HealthInfo Canterbury
Broken collar bone (fractured clavicle)
Tāhei tāwhatiwhati
A broken collar bone (also called a fractured clavicle) is a very common injury in people of all ages.
Your collar bone (clavicle) sits between your breastbone (sternum) and shoulder blade (scapula). It connects your arm to the rest of your body. It works to allow full movement in your shoulder.
Breaks are often caused by a direct blow to your shoulder. For example, if you fall onto your shoulder, fall onto an outstretched hand or have a car accident.
Symptoms of a broken collar bone
A broken collar bone can be very painful and may make it hard to move your arm. As well, you may:
- have a sagging shoulder (down and forward)
- feel a grinding sensation if you try to raise the arm
- feel a deformity or bump over the break, which is painful when you apply gentle pressure
- have bruising, swelling and tenderness over your collarbone.
Diagnosing a broken collar bone
Your doctor will listen to what happened and carefully examine your shoulder to make sure that no nerves or blood vessels are damaged.
You'll need an X-ray to show exactly where the break is, and how bad it is. You may need several X-rays of your shoulder to check for any other injuries. If other bones are broken or it looks like a complex break, you may also need a CT scan to show the breaks in better detail.
Self-care for a broken collar bone
There are some things you can do to help your recovery, whether or not you're having surgery.
- If you smoke, stop smoking. Continuing to smoke will slow down how quickly you heal.
- Don't do any heavy lifting, as this will only increase your pain and slow your recovery. You'll probably need some time off work to let your shoulder recover.
- Take regular pain relief. The best pain relief is paracetamol (Panadol). Take two tablets every four hours but no more than eight tablets a day. Avoid anti-inflammatories as they may slow down bone healing.
- At first it may be difficult to sleep with this injury. Sleeping in a recliner chair or packing pillows around you may help.
- Keep your arm in a sling, bent at a right angle at the elbow. This puts the least stress on the injured part of your collar bone. At first, wear the sling under your clothes, as this will act like a splint for your arm and keep your shoulder still. Don't drive while your arm is in a sling.
- Hold an ice pack against your shoulder for 15 minutes at a time to reduce pain and swelling in the first two days.
- Keep your hand, wrist and elbow moving to stop them becoming stiff.
In the first two weeks, it's important to regularly take off the sling and move your hands, wrist and elbow. You can do this while keeping your arm by your side and your shoulder still. Take your hand out of the sling and slowly bend and straighten your elbow. Turn your palm up to the ceiling and down to the floor. Move your wrist up and down and clench and open your fingers regularly. See the picture.
After two weeks, as the pain in your collar bone starts getting better, start working on getting your shoulder moving by doing resisting rotation, inwards and outwards exercises. When you start doing these exercises, don't push too hard with your other hand. You can gradually increase the pressure as the pain improves.
As the pain improves, add flexion and extension exercises followed by adduction and abduction exercises.
It's important not to do too much too quickly, as this could affect how well your bone heals. It's OK to feel some mild pain but if the exercise is very painful, you're probably doing too much.
Treating a broken collar bone
How a broken collar bone is treated depends on what the break looks like. Usually, it doesn't need surgery and is treated by putting your arm in a sling.
But if the broken ends have moved out of line and aren't touching or the bone is broken into lots of pieces, you may need surgery.
If you do need surgery, it will be done by an orthopaedic (bone) surgeon. The precise surgery you have will depend on what type of break you have – your surgeon will discuss details of the surgery, risks, benefits and recovery with you.
The surgery will involve some metal (a plate, screws or possibly wires) to align your collar bone properly and support it while it heals.
Surgery usually involves one night in hospital and up to six weeks in a sling. You won't be able to drive while your arm is in a sling. You'll also have a course of physiotherapy to strengthen your shoulder and get it moving again.
You'll need some weeks off work after surgery. How long will depend on the injury and the type of work you do.
While you're recovering, you should avoid lifting or carrying anything on your injured side. You should also avoid any sport or any other activity that may make your injury worse. Your surgeon will let you know when it's safe to start doing these things again.
Some people find the metal plate used in the surgery quite irritating, especially when carrying a backpack or using a seatbelt. If this happens to you, talk to your general practice team about being referred for further surgery to take the metal out once the bone has healed. This usually won't be done until at least 12 months after your surgery.
Written by HealthInfo clinical advisers. Last reviewed July 2022.
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Review key: HISHI-13267
