailments & Signs
The symptoms of a collarbone fracture are very clear. In most cases, the two fractured ends of the bone move against each other, which leads to a palpable step on the collarbone. In many cases this is also visible. Hematoma formation and swelling often occur at the fracture site. More rarely, it is an open clavicle fracture. Here the ends of the bones have punctured the skin and there are open wounds and bleeding.
Pain occurs when pressure is applied to the fracture site. In some cases, there is also pain when the head is rotated because the head-turning muscle is attached to a piece of the collarbone. Pain always occurs when moving the arm on the fractured side of the body.
Those affected often place their arm in a relieving position. The arm is shifted slightly forward and rests against the body. This leads to hunched shoulders.
If the shoulder joint is moved, audible rubbing noises can also occur. This can also cause pain. In rare cases, the fracture also injures the nerves or tendons in the collarbone area.
Diagnosis & History
A broken collarbone shows typical symptoms, so that the fracture can usually be diagnosed on the basis of these symptoms. In the case of a collarbone fracture, the arm on the side of the fracture is automatically held in a relieving position. The shoulder is slightly tilted forward.
In addition, swelling and bruising in the fracture area often indicate a broken collarbone. In many cases there is a tactile and visible step at the point of fracture. Pain occurs when pressure is applied to the affected shoulder or when the arm is moved.
If the affected shoulder joint is moved, a typical rubbing noise can often be generated at the fracture site. X-ray examination or computed tomography are used to confirm the diagnosis. When a broken collarbone is diagnosed, it is important to check whether nerves or vessels are also affected by the injury. A broken collarbone usually heals well and without complications.
Complications
A broken collarbone can initially cause severe pain, bruising and swelling in the arm, which is usually associated with restricted movement. Occasionally, these restricted movements in the arm and shoulder remain permanently. In people with certain pre-existing conditions, bone healing is delayed or does not occur at all.
Shortening of the collarbone can also occur, usually associated with reduced mobility of the affected arm. If the broken collarbone is not treated or only treated insufficiently, it can develop into a chronic disease. An operation is always associated with certain risks. Rarely does the collarbone become inflamed after the procedure or bleeding, wound healing disorders and the formation of scars occur.
If nerves are injured, sensory disturbances can occur. If muscles, joints or cartilage are injured, there is a risk of permanent restriction of movement. An implant that has been placed can fail, break or migrate, and as a result must be replaced by a second procedure. Finally, allergic reactions to the materials and agents used can occur. Prescribed medicines can cause unwanted side effects and cause serious complications in undiagnosed diseases.
When should you go to the doctor?
A fracture of the collarbone should of course always be treated by an appropriate doctor. Otherwise, a full and timely recovery will not be possible. Affected people who experience such a fracture usually automatically seek medical attention or a hospital. The pain of such a fracture is immense and unbearable, so that the nearest hospital or an emergency doctor is usually consulted. However, in such a case not only the first aid is very important, since an operation may be necessary.
This can ensure that the broken bone grows back together properly. Those who do not visit the doctor later in the healing process are taking a very large risk. The broken bone can grow together in a misaligned position, which can cause severe pain. Therefore, the following applies: A fracture of the collarbone must always be treated medically and with medication. This is the only way to ensure complete healing. If this is not done, there is a risk of complications that cannot be properly restored afterwards.
Treatment & Therapy
A broken collarbone can be treated in two ways. In almost 98 percent of cases, treatment is by conservative therapy. However, surgical treatment may also be necessary. Which method is ultimately used to treat the fracture always depends on the results of the X-ray examination.
In conservative treatment, patients receive a backpack bandage for around three to four weeks. This is a traction bandage that is placed around both shoulders and pulled taut and tight at the back. This pulls the shoulders back and sets the broken bones in place. In most cases, the treatment is followed by physiotherapy to restore full mobility of the shoulder.
Whenever blood vessels or nerves have been injured by the fracture or in the case of severely displaced fractures, the broken collarbone must be treated surgically. During the operation, injured vessels are treated and the fracture is fixed either with metal plates or screws. These must be removed again after six months to a year. After the operation, the arm and shoulder are fixed and immobilized with a so-called Gilchrist bandage so that the broken collarbone can heal.
Prevention
A broken collarbone cannot really be prevented. It is usually a sports injury or an accident. The necessary caution during sports or other situations where there is a risk of falling can at best reduce the risk of injury and thus prevent a broken collarbone.
Aftercare
If conservative treatment of the broken collarbone is not sufficient, surgery can be carried out, which in turn requires follow-up care. The treatment is inpatient and the sensitivity of the affected arm is checked in the first few days after the operation.
Among other things, the patient should move his elbow or form a fist. The drainage that is created during the operation can be removed after three days at the latest. After the operation, a thorough check of the surgical wound is carried out in the first few days.
In this way, possible wound healing disorders or infections can be recognized early and treated accordingly. If the wound heals as planned, the stitches are removed after around 14 days. Another important part of aftercare for a broken collarbone is physical therapy. They serve to rebuild the affected muscle sections. In addition, the shoulder should be able to move fully again. Additional bandages do not usually have to be applied.
X-ray examinations are carried out to monitor the progress. They are carried out after five to six weeks. Depending on the result, the patient should not lift or carry heavy loads with the treated arm for about six to eight weeks. A final X-ray check is carried out after three to four months. In order to treat any pain that still exists, the patient can be given appropriate medication.
You can do that yourself
In the case of a collarbone fracture, the shoulder should be cooled first. This will relieve pain and reduce bruising. Rapid cooling by applying pads can support the healing process. After the treatment, the doctor’s instructions should be followed first and foremost.
It is important to protect the affected shoulder. It is best to sleep on your back with an orthopedic pillow to avoid further stress. Patients who put a lot of strain on their collarbones at work are best off taking sick leave. Various household medications can also be used to relieve the pain. There are, for example, ointments made from aloe vera, quark wraps or pain-relieving teas. In consultation with the doctor, the healing of the fracture can be accelerated by targeted massages. Ideally, patients should be instructed by a specialist. Otherwise, complications can occur that affect the healing process.
A broken collarbone should be largely healed after three to four weeks. Until then, the medication prescribed by the doctor must be taken and the suggested measures for rest must be followed. If the symptoms persist or severe pain and restricted movement occur, a doctor’s visit is recommended. Various homeopathic remedies such as arnica or St. John’s wort also help. It is best for patients to consult a suitable non- medical practitioner.
