Collarbone Fractures

What is a Collarbone?

The clavicle, which is commonly known as the collarbone, is the bone found on both sides of the chest that connects the sternum of breastbone to both shoulders.

The clavicle sits above several important nerves and blood vessels.

What is a Collarbone Fracture?

A fractured clavicle is the medical term used when the collarbone is broken.

Causes of a broken collarbone:

  • Trauma (sports injuries, car accidents, falls)
  • Weak bones
  • Illness such as osteoporosis or cancer

Collarbone fracture symptoms

Fractured collarbone sufferers have the following symptoms:

  • Severe pain
  • Sagging shoulder (down and forward)
  • Inability to lift the arm because of pain
  • A grinding sensation if an attempt is made to raise the arm
  • A deformity or "bump" over the break
  • Bruising, swelling, and/or tenderness over the collarbone

Diagnosis of Collarbone Fracture

Dr Biggs will need to diagnose a Collarbone fracture

Often, Collarbone fractures can be identified during a physical exam by a medical professional. By examining the joint the cause of symptoms can be pinpointed as there will usually be an obvious deformity at the fracture site.

Diagnostic methods include:

Consultation - During this consultation Dr Biggs will:

  • Take a medical history
  • Perform a physical examination
  • Assess the joint’s range of motion

Arthroscopy

Imaging tests - In order to clearly understand the nature of any loss of the joint space or bone spur formation imaging scans are required:

  • X-rays - an x-ray will pinpoint the severity of the break. X-rays of the entire shoulder will often be done to check for additional injuries. If other bones are broken, your doctor may order a computed tomography (CT or CAT) scan to see the fractures in better detail
  • MRI - can create detailed images of both hard and soft tissues. An MRI can produce cross-sectional images of internal structures required if the diagnosis is unclear.

While not all of these approaches or tests are required to confirm the diagnosis, this diagnostic process will also allow Dr Biggs to review any possible risks or existing conditions that could interfere with the surgery or its outcome.

Treatment for Collarbone Fracture.

If the patient’s bones are displaced, surgery can align the bones exactly and hold them in position while they heal. This can improve shoulder strength after recovery.

If the broken ends of the bones have not shifted out of place and line up correctly, the patient may not need surgery. Broken collarbones can heal without surgery.

Non Surgical Treatment can include:

  • Arm support
  • Medication
  • Physical Therapy

The patient will need to see your doctor regularly until the fracture heals. The fracture can move out of place before it heals. If the bone heals in this position, called a “malunion” it can affect the patient’s arm movement.

Collarbone Fracture Surgery

Plates and Screws: Dr Biggs will reposition the bones into their normal alignment, which will then be held in place with special screws and/or by attaching metal plates to the outer surface of the bone.

Pins: Pins can also be used to hold the repositioned bones in place. The incisions for pin placement tends to be smaller that used for plates.

Untreated Collarbone Fracture

A Collarbone Fracture is not life threatening but can severely impact a patient’s quality of life and function.

It can affect anyone: elite athletes and the active individual, manual labourers and office workers.

Collarbone Fractures can lead to

  • Short Term Impact - ongoing pain and disability.
  • Long Term Impact - damage becomes permanent.

Surgery Risks

As with any major surgery there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.

It is important that the patient is informed of these risks before the surgery takes place.

Complications can be medical (general) or specific to surgery.

Medical complications include those of the anaesthetic and your general well being. Almost any medical condition can occur so this list is not complete. Complications include:

  • Allergic reactions to medications
  • Blood loss requiring transfusion with its low risk of disease transmission
  • Heart attacks, strokes, kidney failure, pneumonia, bladder infections.
  • Complications from nerve blocks such as infection or nerve damage.

Serious medical problems can lead to ongoing health concerns, prolonged hospitalisation or rarely death.

Specific complications for surgery are rare but may include:

Infection - Infections can occur superficially at the incision or in the joint space of the shoulder, a more serious infection. Infection rates vary; if it occurs it can be treated with antibiotics but may require further surgery.

