A break in your collarbone is known as a clavicle fracture.  You may fracture your collarbone by the pressure of a sudden fall on your shoulder or your arm.  The snapping sound of a bone-breaking, intense pain in your shoulder thereafter and inability to move your arm is the foremost indications of a clavicle fracture.

Anatomy

The clavicle (collarbone) is one of the three main bones that make up your shoulder joint. It lies between your upper breastbone (sternum) and your shoulder blade (scapula).  Several blood vessels and nerves lie below it. It not only attaches your arm to the rest of the body but also provides motion and stability to your upper extremity.

Explanation

Clavicle fractures are quite common and people of any age group may sustain them. Most clavicle fractures occur in the middle area of the collarbone. Sometimes they also break at the end where they are connected to the ribcage or the shoulder blade. They occur in two ways:

Comminuted fracture- when your bone breaks into two or more pieces but the pieces remain in their place.

Displaced fracture- when your bone breaks into pieces and they move far away from their place, such that they are not in a straight line.

Causes

The most common causes of clavicle fractures include a sudden fall on your shoulder or outstretched arm, a direct injury to your shoulder or arm while playing sports or during a vehicle collision. An unborn baby can sustain a clavicle fracture when passing through the birth canal.

Risk Factors

Young children or adults below the age of 25 are at a higher risk of procuring a clavicle fracture, as the collarbone remains delicate and fragile, more susceptible to break until that age.  On the other end, elderly men above the age of 55 and women above 75 are more likely to a clavicle fracture.

Symptoms

The most visible symptoms of a clavicle fracture are extreme pain in the shoulder, and an inability to move your arm. Other signs of the fracture include:

• Swelling, almost a bulge, on your shoulder
• The sound of the crackling bone when you try to move your shoulder
• Significant sagging in your shoulder along the collarbone
• Bruising and tenderness over your collarbone
• Babies having sustained clavicle fractures during birth do not move their arms for several days

Diagnosis

Your doctor will diagnose clavicle fracture after a physical examination and some imaging tests.

Doctor’s examination- After understanding your symptoms and how you sustained the injury, your doctor will examine your shoulder carefully for a deformed bulge over your collarbone. He may also look for a small tent kind of formation that is a confirmed sign of clavicle fracture. 

Imaging tests- To confirm the presence of the fracture and to assess damage to the blood vessels and nerves, your doctor will ask you to undergo certain imaging tests that include:

X-ray- The x-ray helps the doctor to know the exact location and gravity of your fracture.  He may also ask you to have your entire shoulder x-rayed, to check whether there are any additional injuries. 

Computed tomography- The doctor may ask you to undergo a CT scan if there are other injuries or fractures besides the clavicle fracture to determine their presence and severity.

Treatment

The doctor will advise you treatment according to the seriousness and type of fracture you have sustained.

Non-Surgical Treatment Techniques

If the bone has broken without shifting from its place, your doctor may recommend non-surgical treatment techniques.  The techniques may be a combination of two or more of the following methods.

Sling support- An arm sling supports the injured arm and shoulder and prevents it from unnecessary movements that may aggravate your pain. Immediately after the injury, your arm is put in a sling to help you recover from the fracture.

Medications- The doctor prescribes some medications to relieve you from the pain while your fracture gets cured.

Physical therapy- If your arm stays immobile after the fracture it may become stiff. Thus, soon after the injury, besides medications and arm sling, your doctor will recommend some elbow movement exercises, in spite of the pain, you may feel. Gradually, as your fracture heals, he may come on to some shoulder exercises to help restore its strength and movement.

If your specialist feels that the fracture has not healed with the desired results or your fracture is a displaced fracture, the specialist may adopt surgery.

Surgical Treatment Techniques

If your bone has broken into two or more pieces and they have shifted out of their place, then your specialist may recommend surgical techniques to bring the pieces back to their actual position and keep them firmly fixed until your fracture heals.

Open reduction with internal fixation technique:  This is the most common way to treat clavicle fractures. The specialist makes a small incision over your collarbone and realigns your displaced bone pieces to their actual position. After this, he fastens them firmly in that position with the help of special metal hardware such as pins, screws and/or plates.