Most clavicle fractures can be treated by wearing a sling to keep the arm and shoulder from moving while the bone heals. With some clavicle fractures, however, the pieces of bone move far out of place when the injury occurs. For these more complicated fractures, surgery may be needed to realign the collarbone.
The clavicle is located between the ribcage (sternum) and the shoulder blade (scapula). It is the bone that connects the arm to the body.
The clavicle lies above several important nerves and blood vessels. However, these vital structures are rarely injured when a fracture occurs.
Clavicle fractures are fairly common and occur in people of all ages. Most fractures occur in the middle portion, or shaft, of the bone. Occasionally, the bone will break where it attaches at the ribcage or shoulder blade.
Clavicle fractures vary. The bone can crack just slightly or break into many pieces (comminuted fracture). The broken pieces of bone may line up straight or may be far out of place (displaced fracture).
Clavicle fractures are most often caused by a direct blow to the shoulder. This can happen during a fall onto the shoulder or a car collision. A fall onto an outstretched arm can also cause a clavicle fracture. In a baby, a clavicle fracture can occur during the passage through the birth canal.
A clavicle fracture can be very painful and may make it hard to move your arm. Other signs and symptoms of a fracture may include:
- Sagging of the shoulder downward and forward
- Inability to lift the arm because of pain
- A grinding sensation when you try to raise the arm
- A deformity or “bump” over the break
- Bruising, swelling, and/or tenderness over the collarbone
Your doctor will want to know how the injury occurred and will ask about your symptoms. He or she will then carefully examine your shoulder.
In a clavicle fracture, there is usually an obvious deformity, or “bump,” at the fracture site. Gentle pressure over the break will bring about pain. Although it is rare for a bone fragment to break through the skin, it may push the skin into a “tent” formation.
Your doctor will also perform tests to ensure that no nerves or blood vessels were damaged when the fracture occurred.
X-rays. X-rays provide images of dense structures, such as bone. Your doctor will order an x-ray to help pinpoint the location of the fracture and to learn more about the severity of the break.
He or she may also order x-rays of your entire shoulder to check for additional injuries. If other bones are broken, your doctor may order a computerized tomography (CT) scan to see the fractures in better detail.