The clavicle is commonly known as the collarbone. Fracture of the clavicle is one of the most common fractures seen in sport and is either caused by a fall where the person lands on the side or point of the shoulder or by a direct blow to the clavicle with another player or piece of sporting equipment. This commonly happens during contact sports, cycling, horse riding and winter sports.
Babies are also subject to this type of fracture during childbirth as they pass through the birth canal and children, because of the softness of their bones, may also break their clavicle during a fall.
Symptoms of this type of injury include:
- A downward and forward sagging of the shoulder
- Pain that makes it difficult to raise the arm
- A grinding sensation when attempting to raise the arm
- A deformity or "bump" over the site of the fracture
- Pain when the area is touched
Fortunately, most fractures of the clavicle heal by themselves without surgery. All that may be needed is to immobilise the arm in a sling for 3-4 weeks in the case of a child, and 6-8 weeks in the case of an adult. Pain medication can be used during the acute stage. Once the acute pain subsides, we would begin passive range of motion exercises to prevent stiffness and promote flexibility. Strengthening exercises will follow to restore proper muscle balance and function to the shoulder area.
Sometimes when a compound fracture has occurred, conservative management is insufficient for healing of the clavicle and surgery may be required. Surgery involves lining up both ends of the bone and fixing them together with pins or plate and screws.
Physiotherapy begins immediately after surgery to promote the healing process. We would perform passive range of motion exercises, followed by active range of motion exercises when the acute pain lessens. Strengthening exercises and functional exercises to improve activities of daily living make up the latter part of the programme. The fracture should be completely healed after two or three months and you can then return to sporting activities.
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