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Clavicle Fractures

What is a Clavicle Fracture and How Does it Occur?

The clavicle, also known as the “collarbone,” is a thin bone that attaches the shoulder to the sternum (breastbone). A broken collarbone usually happens when a child falls directly onto the shoulder.

How is a Clavicle Fracture Diagnosed?

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A child with a clavicle fracture usually has pain, swelling, and possibly bruising directly over the clavicle, usually midway between the neck and the shoulder. Most likely, they will initially support the elbow with the opposite hand as allowing the arm to hang at the side is usually painful. They will probably not want to use or move the arm that is injured. In most cases, X-rays confirm the diagnosis. Occasionally, a very subtle fracture cannot be seen on X-ray, and your physician can make the diagnosis through their exam.

 

How is a Clavicle Fracture Treated?

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Unlike other fractures, a clavicle fracture does NOT need to be lined up perfectly to heal well. Clavicle fractures are initially treated by putting the arm on the injured side in a sling until the pain improves. The sling does not stabilize the fracture or help it to heal sooner. It is used to provide comfort to the child. The sling is not needed when sleeping.

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Once the pain improves (usually in 2-3 weeks), the child does not need to wear the sling any longer and may start working on moving the shoulder. Caregivers may still consider having the child wear the sling to school as a reminder not only to them but also to other children that the fracture has not completely healed. It is also a reminder that activities putting the child at risk for a fall should be avoided. Your physician may have the child return to clinic for X-rays in approximately 6 weeks.

Clavicle fractures in younger children may heal within 6 weeks, but it may take 10-12 weeks for a clavicle fracture to heal in an older child or adolescent. Clavicle fractures rarely require surgery in children. Surgery is occasionally considered in teenagers with significantly displaced fractures.

What is the Long-Term Outcome After a Clavicle Fracture?

Clavicle fractures in children usually heal in 6 to 12 weeks. Children should have no problems returning to sports or other physical activities after the fracture is healed. Clavicle fractures usually heal with a significant amount of callous (new bone that surrounds the fracture as it heals). Because the clavicle is directly under the skin and because of the new bone that the body creates to heal the fracture, the child will have a “bump” at the fracture site. In younger children, the bump will usually go away over time. In adolescents, the “bump” may improve but will likely remain. Children are unlikely to have any functional problems following a healed clavicle fracture.