Collarbone fracture: Symptoms, diagnosis, and treatment for a broken clavicle. Surgery or conservative treatment?

A broken collarbone, also called a clavicle fracture, is a common injury often caused by a fall onto the shoulder or outstretched arm. A broken collarbone usually affects people of all ages, although athletes and children are particularly at risk . Treatment of a broken collarbone can be conservative or surgical, depending on the severity of the fracture and the presence of any associated injuries.

Symptoms of a collarbone fracture

Typical symptoms

The typical symptoms of a clavicle fracture include immediate, severe pain in the collarbone area . Often, a deformity is visible or palpable. Other signs may include:

• A protective posture of the arm to reduce pain.

• A significant restriction in the mobility of the arm and shoulder.

Neurological symptoms rarely occur, but these require immediate specialist evaluation. If a collarbone fracture is suspected, a physician should be consulted immediately to confirm the diagnosis and initiate appropriate treatment.

Swelling and severe pain

A collarbone fracture often causes various symptoms, including:

• Swelling and bruising in the area of the fracture.

• Severe pain, aggravated by movement of the broken bone.

Even slight movements of the arm or shoulder can intensify the pain. Swelling can spread throughout the entire shoulder girdle, complicating diagnosis. By adopting a protective posture, the patient tries to avoid the painful movements, which can, however, lead to long-term mobility restrictions.

Mobility restrictions

A collarbone fracture leads to significant restrictions in the shoulder joint . Due to the pain and instability of the broken bone, the mobility of the arm is severely reduced. Those affected are often unable to lift or rotate their arm freely. The restricted movement can also affect the shoulder joint due to tension in the muscles surrounding the shoulder. Full mobility can be restored with conservative therapy. A specialist can restore the function of the arm and shoulder using special exercises and techniques.

Causes and risk factors

Common causes of a collarbone fracture

A broken collarbone, also called a clavicle fracture, is a common injury usually caused by direct or indirect force. The most common causes include falls onto the shoulder or an outstretched arm . Direct blows to the collarbone can also fracture a collarbone. Athletes in contact sports such as soccer or handball, as well as cyclists and skiers, who are frequently prone to falls, are particularly vulnerable to this. The circumstances of the accident play a crucial role in assessing a clavicle fracture and determining the appropriate treatment.

Risk factors for breaking the collarbone

Certain risk factors can increase the likelihood of a collarbone fracture. Several factors play a role. These include:

• Age-related factors.

• Osteoporosis, a disease that reduces bone density.

Sports activities with a high risk of falls also represent a risk factor. Certain underlying diseases that affect bone structure can also make the collarbone more susceptible to fracture. To avoid a collarbone fracture, it is important to be aware of these risk factors and take appropriate precautions.

Accidents and sports injuries

Accidents and sports injuries are the most common causes of a collarbone fracture. In sports, direct collisions or falls often occur, which can lead to a collarbone fracture. In traffic accidents, the force of the impact can also cause a collarbone fracture.

The nature of the accident or sports injury often influences the type of fracture and the presence of any associated injuries. Collarbone fractures are diagnosed using X-rays. In some cases, particularly complex fractures, a computed tomography (CT) scan may be required to more accurately assess the extent of the injury.

Diagnosis of a broken collarbone

Diagnostic procedures

If a collarbone fracture is suspected, the diagnosis is usually made through a physical examination and imaging studies . First, the physician will take the patient's medical history to understand the accident and the exact circumstances of the collarbone fracture.

A thorough examination of the shoulder girdle and the affected arm is then performed. The specialist looks for any visible deformities, swelling, or bruising in the collarbone area. Through careful palpation, the doctor can often detect a palpable ridge or abnormal range of motion, which may indicate a clavicle fracture.

Imaging techniques for diagnosis

To confirm the diagnosis and assess the extent of the clavicle fracture, imaging techniques are used, usually an X-ray, or in complex cases, a CT scan . An X-ray is sufficient in most cases to identify the fracture and determine its location. In complex cases, especially if associated injuries are suspected or the fracture fragments are severely displaced, a computed tomography (CT) scan may be necessary.

CT provides more detailed images of the bone and surrounding structures, allowing for a more precise assessment of the clavicle fracture. These imaging techniques help physicians determine the appropriate treatment and detect potential complications early.

Examination and anamnesis

Examination and medical history are crucial for diagnosing a clavicle fracture and determining the appropriate treatment. The physician will question the patient about the circumstances of the injury, the exact symptoms, and the time of onset.

A thorough physical examination helps to locate the affected area and assess the extent of the injury, paying attention to swelling, bruising, deformities, and restricted movement.

The doctor will also check the neurological function of the arm to ensure no nerve damage has occurred. The combination of history and physical examination allows the doctor to make a tentative diagnosis and order the necessary imaging studies.

Treatment of a collarbone fracture. In this case, surgery is advisable

Conservative treatment methods

Non -surgical treatment is sufficient in some cases , especially if the fracture fragments are not severely displaced. Therapy aims to stabilize the broken bone and relieve pain. This is usually done with a special bandage that immobilizes the arm and shoulder. Painkillers can help control pain.

The healing period is approximately 6 weeks, during which the patient should rest the arm and avoid certain movements. Regular check-ups are important to monitor the healing process and ensure that no complications arise.

Surgical techniques for severe fractures

In severe fractures where the fractured fragments are severely displaced or where there are associated injuries, surgery may be necessary . The goal of surgery is to reposition and fix the fragments to ensure proper healing. There are various surgical techniques that can be used depending on the type and location of the clavicle fracture.

Plates and screws are often used to stabilize the fractured fragments. In some cases, a titanium pin may also be inserted into the bone. The surgery is usually performed by a shoulder specialist with trauma surgery experience. Follow-up treatment is required after the surgery to restore mobility to the arm.

Follow-up treatment and rehabilitation

After treatment of a clavicle fracture, whether with or without surgery, targeted follow-up care and rehabilitation are important to restore full function of the arm and shoulder. Rehabilitation usually begins with gentle range-of-motion exercises to improve shoulder joint mobility.

As the treatment progresses, strengthening exercises are added to strengthen the muscles around the shoulder joint. A physiotherapist can guide the patient through the exercises and create individualized training plans. The goal of rehabilitation is to reduce pain, improve mobility, and restore strength so that the patient can regain full use of their arm.

Even after rehabilitation is completed, regular exercises are important to maintain the achieved function in the long term.