Care and Treatment of Clavicle (Collarbone) Injury

The clavicle is located between the ribcage and the shoulder blade. This structure connects the arm to the trunk of the body and lies above several important blood vessels and nerves. These vital body components do not usually become injured with a clavicle fracture.

What causes clavicle fractures?

The collarbone gets broken when there is a direct blow to the shoulder. This can occur during a fall onto the shoulder or during a motor vehicle accident. A fall onto an outstretched arm can also lead to a fracture of the clavicle. Many infants are born with a fracture to the collarbone – an injury that occurs during a traumatic birth.

What are the symptoms of a clavicle fracture?

If you sustain a clavicle fracture, it will most likely be very painful and hard to move your arm. Other symptoms include:

Shoulder sagging downward and forward

A deformity or “bump” over the area of the break

Inability to lift the arm without pain

Bruising, swelling, or tenderness over the clavicle

A grinding sensation when the arm is raised up

How is a clavicle fracture treated?

With some breaks, the ends of the bone have not shifted out of place and line up correctly. These types of fractures do not require surgery, and the orthopedic specialist can treat them with conservative measures. These include the use of an arm support or sling (worn to keep the arm in proper position while the bone heals), mild pain medication, and physical therapy. Therapy is done to increase muscle strength in your shoulder and to prevent stiffness and weakness of the muscles.

The orthopedic specialist will recommend surgery if the bones are displaced (out of place) and do not line up correctly. During the procedure, the bone fragments are situated into their normal alignment and held that way with special screws and plates that are attached to the outer surface of the bone. These structures are not removed until after the bone has healed. Some surgeons use pins to hold the fracture in proper position once the bone ends are put back in alignment.

AC Separation

The acromioclavicular joint (also called the AC joint) is the area where the clavicle meets the highest point of the shoulder blade. An injury to this structure that is common is an AC separation, where a force causes the ligaments that attach to the underside of the clavicle to tear.

What causes an AC separation?

The most common reason for a person to suffer an AC separation is a fall directly onto the shoulder. The force causes the ligaments to be injured and the collarbone separates from the wingbone (shoulder blade). This type of injury will cause the wingbone to move downward with the weight of the arm, creating a bulge above the shoulder.

How is an AC separation treated?

If the shoulder is not seriously deformed, and the AC separation is mild, the orthopedic specialist will recommend nonsurgical treatment modalities. These include the use of a sling, cold packs, and pain medications. Most people will return to full activity once the injury has healed without permanent, significant deformity.

If the pain of AC separation persists with conservative treatment, or the tears to the ligaments are severe, the orthopedic specialist will recommend surgery. This is done to trim back the end of the clavicle so that it will not rub against the shoulder blade. This procedure can be done long after the injury has occurred, too.

Source by Dr J Michael Watt