Clavicle Fractures

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What is a Clavicle Fracture?

A clavicle fracture is a break in the collarbone, one of the main bones in the shoulder, and is a relatively common injury. It is a type of shoulder fracture that typically occurs from falls onto the shoulder or an outstretched arm, which puts sufficient pressure on the clavicle to cause it to snap or break. This injury is often painful, frequently restricting arm movement. 

Clavicle fractures can be categorised into different types based on the location of the break and the nature of the fracture. The main types include:

  • Midshaft Fractures: These are the most common type of clavicle fractures, accounting for approximately 80% of all clavicle fractures. They occur in the middle third of the collarbone.
  • Lateral Fractures: They are less common, affecting the end of the clavicle near the shoulder, and can involve damage to ligaments that attach the clavicle to the shoulder blade.
  • Medial Fractures: These are the least common and occur at the end of the clavicle closest to the breastbone (i.e., sternum). They can be associated with injuries to the chest and other structures in the area.
clavicle fracture singapore
types of clavicle fractures

What causes Clavicle Fractures?

Clavicle fractures are most often caused by a direct blow to the shoulder, which can occur during a fall onto the shoulder or in an accident, such as a car collision. Additionally, a fall onto an outstretched arm from cycling or soccer injury can also result in a clavicle fracture.

How do I know if I have fractured my clavicle?

In most cases, a clavicle fracture is painful and limits arm movement. Some of the symptoms include:

  • Intense Pain: Typically, patients will experience pain at the fracture site, especially when moving the shoulder or arm.
  • Swelling and Tenderness: Noticeable swelling, tenderness, and bruising around the collarbone.
  • Deformity: A visible bump or deformity over the break, indicating possible bone displacement. Alternatively, when pinched and lifted, the skin at the fracture site takes longer than usual to return to its normal position (tenting of the skin). The skin tenting suggests that a potential impending open fracture that requires surgical stabilisation.
  • Limited Mobility: Difficulty or inability to move the shoulder and arm without experiencing pain.
  • Grinding Sensation: A grinding or crunching feeling when attempting to move the shoulder.
  • Drooping Shoulder: The affected shoulder may appear to sag downward and forward, or appear shortened compared to the opposite side.
clavicle fracture pain

Are Clavicle Fractures painful?

As mentioned above, clavicle fractures are often accompanied by pain, similar to other types of broken bones. Nonetheless, the level of pain can vary depending on several factors, including the severity of the fracture, the specific location on the clavicle, and the individual’s pain threshold.

How are Clavicle Fractures diagnosed?

Patients will be asked how their injury occurred, and a physical examination is conducted to check for visible bumps, discolouration, tenderness, or open wounds. This is typically followed by an imaging test such as an X-ray to accurately locate and assess the severity of the fracture.

xrays of clavicle fractures

Who is at risk of Clavicle Fractures in Singapore?

Clavicle fractures typically result from trauma and may not always be preventable. However, certain factors increase the risk:

  • Age: Younger individuals, especially between the ages of 10 and 19 when the clavicle is still developing, and older adults over the age of 65 when bones are weaker, are more prone to fractures.
  • Sports Participation: Engaging in high-impact sports increases the risk due to the potential for traumatic forces, which can exert substantial force on the clavicle.
  • Medical Condition: Conditions like osteoporosis, which weaken bones, and osteopenia, an early stage of decreased bone mass, can heighten susceptibility to fractures.

How serious are Clavicle Fractures?

If a clavicle fracture is due to a traumatic event, it’s important to consider the possibility of accompanying injuries. Sometimes, individuals with a broken collarbone may also experience laboured breathing, indicating a potential lung injury associated with the fracture. Moreover, open fractures, significant deformity or displacement of the clavicle are further signs that specialist care is warranted

In such situations, patients are advised to seek immediate medical attention from an orthopaedic surgeon in Singapore for prompt evaluation and treatment, which are essential to ensure proper healing.

If left untreated, a clavicle fracture can lead to complications such as:

  • Bones healing improperly can cause malalignment (malunion), or a persistent gap between bone fragments (nonunion), both of which may lead to shoulder deformity
  • Chronic pain which limits movement and impacts daily activities
  • Nerve or blood vessel damage, causing sensory or vascular complications such as numbness
  • Secondary injuries, like irritation to nearby muscles and ligaments, resulting in further pain

Seeking prompt evaluation and treatment is essential to prevent these issues and promote optimal recovery.

