COLLARBONE FRACTURE

EIf you didn't pay attention, it happened. In the event of a fall (e.g. bicycle), the collarbone is one of the bones that breaks most often.

A broken collarbone is one of the most common consequences of falls because it connects the arm to the chest, which transfers high forces. In addition, the bone lies directly under the skin and is therefore not protected by muscles or tendons.

Why aren't all collarbone fractures the same?

"Fractures of the clavicle can be very variable due to the anatomy and the course of the fracture."

The clavicle (Latin for key) is between 12 and 15 cm long and S-shaped in an adult.

At its outer end, the clavicle has cartilaginous articular surfaces that articulate on the inside in the sternoclavicular joint and on the outside in the acromioclavicular joint.

Inside and outside the collarbone is reinforced at the joints with tight ligaments and joint capsules. In terms of its size, shape and thickness, the clavicle varies greatly from person to person.

Falls onto the shoulder, directly onto the collarbone or even onto the outstretched arm can result in fractures of the collarbone (clavicle fracture).

Depending on the location of the fracture site (inside, middle, outside) and the form of the fracture (transverse, spiral, comminuted fracture), clavicle fractures are very different and must be viewed very individually with regard to their treatment.

Depending on the course of the fracture and the involvement of the tight ligaments, the extent of instability is important for the assessment.

What initial measures are best after a broken collarbone?

"Cooling, arm sling, painkillers and clarifying whether you will benefit from surgical treatment as a patient."

A broken collarbone hurts a lot at the beginning, but if you leave the arm alone, the pain will subside significantly after a few days.

In the case of a broken collarbone, movement of the bone ends and crepitation (crunching) can often be felt when the arm is moved.

The best measure is to initially protect the arm in an arm sling, which can reduce pain in the early phase.

Immobilization in a “backpack bandage” is counterproductive. According to several studies, the desired adaptation of the fracture ends unfortunately does not occur, but additional muscle pain and nerve compression caused by the bandage often occurs.

Cooling and painkillers or pain drops help over the first few days. Within the first 3-5 days, a decision should be made as to whether the fracture is suitable for conservative treatment or whether surgical treatment can be beneficial.

It is best to clarify these questions with a specialist.

These collarbone fractures benefit from surgery.

"In the case of an unstable fracture, surgical treatment makes sense as it can bring about faster and anatomical bone healing."

In principle, clavicle fractures are well suited for non-surgical treatment if they are only slightly displaced and the clavicle is not shortened too much due to the ends of the fracture being pushed into the vein.

Although everyday movements are usually possible even with mishealed collarbone fractures, shoulder function is better guaranteed for demanding movements and loads with anatomical bone healing.

On the one hand, this is due to the complex biomechanics of the shoulder and the various pull vectors of the muscles, and on the other hand, malpositions can cause problems due to excessive bone formation.

Severely shortened positions (>2.5cm) and dislocations of >shaft width should be treated surgically.

In the case of an unstable fracture, surgical treatment makes sense as it can bring about faster and anatomical bone healing.

Another reason is that friction between the bone fragments can lead to ongoing pain and failure of the bone to heal (pseudarthrosis).

Other reasons for an operation could be earlier activity or cosmetic aspects if the clavicle is elevated.

You can find out from our specialist whether conservative or surgical treatment is more suitable for you.