Topic Overview

What is the collarbone?

The collarbone (clavicle) is one of the main bones of the shoulder joint. It holds the shoulder up and, along with the shoulder blade (scapula) and acromioclavicular (AC) joint, provides stability and strength to the shoulder. The collarbone also protects nerves and blood vessels from the neck to the shoulder.

What causes a broken collarbone?

A broken collarbone is usually caused by falling on an outstretched arm or by direct contact to the collarbone or to the shoulder. This often occurs when playing sports such as football, wrestling, or ice hockey.

The collarbone is one of the most commonly broken (fractured) bones. Young men ages 13 to 20 break it most often. Younger children have greater chances of a broken collarbone during play.

What are the symptoms?

Symptoms of a broken collarbone include:

• Immediate pain after falling or being hit on the collarbone or in the shoulder area.
• Inability to raise the affected arm because of pain.
• A grinding feeling when trying to lift the affected arm.

The affected shoulder does not always appear out of position. But if a deformity is present, it appears as a bump or swelling along the collarbone or at the AC joint. The bone rarely breaks through the skin. But it may push the skin out, causing it to have a tent-shaped look.

A broken collarbone usually is not a serious injury. In rare cases, a broken collarbone can injure a lung or rib or pinch nerves or blood vessels. This may cause the arm to turn pale, tingle, and feel cool or numb.

How is a broken collarbone diagnosed?

Your doctor can usually diagnose a broken collarbone by asking you questions and examining you. Your doctor will check:

• The affected area and look for a lump or bump.
• Blood flow, by taking your pulse and checking your skin color and temperature.
• For damage to your nerves and blood vessels.
• How well you can move your shoulder and other joints.
• The muscle strength of your shoulder.

Your doctor will usually do an X-ray to pinpoint the location and severity of the break.

How is it treated?

Many broken collarbones heal on their own, especially if they are broken at one end. If you don't need surgery, you will use a sling to keep your arm and shoulder from moving while the bone heals. An adult wears a sling for a few days or up to a week. A child may need one for 3 to 4 weeks.

You can begin simple exercises immediately and move on to strengthening exercises if they don't cause pain. Ask your doctor when it is safe to begin to exercise. If you start too soon, the broken collarbone may not heal well. If you are active, do not play sports or other activities until you can move your shoulder easily and it feels strong.

To help relieve pain, try acetaminophen or a nonsteroidal anti-inflammatory drug, such as aspirin, ibuprofen, or naproxen. Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome.

Surgery may be recommended for severe breaks. When the bone is broken near the middle and the ends of the bone do not line up with each other (displaced), surgery is more likely. Many experts believe surgery is especially important when young, active people break this section of their collarbone.

After surgery, you will use a sling for up to 2 weeks. Your doctor or physical therapist will teach you gentle exercises to keep your shoulder moving for about 6 weeks, until you can start exercises to get your strength back. Most people have returned to all their activities by 3 months after surgery.¹