What is a broken Collar Bone (Clavicle)?
A broken Collar Bone (Clavicle) is a very common fracture. It occurs after falling off a height or in contact sport. It can involve the middle or either end of the collar bone. Commonly it can be associated with fracture displacement which results in the bones ends not touching. Most of the time, the skin is not disrupted over the clavicle and it remains what’s called a closed fracture.
Symptoms
As with any broken bone the main symptom is pain.You may feel clicking or crunching around the collar bone as you move your arm. It may have also been accompanied by a sound at the time of the injury.
Diagnosis
The diagnosis of the broken collar bone is made with plain X-Rays. Occasionally we will require a CT Scan to have a closer look at the fracture fragments or to have a look at the ligaments that may be involved. If it involves the outside portion of the clavicle it may require further imaging to have a closer look at the affected ligament.
Treatments
The main treatment for Clavicle fractures remains non-operative. However this does lead to a longer time till the fracture fragments heal completely. It also does take some time for the pain to settle down. The other option is to undergo operative fixation mostly by means of a plate and screws. Generally speaking an incision is made over the fractured site and the fracture is reduced and fixed with a plate and screw construct. The plate and screws are made from titanium. This generally improves the healing rate of the fracture and also decreases the healing time. It does however carry some risks which can be related to prominent hardware under skin with skin irritation. It can also relate to hardware breakage and a small numb patch which forms underneath the associated incision. There is always a small risk of infection and bleeding with any operative intervention.
Outcomes
Operative intervention generally carries a higher union rate when compared to non-operative. This is especially true when the fracture fragments are displaced more than 1cm from each other. Plate fixation also leads to a faster union time. Fixation also assists in establishing significant pain reduction very soon after the surgery is performed. Commonly after fixation patients will need to come back and have their plates removed as they can be palpable under the skin and cause irritation especially in thin individuals.
