A broken collarbone is a common injury, particularly in children and young adults. Your collarbone connects the upper part of your breastbone to your shoulder blade. Common causes of a broken collarbone include falls, sports injuries and trauma from traffic accidents. Infants can sometimes experience a broken collarbone during the birth process.

If you think you or your child has a broken collarbone, seek prompt medical attention. Most broken collarbones heal well with ice, pain relievers, a sling, physical therapy and time. But a complicated broken collarbone may require surgery to realign the broken bone and to implant plates, screws or rods into the bone to maintain proper alignment during healing.

Signs and symptoms of a broken collarbone include:

  • Pain that increases with shoulder movement
  • Swelling
  • Tenderness
  • Bruising
  • A bulge on or near your shoulder
  • A grinding or crackling sound when you try to move your shoulder
  • Stiffness or inability to move your shoulder

When to see a doctor

If you notice any of the signs or symptoms of a broken collarbone, or if you have enough pain in your shoulder that you can't use it normally, see a doctor right away. Do the same for your child. Delays in diagnosis and treatment of a broken collarbone can lead to poor healing.

Common causes of a broken collarbone include:

  • Falls. Falling onto your shoulder or onto your outstretched hand can result in a broken collarbone.
  • Sports injuries. A direct blow to your shoulder from an injury on the field, rink or court can cause a broken collarbone.
  • Vehicle trauma. A broken collarbone can be the result of a car, motorcycle or bike accident.
  • Birth injury. In newborns, a broken collarbone can occur during the birthing process.

Your collarbone doesn't harden completely until about age 20. This puts children and teenagers at higher risk of a broken collarbone. The risk decreases after age 20, but then rises again in older people as bone strength decreases with age.

Most broken collarbones heal without difficulty. But complications may include:

  • Nerve or blood vessel injury. The jagged ends of a broken collarbone may injure nearby nerves and blood vessels. Seek immediate medical attention if you notice any numbness or coldness in your arm or hand.
  • Poor or delayed healing. A severely broken collarbone may not heal quickly or completely. Poor union of the bones during healing may cause the bone to be shorter than it was before the break.
  • A lump in the bone. As part of the healing process, the place where the bone knits together forms a bony lump. This lump is easy to see because it's so close to the skin. While they usually disappear over time, some lumps are permanent.
  • Bone infection. If any part of your broken bone protrudes through your skin, it may be exposed to germs that can cause infection. Prompt treatment of this type of fracture is critical.
  • Osteoarthritis. If the fracture involves the joints that connect your collarbone to your shoulder blade or your breastbone, you may be at increased risk of eventually developing arthritis in that joint.

Depending on the severity of the break, your family doctor or the emergency room physician may recommend that you or your child be examined by an orthopedic surgeon.

What you can do

It may be helpful to write a list that includes:

  • Detailed descriptions of your symptoms and the event that caused the injury
  • Information about past medical problems
  • All your medications and dietary supplements
  • Questions you want to ask the doctor

What to expect from your doctor

Your doctor will likely ask some of the following questions:

  • How exactly did the injury occur?
  • Have you ever experienced any other broken bones?
  • Have you been diagnosed with weakened bones?

During the physical exam, your doctor will inspect the affected area for tenderness, swelling, deformity or an open wound. X-rays are taken to determine the extent of a broken collarbone, pinpoint its exact location and determine if there's injury to the joints. Occasionally, your doctor may also recommend a computerized tomography (CT) scan to obtain more-detailed images.

Restricting the movement of any broken bone is critical to healing. To immobilize a broken collarbone, you'll likely need to wear an arm sling.

The length of time immobilization is needed depends on the severity of the injury. Union of the bone usually takes three to six weeks for children and six to 12 weeks for adults. If a baby has suffered a broken collarbone during labor and delivery, healing typically occurs without specific treatment. Pain control and careful handling of the baby are usually all that's needed.

Medications

To reduce pain and inflammation, your doctor may recommend an over-the-counter pain reliever. If you have severe pain, you may need a prescription medication that contains a narcotic for a few days.

Therapy

Rehabilitation begins soon after initial treatment. In most cases, it's important to begin some motion to minimize stiffness in your shoulder while you're still wearing your sling. After your sling is removed, your doctor may recommend additional rehabilitation exercises or physical therapy to restore muscle strength, joint motion and flexibility.

Surgery

Surgery may be required for a fractured collarbone if the bone has broken through your skin, if it is severely out of place or if the bone has broken into several pieces. Broken collarbone surgery usually includes placing fixation devices — plates, screws or rods — to maintain proper position of your bone during healing. Surgical complications are rare, but can include infection and lack of bone healing.

Applying ice to the affected area during the first two to three days after a collarbone break can help control pain and swelling.

Dec. 06, 2012