• Guide to Treatment & Rehabilitation of a Broken Collarbone

    Throughout the healing process following a collarbone fracture, it is important that the patient maintains the range of movement in the elbow, wrist and hand of the affected limb by going through the movements of these joints every day.

    Once this has been completed the patient should progress to active abduction (moving the arm out to the side) flexion (arm up to the front) extension (arm back) and rotation of the shoulder (hand behind head, then hand behind back) within the limits of pain.

    Once full and pain free range of movement has been achieved, resistance should be added to regain strength in the affected limb, before unrestricted shoulder motion is permitted. A return to sport should be granted by the orthopaedic consultant, based on functional ability and x-ray evidence.

    Broken Collarbone Injury Explained

    A broken collarbone (broken clavicle) is a very common shoulder injury. A broken collarbone frequently occurs when someone falls onto an out stretched hand. For cyclists, it is a very common injury when falling from their bike. The collar bone is attached centrally to the sternum (breast bone) and at its outer side to the shoulder complex. This arrangement means that when a person falls onto an outstretched hand, the force is transmitted up the arm resulting in a collarbone fracture. Sometimes a direct blow to the clavicle can also result in a broken collarbone.

    Broken Collar Bone

    With broken collarbones in children, there is usually little displacement of the two fracture fragments and subsequent healing occurs quickly over a period of 2 to 3 weeks. In older individuals, where more force is applied to produce a broken collarbone, the two fragments often become displaced and are prominent through the skin. Once the fractured bone has been reduced back into place by the treating doctor it will usually heal in about 6 weeks.

    Occasionally there are complications with this type of fracture, including a fragment of bone causing damage to blood vessels in the chest, or imperfect union of the two fracture fragments which leads to a prominent notch once healing has taken place.

    Signs & Symptoms of a Broken Collarbone

    Because the collarbone is so close to the surface of the skin, the fracture is usually characterised by the protruding fracture fragments. As with any fracture there is considerable pain, and bruising may be visible. The patient will hold the arm immobile in an attempt to relieve the pain.

    What you can do

    • Consult a sports injury expert
    • Practice exercises to maintain range of movement
    • Maintain forearm & grip strength with hand therapy exercises
    • Use resistance bands for shoulder strengthening exercises
    • Wear a shoulder support for reassurance

    Broken Collarbone Treatment

    Treatment of a broken collarbone is dependent upon the degree of displacement of the fracture fragments. If the two pieces of bone are reasonably well aligned, it will usually be sufficient to immobilise the affected arm in a sling or a figure-of-eight harness.

    Where there is excessive displacement that prevents fracture union and healing, the orthopaedic consultant may choose to repair the fracture surgically using screws. However, this situation is rare as the clavicle has a very good capacity to heal.

    Throughout the healing process the patient should follow a series of exercises to maintain the range of movement in the elbow, wrist and hand of the affected limb. Hand therapy balls and therapeutic putty are particularly helpful to maintain forearm and grip strength.

    After a few weeks shoulder range of movement exercises can be progressed to gradually increase available shoulder movement. These exercises may be a little uncomfortable, but with some encouragement from a chartered physiotherapist this discomfort should quickly resolve as normal movement returns. Shoulder strengthening should then begin using resistance bands to regain full function. Resistance bands are ideal for shoulder rehabilitation as they allow multi-planar movements and rotations to be strengthened, critical for a return to normal function.

    Once full range of movement and shoulder strength has been achieved, unrestricted shoulder motion is permitted. A return to sport should be granted by the orthopaedic consultant, based on functional ability and x-ray evidence. Many people find that a shoulder support is helpful following a collarbone fracture to provide protection and peace of mind when returning to activity.

    Broken Collarbone Prevention

    Because of the traumatic nature of a broken collarbone, prevention strategies are limited. Care should be taken to avoid falls onto an outstretched arm, especially where weather conditions make the surface extra slippery.

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