Clavicle Fracture Treatment and Healing

In this article, we’ll explain everything you need to know about clavicle fractures. From understanding the anatomy and common causes to exploring effective clavicle fracture treatments and the healing process, we’ve got you covered.

Understanding Clavicle Fractures

The clavicle, commonly known as the collarbone, is a long, slender bone that connects the arm to the trunk of the body. Each person has two clavicles—one on the left and one on the right—that span horizontally from the sternum (breastbone) to the scapula (shoulder blade). These bones act as a strut that supports the shoulder girdle and allows for a wide range of arm motions.

Key Functions of the Clavicle:

• Structural Support: Holds the shoulder joint away from the torso, providing stability and facilitating arm movement.
• Protection: Safeguards vital nerves and blood vessels that run beneath it, supplying the upper limb.
• Force Transmission: Helps transmit forces from the upper limb to the central skeleton during activities involving the arms.

Given its location and function, the clavicle is essential for many daily activities—from lifting and pushing to throwing and reaching.

Common Causes of Clavicle Fractures

A clavicle fracture occurs when there is a break in the collarbone. Understanding the common causes can help in both prevention and early recognition.

Falls

• Fall Onto an Outstretched Hand (FOOSH): Falling onto an outstretched hand transmits force up the arm to the clavicle.
• Direct Impact on the Shoulder: Falling directly onto the shoulder can generate enough force to fracture the clavicle.

Vehicular Accidents

• Motor Vehicle Collisions: The force from a car or motorcycle accident can cause significant trauma to the clavicle.
• Bicycle Accidents: Cyclists are vulnerable to clavicle fractures in traffic accidents.

Birth Injuries

• Difficult Deliveries: In newborns, clavicle fractures can occur during complicated births.

Osteoporosis and Bone Health

• Weakened Bones: Conditions like osteoporosis increase fracture risk, even from minor impacts.

High-Energy Trauma

• Industrial Accidents: Falls from heights or heavy objects striking the shoulder.
• Recreational Activities: High-speed sports like skiing or snowboarding carry risks due to potential falls.

Sports Injuries

• Cycling and Skateboarding: High-impact collisions with the ground can result in clavicle fractures.
• Contact Sports: Activities like football, rugby, and hockey involve physical contact and movements that can lead to shoulder impacts.

The risk of clavicle fractures significantly increases during hockey season. Teenage boys participating in competitive leagues are especially susceptible. If you or someone you know has suffered a clavicle fracture from hockey or other activities, learn how Calgary Flames team physicians get players back in the game post-fracture.

Who Is at Risk?

A broken clavicle can happen to anyone, but certain factors increase the likelihood of this injury.

Age and Gender Factors

• Children and Teenagers: Active play and sports make children susceptible since their developing bones can fracture more easily. Teenage boys are at a higher risk of clavicle fractures during the winter months when hockey season is in full swing. Growth spurts during adolescence can also make bones more susceptible to fractures.
• Young Adults: Participation in high-energy activities or contact sports raises risk.
• Older Adults: Bones become less dense with age; simple falls can cause fractures.
• Gender Trends: Males are more likely to experience clavicle fractures, possibly due to higher participation in riskier activities. However, the gap is narrowing as more females engage in various sports.

Lifestyle Risk Factors

• Previous Injuries: A prior clavicle fracture can weaken the bone, increasing the risk of re-injury.
• Bone Health: Nutritional deficiencies and conditions like osteoporosis make fractures more likely.
• Health Choices: Smoking and excessive alcohol consumption negatively affect bone density and healing.

High-Risk Activities and Occupations

• Contact Sports: Activities that involve hard impacts on the shoulder. As a high-impact sport, hockey poses a significant risk for clavicle fractures. The combination of speed, physical contact, and hard playing surfaces increases the likelihood of injury.
• Cycling and Mountain Biking: Falls at high speeds or on uneven terrain increase risk.
• Skateboarding and Rollerblading: Balance and coordination challenges make falls common.
• Winter Sports: Skiing and snowboarding involve high speeds and potential collisions.
• Physical Jobs: Manual labor with risks of falls or accidents, such as construction or roofing.

