Clavicle Fracture

clavicle fracture

INTRODUCTION:

The collarbone, also called the clavicle, is the bone over the top of your chest, between your breastbone (sternum) and shoulder blade (scapula). It is easy to feel the clavicle, because unlike other bones which are covered with muscle, only skin covers a large part of the bone.

Clavicle fractures are extremely common. Broken collarbones occur in babies (usually during birth), children and adolescents (because the clavicle does not completely ossify, or develop, until the late teens), athletes (because of the risks of being hit or falling), or during many types of accidents and falls.

MECHANISM OF INJURY:

Clavicle fractures are common injuries, and they can occur different ways:

  • Some patients fall on an outstretched hand,
  • fall and hit the outside of their shoulder.
  • Broken collarbones can also occur from a direct hit to the clavicle.
  • In babies, clavicle fractures occur at birth during passage through the birth canal.
  • collision with an opponent in a contact sport such as Rugby or American Football

SYMPTOMS:

  • Pain on the collar bone!
  • Sharp pain when any movement is made.
  • Referred pain: dull to extreme ache in and around clavicle area, including surrounding muscles.
  • Possible nausea, dizziness, and/or spotty vision due to extreme pain
  • Swelling.
  • A bony deformity may be seen or felt

DIAGNOSIS:

Imaging Studies

  • Routine clavicle radiography
  • Fracture is usually demonstrated on an anteroposterior (AP) view.
  • Apical lordotic views may be required to define the degree of displacement.
  • Other tests may be required when clinically indicated to assess the possibility of life-threatening associated injuries.
  • Chest radiography, if pneumothorax suspected
  • Angiography, if vascular injury suspecte

TREATMENT:

Treatment usually involves resting the affected extremity and supporting the arm with the use of a sling, supported over the opposite shoulder. In older practice, a figure-8 brace was used, designed to provide immobilization of the fracture to facilitate healing. Current practice is generally to provide a sling, and pain relief, and to allow the bone to heal itself, monitoring progress with X-rays every week or few weeks. Surgery is rarely used.

More than 90% of clavicle fractures are successfully healed by non-operative treatment. The surgery is indicated in the following conditions.

1. – The impending of the fracture site penetrating the skin.
2. – The fracture of clavicle associated to nerve and vessel injuries.
3. – The symptomatic or painful nonunion and
4. – Fracture at the end of the clavicle which injures or threatens the ligament of acromioclavicular joint.

A discontinuity in the bone shape often results from such a fracture. In rare cases (2-5%) surgery may be required when skin is broken or if the fracture is extremely displaced (disunion). Surgical procedure will often call for a plate to be affixed along the bone on either side of the fracture and screwed into the clavicle. In some cases the plate may be removed after healing. Surgical intervention in the region of the clavicle is avoided if possible, due to various important structures beneath.

For adults, healing time—four to six weeks—is longer than for children—three weeks. After two to three months the clavicle strengthens, generally regaining its former full strength after half a year.

PHYSIOLINE’S SPECIALIZED PHYSIOTHERAPY HAS VITAL ROLE TO PLAY

At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to:

  • Pain relief
  • Reduce stiffness
  • Strengthening of muscle
  • Regain full range of motion
  • Advice to wear shoulder sling.
  • Sports specific training

Visit Physioline for the Consultation and treatment