Clavicle (Collarbone) Fractures
What Is a Clavicle Fracture?
A clavicle fracture, commonly called a broken collarbone, is one of the most common bone injuries. The clavicle is the long, slightly curved bone that connects the breastbone (sternum) to the shoulder blade. It acts as a strut that holds the shoulder in its normal position, allowing for strength, stability, and a full range of arm motion.
Most clavicle fractures occur in the middle portion of the bone, although fractures can also occur near the shoulder (distal clavicle) or near the breastbone (medial clavicle). The severity of the injury can range from a simple crack in the bone to a displaced fracture where the broken ends have shifted apart.
Most clavicle fractures heal well, and with proper treatment, patients are able to return to their normal work, sports, and recreational activities.
Causes of Clavicle Fractures
Clavicle fractures usually result from a direct impact to the shoulder or a fall onto an outstretched arm.
Common causes include:
- Falls while walking, running, skiing, or cycling
- Sports injuries during football, hockey, soccer, rugby, wrestling, or lacrosse
- Bicycle or motorcycle accidents
- Motor vehicle collisions
- Falls from heights
- Direct blows during contact sports
Clavicle Fractures in Athletes
Clavicle fractures are among the most common injuries seen in athletes. They frequently occur in:
- Football players
- Hockey players
- Cyclists
- Mountain bikers
- Skiers and snowboarders
- Baseball and softball players
- Soccer players
- Wrestlers
- Equestrian athletes
Athletes often seek treatment that provides the most reliable healing while allowing a safe return to competition as quickly as possible.
Symptoms
Symptoms usually occur immediately after the injury and may include:
- Sudden pain over the collarbone
- Swelling and bruising
- A visible bump or deformity along the collarbone
- Tenderness when touching the injured area
- Difficulty lifting or moving the arm
- Pain with shoulder movement
- A grinding or popping sensation with movement
- The shoulder appearing to droop downward or forward
In severe injuries, the broken bone may press against the skin or, rarely, break through the skin. Immediate medical evaluation is recommended in these situations.
Treatment Options
Treatment depends on several factors, including:
- Location of the fracture
- Amount of displacement between the broken bone ends
- Patient age
- Activity level
- Hand dominance
- Overall health
- Athletic and occupational demands
Your orthopedic surgeon will recommend the treatment option that offers the best opportunity for healing and restoring normal shoulder function.
Non-Operative Treatment
Many clavicle fractures heal successfully without surgery.
Non-operative treatment typically includes:
- Sling immobilization for comfort
- Ice and anti-inflammatory medications to reduce pain and swelling
- Early gentle shoulder motion once pain begins to improve
- Physical therapy to restore flexibility, strength, and shoulder mechanics
- Gradual return to normal activities as healing progresses
Non-surgical treatment is commonly recommended for:
- Fractures that remain well aligned
- Minimally displaced fractures
- Many fractures in children and adolescents
- Patients whose activity level does not require rapid return to high-demand activities
Most patients experience excellent pain relief and regain normal shoulder function following healing.
Operative Treatment
Surgery may be recommended when the fracture is unlikely to heal properly without stabilization.
Common reasons to consider surgery include:
- Significant displacement or shortening of the clavicle
- Multiple fracture fragments
- Open fractures
- Skin at risk from pressure caused by the bone
- Associated nerve or blood vessel injuries
- Failure of the fracture to heal (nonunion)
- Symptomatic healing in a poor position (malunion)
- High-demand athletes or physically demanding occupations where restoring shoulder strength and alignment is especially important
Treatment Considerations for Athletes
Treatment for athletes is individualized based on:
- Type of sport
- Level of competition
- Position played
- Timing within the season
- Degree of fracture displacement
- Goals for return to play
While many athletes recover successfully without surgery, competitive athletes with significantly displaced fractures often choose surgical fixation because it may:
- Restore normal shoulder alignment
- Provide more predictable healing
- Allow earlier shoulder motion
- Potentially shorten the time needed to safely return to competition
- Reduce the risk of the fracture healing in a shortened position
The decision should be made after a detailed discussion with an orthopedic sports medicine specialist.
Surgical Repair
The most common surgical treatment is open reduction and internal fixation (ORIF).
During Surgery
- The broken bone ends are carefully realigned.
- The fracture is stabilized using a specially designed plate and screws or, in selected cases, an intramedullary device placed inside the bone.
- The hardware holds the bone securely while it heals.
Goals of Surgery
- Restore the normal length and alignment of the clavicle
- Improve fracture healing
- Restore shoulder strength and mechanics
- Allow earlier rehabilitation
- Reduce the risk of nonunion in selected fractures
Most patients do not require hardware removal unless the implants become bothersome after the fracture has healed.
Recovery After Non-Operative Treatment
Although every fracture heals at its own pace, a typical recovery includes:
First 2–4 weeks
- Sling for comfort
- Gentle hand, wrist, and elbow motion
- Pain gradually improves
Weeks 3–6
- Begin gentle shoulder range-of-motion exercises
- Gradually discontinue sling as comfort allows
Weeks 6–12
- Progressive strengthening program
- Return to most everyday activities
- X-rays confirm ongoing healing
Typical Return to Activities
- Daily activities: 2–6 weeks
- Driving: 2–6 weeks (when comfortable and no longer requiring a sling)
- Non-contact sports: 6–10 weeks
- Heavy lifting: 8–12 weeks
- Contact sports: 10–16 weeks, after healing is confirmed on X-rays
Recovery After Surgical Repair
Surgical fixation generally allows earlier shoulder movement because the fracture is stabilized with hardware, although bone healing still requires time.
First 2 weeks
- Sling for comfort
- Gentle shoulder motion begins early
- Incision healing
Weeks 2–6
- Gradually increase range of motion
- Light daily activities
Weeks 6–12
- Progressive strengthening
- Return to more demanding activities
After 3 months
- Most fractures have healed sufficiently for unrestricted strengthening
- Return to higher-level sports is often possible once healing is confirmed
Typical Return to Activities After Surgery
- Daily activities: 2–4 weeks
- Driving: 2–4 weeks
- Office work: 1–3 weeks
- Manual labor: 8–12 weeks
- Non-contact sports: 6–10 weeks
- Contact and collision sports: 10–16 weeks, after the fracture has healed and shoulder strength has returned
Outlook
The vast majority of clavicle fractures heal successfully with either non-operative treatment or surgery. Most patients regain excellent shoulder function and are able to return to work, sports, and recreational activities without long-term limitations.
At Midwest Orthopedic and Musculoskeletal Alliance, our fellowship-trained orthopedic trauma and sports medicine specialists provide comprehensive care for clavicle fractures, from initial diagnosis through rehabilitation. We work closely with each patient to develop an individualized treatment plan that promotes reliable healing, restores shoulder function, and helps patients safely return to the activities they enjoy as quickly as possible.
Get Expert Care for a Collarbone Fracture
If you have sustained a collarbone fracture or are experiencing shoulder pain after an injury, contact Midwest Orthopedic and Musculoskeletal Alliance today at 414-384-6700. Our team in Southeastern Wisconsin will evaluate your condition and recommend the most appropriate course of treatment.