BY DR. CHAN BENG KUEN
SPECIALIST ORTHOPAEDIC SURGEON
ORTHOPAEDICS INTERNATIONAL
The clavicle (or the collar bone) connects the shoulder and upper arm to the rest of the body. It is the bone that is most commonly fractured. The fracture occurs as a result of a fall on the outstretched hand or on to the shoulder. Patients usually complain of pain and deformity over the clavicle. They may also feel the fractured bone ends (crepitus) grating against each other as they move their shoulder.
While rare, these fractured ends may injure the nerves and blood vessels beneath the bone. An “open” fracture is the more common complication. This can occur when the fractured bone protrudes through the minimal soft tissue protection and skin.
In other cases, the separation of fractured bone ends by soft tissue may impede healing. In such instances, surgical intervention is necessary. A surgical fixation of these fractures using plates or wires is the most common solution.
The vast majority of these injuries can be treated non-operatively. The arm is supported in a sling for 6 weeks and allowed to heal naturally. Gentle shoulder exercises can be started when the pain is less so as to prevent shoulder stiffness.
After the initial healing phase, the patient is advised to undergo a rehabilitation program to regain strength and mobility in the upper limb.