What are the treatment options for Clavicle Fractures in Singapore?

Depending on the severity of the fracture, treatment options for clavicle fractures may range from conservative treatments to surgical interventions. Some of the conservative, non-surgical treatment options are:

  • Arm Support: Utilise a simple arm sling for immediate comfort and to maintain arm and shoulder position during healing.
  • Medication: Take pain medication, such as acetaminophen, to alleviate discomfort during the healing process.
  • Physical Therapy: Engage in physical therapy exercises to maintain arm motion, prevent shoulder and elbow stiffness, and gradually regain strength and mobility as the fracture heals.

However, more complicated fractures, where the bone fragments are significantly displaced, may require surgical intervention to realign and stabilise the collarbone. In more severe situations, a surgery called Open reduction and internal fixation (ORIF) may be required. This procedure is employed to treat clavicle fractures by realigning the broken bones to their correct position and securing them in place with internal fixation devices like metal plates, screws, or pins. These devices are surgically inserted into the bone to stabilise it during the healing process. Depending on the situation, the fixation devices may either remain in place permanently or necessitate follow-up surgery for removal.

It is important to note that Individuals with a clavicle fracture often experience loss of shoulder and arm strength. As the bone heals, pain diminishes, and gentle shoulder exercises may be recommended to prevent stiffness and weakness. More intense exercises are gradually introduced as the fracture fully heals.

Summary

A clavicle fracture, or broken collarbone, is a common injury often caused by trauma events such as falls, sports injuries, or accidents. Symptoms may include pain, swelling, and difficulty moving the arm. Treatment can involve using a sling, pain medication, and physical therapy. In severe cases, orthopaedic surgery may be necessary to realign and stabilise the bone. Prompt medical attention is crucial to prevent complications and ensure proper healing.

Visit Alps Orthopaedic Centre

In the case of experiencing significant trauma to your clavicles and noticing signs of a fracture, book an appointment with orthopaedic specialist Dr Jerry Chen, Consultant Orthopaedic Surgeon at Alps Orthopaedic Centre, for prompt medical assessment and specialised care.

Frequently Asked Questions

Can Clavicle Fractures be prevented?

As most collarbone fractures occur suddenly and unexpectedly due to accidents, preventing them entirely can be challenging. However, individuals engaged in high-impact activities are advised to take appropriate safety measures, such as using protective gear, to reduce the risk of severe injuries.

In many cases, individuals with clavicle fractures can regain their full range of motion and lead normal lives after proper treatment and rehabilitation.

Once a clavicle fracture has fully healed and the bone has regained its strength, it is unlikely to recur spontaneously. However, in some cases, particularly if there were complications during healing, there may be a slightly increased risk of re-injury to the same area. Hence, it is crucial for individuals to seek the appropriate treatment from a qualified professional such as an orthopaedic specialist.

The recovery time for clavicle fractures varies depending on severity, typically ranging from weeks to months. Consulting with a specialist helps understand each individual’s specific recovery timeline.

References

  1. Bentley TP, Hosseinzadeh S. Clavicle Fractures. [Updated 2023, Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507892/ 
  2. American Academy of Orthopaedic Surgeons. (n.d.). Clavicle Fracture (Broken Collarbone). OrthoInfo. Available from: https://orthoinfo.aaos.org/en/diseases–conditions/clavicle-fracture-broken-collarbone/
  3. Johns Hopkins Medicine. (n.d.). Clavicle Fractures. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/clavicle-fractures
  4. Kleinhenz, B. P. (2024, February 01). Clavicle Fractures. Medscape. Available from: https://emedicine.medscape.com/article/92429-overview
  5. Gemas, T. (2017, August 29). Clavicle Fracture. Sports-health. Available from: https://www.sports-health.com/sports-injuries/shoulder-injuries/diagnosis-and-causes-clavicle-fracture
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Dr Jerry Chen

MBBS (S’pore), MRCSEd, MMed (Ortho), FRCSEd (Ortho)

Fellowship-trained Consultant Orthopaedic Surgeon & Medical Director

Why Alps Orthopaedic Centre?

