Broken collar bone (fractured clavicle) Tāhei tāwhatiwhati

Breaks to the collar bone are caused by any injury that puts increased pressure onto the bone, for example, if you:

• fall onto your shoulder
• fall onto an outstretched hand
• have a car accident.

A broken collar bone can be very painful and can 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 touch it
• have bruising, swelling and tenderness over your collar bone.

Complications of breaking your collar bone are not very common but include:

• arthritis
• continuing pain if the bone does not heal
• damage to your lung or nearby blood vessels and nerves, if the injury is severe and the broken ends of the bone move out of position.

Your healthcare provider will listen to what happened and carefully examine your shoulder to make sure that no nerves or blood vessels are also damaged.

You will need an x-ray to show exactly where the break is and how bad it is. You may need more 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.

Scans and x-rays

How your broken collar bone is treated depends on what the break looks like. Usually, it does not need surgery and it is treated by putting your arm in a sling.

But if the broken ends have moved out of line and are not touching or the bone has broken into lots of pieces, you may need surgery.

If you need surgery, it will be done by an orthopaedic (bone) surgeon. The 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 staying a night in hospital and up to 6 weeks wearing a sling.

Recovering after surgery

You will need some weeks off work after surgery. How long will depend on the injury and the type of work you do. You will not be able to drive while your arm is in a sling.

You will also have a course of physiotherapy to strengthen your shoulder and get it moving again.

While you are 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 is 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 healthcare provider about further surgery to take the metal out once the bone has healed. This usually will not be done until at least 12 months after your surgery.

There are some things you can do to help your recovery, whether or not you are having surgery.

• If you are a smoker, stop smoking. Smoking slows the healing process.
• Avoid heavy lifting — this will only increase your pain and slow your recovery. You will probably need some time off work to let your shoulder recover.
• Take regular pain relief as recommended by your healthcare provider. Seek advice from your healthcare provider if you still have pain while taking the recommended pain relief. Do not take extra pain relief that has not been prescribed for you.
• 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. Do not 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 2 days. Wrap the ice (or a bag of frozen peas) in a cloth — do not put it directly onto your skin.
• Keep your hand, wrist and elbow moving to stop them becoming stiff.

Pain relief medicines for adults

Gradual gentle movements for your arm

In the first 2 weeks, it is important to regularly take off your 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 the palm of your hand up to the ceiling and down to the floor.
• Move your wrist up and down and clench and open your fingers regularly.

After 2 weeks, as the pain in your collar bone eases, start to move your shoulder by doing resisting rotation, inwards and outwards exercises.

When you start doing these exercises, do not 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 is important not to do too much too quickly, as this could affect how well your bone heals. It is okay to feel some mild pain but if the exercise is very painful, you are probably doing too much.