Clavicle fractures are just one of the many injuries that athletes may encounter, especially in high-impact sports like hockey. If you’re interested in learning more about common sports-related fractures and their treatments, you might find these articles helpful:

• Understanding Broken Bones Resulting from Sports Injuries
• A Guide to Understanding and Treating Common Sports-Related Fractures

Signs and Symptoms of a Broken Clavicle

Recognizing the signs of a clavicle fracture is crucial for seeking prompt medical attention. Common signs and symptoms include:

1. Sharp Pain at the Site of the Fracture
   • Immediate Pain: A sudden, intense pain at the moment of injury is common.
   • Persistent Discomfort: The pain may continue and worsen with arm movement.
2. Swelling and Bruising
   • Visible Swelling: The area around the collarbone may swell soon after the injury.
   • Bruising: Discoloration or bruising can develop over the clavicle and surrounding areas.
3. Difficulty Moving the Arm and Shoulder
   • Limited Range of Motion: Raising the arm or moving the shoulder can be painful or impossible.
   • Guarding Behavior: You might cradle the injured arm to minimize movement and reduce pain.
4. A Bulge or Deformity Over the Clavicle
   • Visible Bump: A lump or bump may appear over the fracture site due to bone displacement.
   • Skin Tenting: In severe cases, the broken bone may push the skin upward, creating a tent-like appearance.
5. Grinding or Crackling Sensation
   • Crepitus: You might feel or hear a grating sensation when trying to move the shoulder.
6. Drooping Shoulder
   • Sagging Appearance: The shoulder on the affected side may appear lower than the uninjured side.
   • Forward Slump: The shoulder may slump forward due to the lack of support from the broken clavicle.
7. Numbness or Tingling
   • Nerve Involvement: If nerves are affected, you might experience numbness or a tingling sensation down the arm.

When to Seek Medical Attention

If you experience any of these symptoms following an injury to your shoulder or a fall, it’s important to consult a healthcare professional promptly:

• Bone Protrusion: If the bone has broken through the skin (an open fracture), seek immediate medical care.
• Severe Deformity: Obvious misalignment or severe drooping of the shoulder requires urgent attention.
• Loss of Sensation or Pulse: If you notice numbness, loss of feeling, or a weak pulse in the arm or hand, this could indicate nerve or blood vessel damage.

How Clavicle Fractures Are Diagnosed

A doctor will perform a physical examination and may ask about the circumstances of the injury.

Diagnostic tests commonly include:

• X-rays: The primary tool to visualize the fracture and determine its location and severity.
• CT Scans: In complex cases, a CT scan may provide more detailed images of the bone fragments.
• Ultrasound: Sometimes used in children to avoid radiation exposure.

Clavicle fractures vary in severity:

• Non-Displaced Fractures: The bone cracks but remains aligned. These typically heal well with conservative treatment.
• Displaced Fractures: The bone ends are out of alignment. Treatment may involve repositioning and, in some cases, surgery.
• Comminuted Fractures: The bone shatters into several pieces. This type often requires surgical intervention.

Prompt diagnosis and treatment are essential for:

• Effective Healing: Ensures proper bone union.
• Reducing Complications: Minimizes the risk of non-union (where the bone doesn’t heal) or malunion (where the bone heals improperly).
• Accelerating Recovery: Starting appropriate treatments and therapies such as Low-Intensity Pulsed Ultrasound (LIPUS) can enhance the healing process. A study found that the overall success rate of healing fractures with ultrasound treatment for delayed unions was 91% and for nonunions 86%.

By being aware of the signs and symptoms of a broken clavicle, you can take immediate action to seek medical care. Early intervention not only alleviates pain but also sets the stage for a smoother recovery.

Clavicle Fracture Treatment Options

The primary goals are to ensure the bone heals properly, restore function, and minimize complications. Treatment options typically fall into two main categories: non-surgical (conservative) treatments and surgical interventions.

The choice between them depends on several factors, including the severity and type of fracture, the patient’s age, activity level, and overall health.

Surgical Treatments

Surgery may be recommended for clavicle fractures that are significantly displaced or broken into several pieces, or if the fracture threatens the skin or neurovascular structures. Common surgical procedures include:

1. Open Reduction and Internal Fixation (ORIF)
   • Plate and Screws: The most common method involves repositioning the bone fragments (open reduction) and securing them with metal plates and screws (internal fixation).
   • Intramedullary Nailing: A rod is inserted into the marrow canal of the clavicle to hold the bone pieces together.
2. Minimally Invasive Techniques
   • Smaller Incisions: Advances in surgical techniques allow for smaller incisions, which may reduce scarring and recovery time.

Advantages of Surgical Treatment:

• Improved Alignment: Directly restores the proper alignment of the bone, which may lead to better functional outcomes.
• Early Mobilization: Patients may begin gentle shoulder movements sooner compared to non-surgical treatment.

