Clavicle fracture

A clavicle fracture is a broken collarbone. The clavicle is the bone that secures the arm to the body and connects the breastbone (sternum) to the shoulder blade (scapula). Full use of the clavicle is essential when doing things we take for granted — like putting our arms over our heads. The clavicle tends to break in the middle, though it may break where it connects to the shoulder blade or sternum.  

The broken ends of the clavicle tend to stay pretty close to one another, and the damage is usually very localized. But in rare occurrences, the broken bone can damage surrounding tissue, nerves and blood vessels. It is possible —though quite unlikely — that the bone will pierce the skin (surface fracture) or the upper portion of the lung. Even in the best of circumstances, a clavicle fracture is an injury that must be treated promptly by medical professionals. If you have sustained a traumatic injury to the region where your arm articulates with your body, and your shoulder is immobile or your collarbone is swollen or misshapen, you must seek medical attention.  

Anatomy of the shoulder

The shoulder, the human joint with the greatest range of motion, is composed of the following:

• Scapula (shoulder blade)
• Humerus (upper arm bone)
• Clavicle (connects the scapula to the breastbone)
• Rotator cuff (four muscles that bind the “ball-and-socket” joint where the scapula meets the humerus)
• Sternum (the breastbone)

Different types of clavicle fractures have different symptoms. Generally speaking, if you have fractured your clavicle, it will swell and feel tender. When you attempt to move your arm, you will feel pain. A bump may form at your clavicle, and bruises may appear on your shoulder or along the length of your collarbone.

The following are common clavicle fracture symptoms:

• Pain
• Swelling
• Bruising
• Deformed collarbone
• Slumped shoulder

The symptoms of clavicle fracture may be mistaken for the symptoms of other medical conditions (rotator cuff tear, separated shoulder, etc.). Make sure you consult a doctor to determine if you have a clavicle fracture, and get the appropriate treatment. 

A clavicle fracture is generally the result of a strong blow. In some cases, it is the result of vulnerability. The following are the most common causes of clavicle fracture:

• Direct blow to the top or side of the shoulder—A direct blow to the top or side of the shoulder can cause a fracture of the outer third of the clavicle.
• Direct blow to the mid-collarbone—A direct blow to the mid-collarbone can cause a fracture of the middle third of the clavicle.    
• Direct blow to the breastbone—A direct blow to the breastbone can cause a fracture in the inner third of the clavicle.
• Falling on an extended arm—When your arm is extended, your clavicle is already stressed, making it vulnerable to fracture.
• Birth—Babies may sustain clavicle fractures during traumatic childbirths.
• Undeveloped clavicle—The collarbone does not fully form and ossify until the late teenage years, making adolescents more vulnerable to clavicle fractures than adults.

Clavicle fractures can be divided into three main types:

• Fracture in the outer third of the clavicle—Making up approximately 15 percent of all clavicle fractures, this type of fracture is generally caused by a direct blow to the top or side of the shoulder.
• Fracture in the middle third of the clavicle—Making up approximately 80 percent of all clavicle fractures, this type of fracture tends to be caused by a fall on an extended arm or a direct blow to the collarbone’s middle.
• Fracture in the inner third of the clavicle—This type of fracture is a rarity and tends to be caused by a direct blow to the breastbone.

The multidisciplinary team of trauma and fracture experts at Northwell Health Orthopaedic Institute treats clavicle fractures as well as a broad range of conditions that affect the bones.