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. The patients usually complains of pain and deformity over the clavicle and occasionally, they will feel the grating of the fractured bone ends (crepitus) as they move the shoulder.
As the bone is just beneath the skin with very little soft tissue protection, sometimes the fractured bone ends protrude through the skin, converting it into an “open” fracture. Rarely, the fractured ends injure some nerves and blood vessels beneath the bone.
In addition, the fractured bone ends may be separated by soft tissue and this will impede healing. In these instances, surgical intervention is necessary. Surgical fixation of these fractures may be necessary and plates or wires are commonly used.
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 fracture healing, the patient is advised to undergo a strengthening program to regain the strength and mobility of the upper limb.