Broken Collarbone (Clavicle Fracture)
What is a clavicle fracture?
A clavicle fracture is a break in the collarbone. You have two clavicles — long, slender, S-shaped bones connecting the shoulders to the upper chest. Broken collarbones are common, making up about 5% of all adult bone fractures.
Are there different kinds of clavicle fractures?
A collarbone can crack in one place or break into several pieces (comminuted fracture). The broken pieces may still line up or may end up out of place (displaced fracture).
Symptoms and Causes
How do people break their collarbones?
A clavicle breaks when force or pressure causes it to snap. Common causes are:
- Collisions (trauma) when an arm is outstretched, like during skiing, hockey, football and other sports.
- Direct hits to the clavicle, such as in a car accident.
- Falls onto the clavicle or an extended arm.
- Passing through the birth canal for a baby.
What are the symptoms of a broken collarbone?
If you break your collarbone, you may experience:
- Snapping or grinding noise when the bone breaks.
- Sharp pain, which gets worse when you move that area.
- Shoulder slumping down or forward because the bone no longer supports it.
- Difficulty moving or lifting the arm, with a possible grinding feeling when you do.
- Bruising, swelling or tenderness in the area.
- Bump that you can see through the skin.
- Numbness or “pins and needles” (less often).
- Bone poking through the skin, with bleeding (rarely).
Diagnosis and Tests
How is a clavicle fracture diagnosed?
If you think you’ve broken your clavicle, seek immediate medical attention. A healthcare provider will:
- Ask you to describe what happened.
- Examine the area.
- Take X-rays of the injured area to confirm a broken bone. X-rays can also show exactly where the break is, how bad it is and whether any other bones broke.
If the healthcare provider thinks there’s damage to a joint or artery, you may get more tests:
Management and Treatment
What should I do if I break my clavicle?
If you think you broke your collarbone, take these steps immediately:
- Put your arm in a sling to stop it from moving. You can create a sling from a piece of cloth like a towel or shirt. Wrap it around your arm and fasten it to the back of your neck to hold up your arm.
- Apply ice to reduce pain and swelling.
- Take over-the-counter pain medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include ibuprofen (Advil®, Motrin®), naproxen, (Aleve®) or acetaminophen (Tylenol®) if it doesn’t interfere with your other medications or health issues.
- Call a healthcare provider or go to the emergency room.
What does a healthcare provider do to treat a broken collarbone?
Most clavicle fractures don’t need surgery. If the broken parts of the bone are in a good position to heal, healthcare providers may recommend:
- Arm support: A sling can help you feel more comfortable as you heal. It can also prevent broken parts of bone from moving around.
- Medication: Over-the-counter medications can relieve pain as the bone heals. Some healthcare providers may prescribe stronger drugs, such as opioids, for a very short period of time. Those come with risk of drug addiction, though, and should be used only if really necessary
- Physical therapy: A physical therapist can teach you special exercises. These exercises can improve motion in your arm, strengthen your shoulder and prevent stiffness. You may do the exercises in a physical therapist’s office, at home or both.
What if I need surgery?
Sometimes you need surgery to treat a broken collarbone, like when:
- Blood vessels or nerves get injured.
- Fractures break through the skin.
- Pieces of broken collarbone are not in a good position to heal.
Surgery to treat a clavicle fracture is called open reduction and internal fixation. The operation puts broken pieces of collarbone back where they belong (reduction). It then uses metal devices to keep the pieces in place (fixation). An orthopaedic surgeon (specialist in bone and muscle injuries) may perform the procedure using:
- Plates and screws attached to the outer surfaces of the bone. The hardware usually isn’t removed after the bone heals, unless it causes discomfort (this usually happens a year or more after the surgery).
- Pins or screws through the bone. They are usually removed once the fracture has healed.
How can I prevent a clavicle fracture?
Clavicle fractures happen suddenly and are difficult to prevent. But certain things can help keep your bones safer:
- Drive safely and wear a seatbelt when riding in a vehicle.
- Eat a well-balanced diet with plenty of calcium to keep your bones strong.
- Use good technique and body positioning for any sports you play or activities you do (such as bike riding).
- Wear protective gear when playing sports or participating in hobbies.
Outlook / Prognosis
What is the outlook for a broken clavicle without surgery?
Most collarbone fractures heal in six to eight weeks, without surgery or complications. Most people are able to start getting back to normal activities by three months or so, but full recovery may take up to six to 12 months.
You may feel a bump where the fracture healed. The bump may get smaller on its own over time, but it might never go away completely. You may also have less strength in your shoulder and arm. But unless you have other injuries, you can often return to normal activities within a few weeks.
What is the outlook for a broken clavicle with surgery?
If you have surgery, you may feel the plate or other hardware inside your body. You’ll also have limited use of your arm for six to eight weeks. After that, you can start using it for normal daily activities such as bathing, dressing and eating. You should wait for your healthcare provider’s permission before doing things that involve lifting, pulling or pushing. You should also wait to play sports. In general, recovery is similar to treating a broken clavicle without surgery with return to normal activity around three months or so and full recovery up to six to 12 months after surgery.
While your break heals, you should follow-up with your surgeon or other healthcare provider to make sure you don’t have complications. Complications after surgery may include:
- Malunion: If the pieces of bone move out of place and heal in the wrong position, healthcare providers call it a malunion. It may need surgery.
- Pain and stiffness: Sometimes the shoulder can get very stiff or painful after surgery. Your healthcare provider may recommend physical therapy or remove any irritating pieces of hardware.
- Wound problems: The place where the surgeon cut your skin may have trouble healing, get infected or bleed.
What can I do to make sure I heal after a broken collarbone?
Whether you have surgery or not, you should go to all your follow-up appointments. At those checkups, your healthcare provider will:
- Check the motion in your shoulder.
- Talk to you about how you feel and whether you still have pain.
- Take more X-rays if needed.
You should also follow all exercise advice from your healthcare provider and physical therapist. Physical therapy can be slow and uncomfortable, but it’s important if you want to return to your normal activities.
In the first few weeks of physical therapy, you will do gentle exercises to help prevent stiffness and pain. You will eventually start exercises with light weights and stretchy bands. Once the bone fragments rejoin, you will do more aggressive strength training.
A note from Cleveland Clinic
A clavicle fracture is a break in the collarbone that’s often painful. Most people don’t need surgery, but some require an operation to put the pieces of bone back in place. Physical therapy is important to get you back to daily activities. Talk to your healthcare provider about exercises to reduce pain and stiffness and regain strength.