Non-Surgical Treatments

For many clavicle fractures, especially those where the bone fragments are not significantly displaced, non-surgical management is effective and preferred. Non-surgical treatment generally involves:

1. Immobilization

An arm sling reduces movement at the fracture site while a figure-of-eight strap helps maintain alignment.

2. Pain Management

Over-the-counter pain relievers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce inflammation.

3. Rest and Activity Modification

Avoid lifting, reaching, or any activities that may strain the shoulder. As healing progresses, the gradual reintroduction of movement is encouraged under medical supervision.

4. Physical Therapy

Once the initial pain and swelling subside, a physical therapist may introduce gentle exercises to maintain range of motion in the elbow, wrist, and hand. As healing continues, strengthening exercises for the shoulder and arm muscles help restore function and prevent stiffness.

Advantages of Non-Surgical Treatment:

• Avoids Surgical Risks: Eliminates risks associated with surgery, such as infection or adverse reactions to anesthesia.
• Natural Healing: Allows the body to heal the fracture naturally, which can be effective for simple fractures.

The Healing Process of Clavicle Fractures

Healing a clavicle fracture is a process that involves the body’s natural ability to repair bone tissue. The healing timeline can vary based on several factors, including the severity of the fracture, the treatment method, and individual health considerations.

Typical Healing Timelines

• Children and Adolescents: 4 to 6 weeks.
• Adults: 6 to 12 weeks.
• Older Adults: May extend beyond 12 weeks.

Stages of Bone Healing:

1. Inflammation Phase (First Few Days):
   • What Happens: Blood clots form around the fracture site, providing the foundation for new bone growth.
   • Symptoms: Swelling, redness, and pain are common as the body initiates the healing response.
2. Reparative Phase (Week 1 to Week 6):
   • What Happens: A soft callus made of collagen forms, gradually replaced by a hard bony callus as new bone tissue develops.
   • Symptoms: Pain and swelling begin to decrease. Movement may still be limited.
3. Remodeling Phase (Week 6 onward):
   • What Happens: The bone continues to strengthen and reshape itself, restoring the original bone structure.
   • Duration: This phase can last several months to years, but most functional recovery occurs within the first few months.

Factors Affecting Healing

• Severity of Fracture: Displaced fractures may require more time.
• Age and Health: Bone density and chronic conditions influence healing.
• Lifestyle Factors: Smoking and poor nutrition can impede recovery.
• Adherence to Treatment: Following medical advice is crucial.

Ways to Support the Healing Process

• Follow Medical Advice: Attend appointments and imaging tests.
• Nutrition: Consume calcium, vitamin D, and protein-rich foods.
• Lifestyle Modifications: Quit smoking and limit alcohol.
• Physical Therapy: Engage in recommended exercises.
• Consider LIPUS: May stimulate bone healing at the cellular level.

Accelerating Healing with LIPUS Technology

Recovering from a clavicle fracture can be a lengthy process, but advancements in medical technology offer innovative ways to potentially accelerate healing. One such advancement is Low-Intensity Pulsed Ultrasound (LIPUS) therapy, a non-invasive treatment that may enhance the body’s natural bone-healing processes.

LIPUS is a non-invasive therapy that uses low-intensity sound waves to stimulate bone healing at the cellular level. Applied directly over the fracture site using a specialized device, LIPUS delivers painless, pulsed sound waves that penetrate soft tissue and reach the bone.

How LIPUS Works

• Stimulates Bone Cells: Activates osteoblasts, promoting new bone formation.
• Increases Blood Flow: Enhances circulation to the fracture area, supplying essential nutrients and oxygen.
• Encourages Growth Factors: Boosts proteins crucial for bone regeneration.

Benefits of LIPUS for Clavicle Fractures

• Non-Surgical Management with LIPUS: Enhance bone healing without surgery.
• Surgical Fixation with LIPUS Therapy: Promote faster healing after surgical alignment.
• Physical Therapy Integration: Combining LIPUS with physical therapy aids in restoring strength and mobility.

By integrating treatments like LIPUS into your clavicle fracture recovery plan, you can take an active role in your recovery process. This technology offers a promising avenue to speed up the healing of clavicle fractures, helping you get back to your daily life sooner.

Interested in learning more about LIPUS therapy and how it can aid in healing your clavicle fracture? Contact Fracture Healing to learn more about LIPUS technology and its accelerated healing benefits.