A fracture of the clavicle (collarbone) is unfortunately a common injury in contact and collision sports, such as football. Typically the injury occurs when the athlete lands on his or her shoulder. An athletic trainer or physician on the field can usually make the diagnosis right away. The clavicle will show deformity at the fracture site where the bone is often prominent or even tenting the skin. The athlete will have severe pain at the fracture site, and he will usually not move the arm secondary to this pain.
Note the separation of the fracture ends.
Evaluation in the emergency room or in the physician’s office is critical. X-rays are usually taken to confirm the injury. Frequently clavicle fractures are treated nonoperatively. The athlete is placed in a sling to wear almost all the time initially. The sling keeps the arm from moving, and this immobilization helps to decrease the pain. As the fracture starts to heal, motion becomes more comfortable. At that point, I think it’s reasonable to wear the sling less and less to start shoulder range of motion and gentle strengthening exercises. The fracture typically heals, but it can often take 3 to 4 months before complete healing is noted by x-ray.
Note how the pin inside the bone holds the fracture ends in better position until it heals.
Some sports medicine surgeons are beginning to advocate early surgical treatment of clavicle fractures, especially in high-level athletes. Fixing the fracture either with a plate and screws or a device that goes down the center of the bone across the fracture can help the clavicle fracture line up better and heal in a more anatomic position. In my experience, high-level athletes with fractures that have shortened, where there is significant displacement or overlapping of the fracture ends, do seem to have good outcomes with surgical treatment. Although it still takes 8 to 12 weeks to get back to sports, they do seem to have better strength and functional ability with their shoulders after the fracture has healed. Consultation with a sports medicine physician is crucial after a clavicle fracture to determine the best treatment for each athlete.
If you have specific questions about clavicle fractures, please Ask Dr. Geier directly or Schedule an Appointment.
Other Shoulder Injuries
Adhesive Capsulitis
Biceps ruptures (proximal)
Clavicle Fracture
Distal Clavicle Osteolysis
Glenohumeral Internal Rotation Deficit (GIRD)
Internal Impingement of the Shoulder
Little Leaguer’s Shoulder
Pectoralis Tendon Rupture
Rotator Cuff Injuries
Shoulder Dislocations
Shoulder Impingement
Shoulder Separations
Superior Labral (SLAP) Tears
Sternoclavicular Dislocations
C. David Geier Jr., M.D.
