How Do Broken Collarbones Happen?
The collarbone connects the shoulder blade to the upper part of the breastbone. Breaking the collarbone is not an uncommon injury, especially for children and young adults. A broken collarbone, otherwise known as a fractured clavicle, could occur due to trauma from a vehicle accident, from crashing while riding a bike, or a sports injury, such as a blow to the shoulder, which can happen whether you’re on a field, a court, or an ice rink. Breaks can also happen when you fall onto an outstretched arm or shoulder, causing the bone to snap or break. Babies have been known to sustain a broken collarbone during the birthing process. Children are particularly susceptible to this injury because collarbones don’t harden until around age 20. Senior citizens are also vulnerable because of their decreased bone strength. Osteoporosis or cancer can also weaken bones, as well as genetic factors. The fractures themselves range in severity between a slight crack to breaking into multiple pieces.
Most collarbone fractures happen in the middle third of the clavicle. Stick sports, such as hockey and lacrosse, are the most frequent culprit, along with falls on outstretched arms. The part of the collarbone near the shoulder tip, the outer third of the clavicle, is more likely to be injured in accidental falls, football tackles, or car collisions. Force is transmitted to the top or the side of the shoulder when this happens. Fractures to the inner third of the collarbone nearest to the breastbone are rare, but still possible if one suffers a direct hit to the front of the chest, such as from the chest hitting the steering wheel in a car crash.
What Are the Symptoms?
Some symptoms of a broken collarbone are bruising, swelling, and tenderness. There may be stiffness or pain that increases whenever you move your shoulder, or you may not be able to move your shoulder at all.
You might see a bulge on or near the shoulder and an abnormal collarbone contour. You may also hear crackling or grinding sounds when you move your shoulder. Sometimes you’ll hear a clicking or popping sound, and a feeling when the break happens, followed by sharp, sudden pain. Once the initial pain subsides, the ache becomes dull and constant
What are the signs?
People holding their arms close to their bodies and supporting that arm with the opposite hand is sign to watch out for. They are doing this to avoid shoulder movement to reduce their pain levels.
Some people, such as young athletes, may still have a good range of motion in their arms despite the fractured clavicle.
For those who sustain fractures at the ends of the bone that attach to the shoulder blade, a downward and forward slumped shoulder is noticeable, indicating which side is injured. With newborn babies, you may notice they are not moving their arm for several days, which is usually a sign of a collarbone fracture.
If you are experiencing these signs and symptoms after an injury to the collarbone area, you can apply ice every 20 to 30 minutes, every few hours for the first two or three days. This helps manage the pain and swelling.
If you find someone who has suffered a broken clavicle, especially in an automobile accident, it is best not to move that person in case there are other injuries that could worsen because of movement. Ideally, you should wait for a trained emergency medical services professional to arrive, but do move the injured person if he or she is in danger. Be cautious and avoid movements in the injured collarbone, neck, and back areas.
Move the arm as little as possible and use an ice pack wrapped in a towel, if available, to place on the broken collarbone. Ibuprofen, acetaminophen, or aspirin can be given as pain relievers but avoid giving aspirin to children. If there is a first aid kit available, a sling can be made from a triangle bandage to further relieve pain. If not, a sling can also be made from a towel or a large handkerchief. Fold the cloth in half to make a triangle, then fold this around the forearm with one point towards the elbow and the other two points tied around the neck. The elbow should be bent to prevent movement and supported by the sling that is across the chest.
If you notice any of the signs and are experiencing enough pain to cause you to be unable to use your arm normally, then you should seek medical treatment.
Most likely, that doctor will be an emergency medicine specialist at the hospital’s emergency department or your own primary care physician. During the examination, the shoulder, upper chest, and collarbone areas are checked for swelling, tenderness, abrasions, bruising, open wounds, or deformities. The doctor also checks for nerve or blood vessel damage by checking your pulse at both the elbow and the wrist, in addition to the amount of strength and feeling you have in your fingers, hand, and arm. He or she will also use a stethoscope to determine if you have lung damage. An X-ray will be taken to determine the extent of the break, find the exact location, and establish whether there is an injury to the joints. Generally, it’s best to restrict movement so that the broken bone can heal. This is typically done with an arm sling. Children’s bones heal faster, between three to six weeks, while adults will need six to 12 weeks of immobilization to fully heal.
For pain and inflammation reduction, an over-the-counter pain reliever may be all that is needed. For more severe pain, there are prescription medications that contain a narcotic that can be used for a brief period. While wearing the arm sling, you will be moving your shoulder to reduce stiffness. Once you are no longer wearing the sling, you may need physical therapy or further rehabilitation to restore flexibility, muscle strength, and joint motion.
Besides severe pain, tingling, numbness, rapid swelling, and discoloration, you should seek immediate medical attention if you believe there are other injuries besides the broken collarbone, or if the bone is close to or already poking through the skin. Most importantly, any breathing difficulties or instances of coughing up bloody fluids need to be addressed quickly.
If the fractured collarbone has broken through skin, is broken in several places, or is severely displaced, surgery is often necessary. Your doctor will refer you to an orthopedic surgeon or orthopedist. Screws, rods, or plates may be needed to keep the bone in place while it heals. Screws and plates are attached to the bone’s outer surface after the bone fragments have been repositioned into proper alignment. Screws and plates are usually permanent, even after the bone fracture has healed, unless they cause discomfort. Pins are used to hold the fracture in position and removed after the bone has healed.
While not common, complications may arise, such as infections or the bone not healing. With surgery, there are some risks include bleeding, wounds that do not heal, infections, continued or increased pain, blood clots, and adverse reactions to anesthesia.
Lung injuries are another possible complication. The elderly, people who smoke or use tobacco, or those who have diabetes are at higher risk for complications during and after surgery and are most likely to have bone and wound healing problems.
If your collarbone was seriously broken, one consequence is that healing will happen very slowly or not completely. Improper healing could lead to shortening of the bone. Jagged ends of the broken collarbone may injure nerves and blood vessels, causing numbness or cold feelings in your hand or arm, which requires urgent medical attention. While the bone is healing, a bony lump usually forms and disappears over time, but some lumps become permanent. These lumps can usually be seen underneath the skin. If the fracture involves the joints, especially the ones that connect the collarbone to the breastbone or shoulder blade, you may have a high risk of developing arthritis in those joints.
Fractured clavicles or broken collarbones will take time to heal, up to several months, whether or not you have surgery. The recovery time could be as short as six weeks for a minor injury and as many as four to six months if your injury requires surgery. You can expect to return to normal activities around three months after the injury occurs. Consult with your doctor on whether the injured area is stable enough for normal activity, especially if you participate in sports. If you attempt to resume regular activities or lift your arm too soon, you may cause hardware breakage (if you’ve had surgery) or movement of the bone fragments because they haven’t had enough time to be unified and bonded. In other words, if you break the clavicle again, you will have to start the healing process all over.