Collarbones: More Important than You Think
The clavicle, also commonly known as the “collarbone,” is one of the most frequently fractured bones in the human body. This “S” shaped bone lies horizontally and extends from the midline of the neck to the top of the shoulder. One can easily feel their own clavicle bone, evidence that it is fairly exposed to the environment and thus susceptible to injury. Most fractures typically occur from direct trauma such as recreational activities, motor vehicle collisions, falls onto an outstretched hand, or even during childbirth. The majority of these fractures occur at the middle of the bone, the weakest region, and are easily seen or felt. In addition, there may be tenderness at the site accompanied with difficulty moving or raising the arm.
The clavicle serves multiple purposes, including maintaining the position of the arm at the side of the chest and allowing for one to fully raise the arm above the head and create a complete circular motion. There are six muscles in the chest, neck,
shoulder, and upper back that attach to this bone’s flat surface and rely on this anchor for stability. The collarbone also overlies and protects important blood vessels and nerves, which can be at risk during injury.
Treatment Treatment for a simple, minimally displaced
collarbone fracture, includes a sling to support the arm’s weight which provides pain relief and comfort during the healing process. This is followed by 6–12 weeks of restricted weight bearing (3–6
weeks in children) and a follow-up exam with the physician to ensure proper healing. During this
period, physicians generally prescribed daily elbow range of motion to prevent stiffness. Surgery may be necessary when the ends of the fracture are not aligned, the fracture involves several fragments, or the bone has punctured the skin. Surgical repair involves placing a plate secured with screws along the fracture site. With any period of prolonged immobility, muscles begin to weaken. Physical therapy and gradual strengthening exercises are encouraged to restore full function. For non-operative clavicle fractures, the healing process requires time to heal before strenuous exercises are pursued. This differs in surgically repaired fractures that rely on hardware for support, allowing earlier initiation of shoulder range of motion.
Return to Play Fortunately, the prognosis for collarbone fractures is very good. Following healing, approximately 2–3 months later, the majority of patients return to full mobility whether this is the vigorous activity of a professional athlete or a child simply riding their bike. Complications may arise for particular fracture patterns and it’s important to follow your physician’s recommendations for treatment and healing.