Damage to nerves of Blood Vessels - Also rare but can lead to weakness or loss of sensation in part of the arm. Damage to blood vessels may require further surgery if bleeding is ongoing.

Blood Clots (Deep Venous Thrombosis) - Blood Clots can form in the arm muscles and can travel to the lung (Pulmonary embolism). These can occasionally be serious and even life threatening. If the patient suffers arm pain, redness or swelling, or have shortness of breath at any stage, contact Dr Biggs

Preparation for Collar Bone Surgery

Once Dr Biggs decides that surgery is required, preparation is necessary to achieve the best results and a quick, problem free recovery.

Preparing mentally and physically for surgery is an important step toward a successful result.

  • Dr Biggs will create a treatment plan and
  • Patients will also need to understand the process and their role in it

Participating and completing a tailored exercise program before (ie. pre-hab) with a trained physiotherapist will achieve the best result after surgery.

Dr Biggs will also need to:

  • Discuss any medications being taken with your doctor or physician to see which ones should be stopped before surgery
  • Do not eat or drink anything, including water, for 6 hours before surgery
  • Stop taking aspirin, warfarin, anti-inflammatory medications or drugs that increase the risk of bleeding one week before surgery to minimise bleeding
  • Review blood replacement options (including banking blood) with your doctor
  • Stop or cut down smoking to reduce your surgery risks and improve your recovery

Report any infections to Dr Biggs prior to surgery as the procedure cannot be performed until all infections have cleared up.

Preparation for Collar Bone Surgery

Once Dr Biggs decides that surgery is required, preparation is necessary to achieve the best results and a quick, problem free recovery.

Preparing mentally and physically for surgery is an important step toward a successful result.

  • Dr Biggs will create a treatment plan and
  • patients will also need to understand the process and their role in it

Participating and completing a tailored exercise program before (ie. pre-hab) with a trained physiotherapist will achieve the best result after surgery.

Dr Biggs will also need to:

  • discuss any medications being taken with your doctor or physician to see which ones should be stopped before surgery
  • do not eat or drink anything, including water, for 6 hours before surgery
  • stop taking aspirin, warfarin, anti-inflammatory medications or drugs that increase the risk of bleeding one week before surgery to minimise bleeding
  • review blood replacement options (including banking blood) with your doctor
  • stop or cut down smoking to reduce your surgery risks and improve your recovery

Report any infections to Dr Biggs prior to surgery as the procedure cannot be performed until all infections have cleared up.

Post Surgery

The patient will wake up in the recovery room and then be transferred back to their hospital room.

  • Pain medication will be provided to keep the patient comfortable.
  • A bandage will be around the operated shoulder and the arm will be in a sling or brace.
  • The sling will be worn for about 4-6 weeks to facilitate healing.

Dr Biggs will see the patient prior to discharge and explain the findings of the operation and what was done during Surgery.

  • The bandage will usually be removed 48 hours post surgery and place dressings provided by your surgeon over the area.
  • It is normal for the shoulder to swell after the surgery.Placing Ice-Packs on the shoulder will help to reduce swelling. Ice packs should be applied to the area for 20 min 3-4 times a day until swelling has reduced.

The patient should keep a pillow under their elbow while lying in bed.

  • The patient will not be allowed to lift anything over your head or anything greater than 1 kilo for the first 6 weeks.
  • 7-10 days after surgery Dr Biggs will see the patient to monitor their progress and remove the sutures.

It is recommended that the patient not drive during the first 6 weeks while wearing a sling due to safety reasons and the risk of injury to the surgical site.

The patient will be given specific instructions regarding activity and a rehabilitation program of exercise and strengthening.

Eating a healthy diet and not smoking will promote healing.

  • Australian Orthopaedic Association
  • Royal Australasian College of Surgeons
  • Cronulla-Sutherland Sharks
  • NSW Swifts
  • Sydney Swans
  • South Sydney Rabbitohs