Broken Collarbone: Symptoms, Treatment and Recovery

01Anatomy

The collarbone and types of break

Mayo Clinic explains that the collarbone, or clavicle, connects the shoulder blade to the breastbone. Because it lies just under the skin at the front of the shoulder, a break is often easy to notice.

Breaks differ. Mayo Clinic describes fractures that break through the skin, are out of place or are in several pieces, and fractures that involve the joints connecting the collarbone to the shoulder blade or breastbone. The type of break is one of the main factors in deciding treatment. For other causes of pain in this area, see our guide on collarbone pain.

02Causes

How collarbones break

Mayo Clinic lists the common causes:

• falls, such as falling onto the shoulder or onto an outstretched arm
• sports injuries, such as a direct blow to the shoulder
• traffic accidents, including car, motorcycle and bike crashes
• birth injury in newborns, usually after a difficult vaginal birth

Children and teenagers are at higher risk than adults. Mayo Clinic says the risk falls after age 20 and rises again in older people as bones lose strength.

04Diagnosis

Examination and x-rays

During the physical exam, Mayo Clinic says a health professional looks for tenderness, swelling or an open wound. X-rays show where the break is, how bad it is and whether the joints are involved, and a CT scan can give more detailed images.

Mayo Clinic suggests bringing a list with details of the injury and when it happened, past medical problems, all medicines and supplements you take, and your questions. The team may ask whether you have broken a bone before or have been told you have weak bones. Depending on the break, you may be referred to an orthopedic surgeon.

05Sling

Sling, pain relief and ice

Mayo Clinic explains that a broken bone must be kept still to heal, so people with a broken collarbone usually need to wear a sling. Mayo Clinic does not give a fixed number of weeks; how long to wear it, and whether to take it off at night or for washing, should be confirmed with the team treating you.

An over-the-counter pain reliever may be all that is needed. Some people with intense pain need a stronger prescription painkiller for a few days, used only for a short time and as directed, because it can be habit-forming. Mayo Clinic also suggests ice for 20 to 30 minutes every few hours during the first 2 to 3 days to help control pain and swelling. The sources do not give specific advice on sleeping positions; ask your team how to position the arm at night.

06Surgery

When surgery is considered

Mayo Clinic says surgery might be needed if the collarbone has broken through the skin, is out of place or is in several pieces. It usually involves plates, screws or rods to hold the bone in place while it heals. Surgical complications are rare but can include infection.

Children and teenagers under 16 rarely need surgery because they heal more quickly than adults. Mayo Clinic says a newborn’s collarbone broken during birth typically heals in about two weeks with pain control and careful handling.

07Movement

Authorized movement and rehabilitation

Mayo Clinic explains that exercises to restore movement begin soon after treatment starts, because it is usually important to start moving to reduce stiffness. Later, other exercises or physical therapy help the joint move better and rebuild muscle strength.

Which movements are allowed, and when, depends on the type of break and the treatment. Start the exercises your team gives you and progress as they advise. Less pain does not necessarily mean the bone has finished healing, so heavier lifting and loading should wait until you have been told it is safe.

08Healing

Healing times and complications

Mayo Clinic says bone healing often takes 3 to 6 weeks in children and 6 to 12 weeks in adults. Most broken collarbones heal without difficulty. Possible complications include:

• nerve or blood vessel injury from the broken bone ends, which is rare
• slow healing or non-healing of a badly broken collarbone, and shortening of the bone if the pieces join poorly
• a bony lump where the bone knits together, which often shrinks over time but may not disappear
• arthritis in the nearby joint if the break involved it

09Sources

Where the sources differ

Both sources for this guide are Mayo Clinic pages, so they do not contradict each other. Their limits are worth noting.

No fixed sling time. Mayo Clinic says a sling is usually needed but does not state how long; this varies with the break and treatment.

No return-to-activity schedule. Healing ranges of 3 to 6 weeks in children and 6 to 12 weeks in adults describe bone healing, not when you can lift, drive, work or play sport; those decisions are made with your clinician. Sleeping positions are not covered either.

10Summary

In summary

A broken collarbone is common, usually after a fall, a sports blow or an accident. Pain on moving the shoulder, swelling, bruising and a bump are typical, and it should be checked promptly, with immediate care for numbness, coldness or a break through the skin. X-rays show the type of break.

Most heal with a sling, pain relief, early exercises and time, and some need surgery. Ask your team when to stop the sling, start lifting, and return to work or sport. Once your doctor has cleared you, our physiotherapy practice in Bilbao can help adults regain shoulder movement and strength (consultations are in Spanish).