At Alps Orthopaedic Centre, we specialise in Enhanced Recovery After Surgery (ERAS). Performed as a Day Surgery, the ERAS Direct Anterior Approach in Total Hip Replacement (THR) technique as well as ERAS Total Knee Replacement (TKR), reduces the average hospitalisation stay, utilising techniques which enable the patient to suffer from less pain and recover faster. We are an Orthopaedic clinic in Singapore, which specialises in ERAS and do our utmost to enable patients to return to everyday activities as early as possible. 

Our Orthopaedic clinic provides specialised diagnosis and effective treatment of musculoskeletal problems, especially Day Surgery / Enhanced Recovery After Surgery (ERAS) For Hip and Knee Surgery, Sports Injuries and Trauma Fractures. If you are considering hip or knee surgery or minimally invasive treatments, book an appointment with our experienced Consultant Orthopaedic Surgeon, Dr Jerry Chen, for a thorough assessment and treatment plan. 

Our aim is to boost patient well-being, optimising every aspect of the surgical journey. By minimising the recovery period, patients are able to go back to activities that they love. The Alps team offers comprehensive financial counselling sessions to ensure our patients understand their options and make informed decisions regarding their treatment plans.

Has this article been insightful? Share it!

Dr Jerry Chen

MBBS (S’pore), MRCSEd, MMed (Ortho), FRCSEd (Ortho)

Fellowship-trained Consultant Orthopaedic Surgeon & Medical Director

Why Alps Orthopaedic Centre?

At Alps Orthopaedic Centre, we specialise in Enhanced Recovery After Surgery (ERAS). Performed as a Day Surgery, the ERAS Direct Anterior Approach in Total Hip Replacement (THR) technique as well as ERAS Total Knee Replacement (TKR), reduces the average hospitalisation stay, utilising techniques which enable the patient to suffer from less pain and recover faster. We are an Orthopaedic clinic in Singapore, which specialises in ERAS and do our utmost to enable patients to return to everyday activities as early as possible. 

Our Orthopaedic clinic provides specialised diagnosis and effective treatment of musculoskeletal problems, especially Day Surgery / Enhanced Recovery After Surgery (ERAS) For Hip and Knee Surgery, Sports Injuries and Trauma Fractures. If you are considering hip or knee surgery or minimally invasive treatments, book an appointment with our experienced Consultant Orthopaedic Surgeon, Dr Jerry Chen, for a thorough assessment and treatment plan. 

Our aim is to boost patient well-being, optimising every aspect of the surgical journey. By minimising the recovery period, patients are able to go back to activities that they love. The Alps team offers comprehensive financial counselling sessions to ensure our patients understand their options and make informed decisions regarding their treatment plans.

Has this article been insightful? Share it!

Dr Jerry Chen

MBBS (S’pore), MRCSEd, MMed (Ortho), FRCSEd (Ortho)

Fellowship-trained Consultant Orthopaedic Surgeon & Medical Director

Why Alps Orthopaedic Centre?

At Alps Orthopaedic Centre, we specialise in Enhanced Recovery After Surgery (ERAS). Performed as a Day Surgery, the ERAS Direct Anterior Approach in Total Hip Replacement (THR) technique as well as ERAS Total Knee Replacement (TKR), reduces the average hospitalisation stay, utilising techniques which enable the patient to suffer from less pain and recover faster. We are an Orthopaedic clinic in Singapore, which specialises in ERAS and do our utmost to enable patients to return to everyday activities as early as possible. 

Our Orthopaedic clinic provides specialised diagnosis and effective treatment of musculoskeletal problems, especially Day Surgery / Enhanced Recovery After Surgery (ERAS) For Hip and Knee Surgery, Sports Injuries and Trauma Fractures. If you are considering hip or knee surgery or minimally invasive treatments, book an appointment with our experienced Consultant Orthopaedic Surgeon, Dr Jerry Chen, for a thorough assessment and treatment plan. 

Our aim is to boost patient well-being, optimising every aspect of the surgical journey. By minimising the recovery period, patients are able to go back to activities that they love. The Alps team offers comprehensive financial counselling sessions to ensure our patients understand their options and make informed decisions regarding their treatment plans.