The clavicle, also known as the collar bone, is an S-shaped bone that connects to the sternum.
The clavicle, also known as the collar bone, is an S-shaped bone that connects to the sternum medially and to the scapula laterally. Traditionally, clavicle fractures (collar bone fractures) were managed conservatively, and they still are in cases where the fracture is nondisplaced or minimally displaced. However, more recent studies have shown that operative intervention may allow patients to return to activities more quickly with less pain during recovery and experience better outcomes overall. Without surgery, a clavicle malunion may form and is usually the result of clavicle shortening and displacement. A malunion can potentially alter the kinematics of the scapula, leading to scapular dyskinesis and malrotation. Studies have shown that clavicular malunion in skeletally mature patients causes decrease in strength and velocity with certain movements of the upper arm, and it is thought that this may be true in adolescent patients as well.
Plain x-rays are used to evaluate the clavicle fracture and assess the fracture pattern, displacement, angulation, comminution and shortening. After the fracture is assessed, appropriate management is decided upon by your surgeon. Typically, pediatric clavicle fractures with little displacement and minimal shortening can be treated nonsurgically by immobilizing the arm in a sling for four weeks. After that point, the patient can begin range of motion exercises and will generally be ready to return to full activities eight to 12 weeks after the fracture.
Learn about surgical options for treating your collarbone fracture.
The clavicle, also known as the collarbone, is commonly fractured in people of all ages. Historically, most clavicle fractures were treated without surgery but more recent studies have shown that this type of non-operative management can lead to longterm dysfunction and, in adults, the bone has a higher likelihood of not healing.
I like to think of the clavicle as one leg of a tripod. If that leg is foreshortened, everything tends to lean. If the clavicle heals in a shortened position, your entire shoulder girdle will actually rotate inward, which is how this dysfunction occurs. I see operative intervention as having several benefits, reestablishing anatomic alignment to restore normal shoulder function, maximizing the chance of bone healing, and stabilizing the bone so that there is no painful clunking or clicking over the fracture ends.
Generally, there are two ways to surgically fix a clavicle bone. The first is with a plate and screw construct that overlays the bone and stabilizes it. This is a great option to restore stability and anatomic alignment, particularly when the fracture is significantly comminuted or in multiple pieces.
Second option, as in Ali’s, case is fixing the bone with a clavicle nail. This is a metal rod that is essentially hidden within the tubular structure of the bone and cannot be felt under the skin after surgery. This minimizes the chance of irritation from the straps of a backpack or a handbag. This surgical technique also minimizes the size of the incisions, which are about two and a half centimeters in length and fall in line with the clavicle. Once they’re healed, they are barely noticeable.
I like patients to limit their range of motion for the first four weeks to minimize the chance for displacement. Motion typically returns quickly and physical therapy is not usually necessary. Clavicle nails are really a great option for patients who have displaced clavicle fractures but want a nice cosmetic result and an early return to normal function.
As our patient, you will have an in-depth consultation with one of our doctors. We will create an individualized treatment plan together, tailored to your problem and lifestyle. Our doctors prefer non-invasive treatments whenever possible, including physical therapy and/or injections. If your problem ultimately does require surgery, our doctors prefer the least invasive surgical techniques possible. Our goals are the same as yours: to get you back to living your best life, pain free.