What is the condition?

A fractured clavicle (broken collarbone) is a common injury where the bone connecting the breastbone to the shoulder breaks. It typically occurs after a fall or direct impact to the shoulder.

 

What are the symptoms?

· Sudden pain over the collarbone after injury

· Swelling or bruising around the area

· A visible bump or deformity

· Pain when moving the shoulder or lifting the arm

· A grinding or clicking sensation

 

What are the risk factors?

· Falls onto the shoulder or outstretched hand

· Contact sports (e.g. rugby, football, martial arts)

· Cycling or road accidents

· Bone weakness from conditions like osteoporosis (less common)

 

How is it diagnosed?

· A physical examination will identify tenderness, swelling, or deformity

· An X-ray confirms the location and pattern of the break

· A CT scan may be needed in complex or joint-involving fractures

 

What are the treatment options?

· Many clavicle fractures heal well with rest, a sling, and physiotherapy

· Most paediatric and adolescent clavicles do not need surgery

· Pain relief and gradual return to movement are important

· Surgery may be advised if the fracture is displaced, shortened, or unstable

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When is surgery required?

· When the bone ends are widely separated or overlapping

· If the bone has pierced the skin (open fracture)

· If the fracture is comminuted (multiple piece)

· Associated with additional upper limb or systemic injuries

· For active individuals who need reliable strength and early return to function

 

What happens if this condition is left untreated?

· The bone may heal in a shortened or displaced position

· This can result in visible deformity, shoulder weakness, or ongoing discomfort

· In some cases, the fracture may not heal (non-union) or heal incorrectly (malunion)

 

How long is the recovery following surgery?

First 6 weeks:

o Sling is usually worn for 4–6 weeks

o Light hand use is allowed (e.g. writing, eating)

o Avoid lifting or overhead movement

6 to 12 weeks:

o Most fractures show early healing (full union on x-ray takes 3-4 months)

o Gradual increase in shoulder movement and use

o Physiotherapy is focused on regaining strength and range of motion

3 to 6 months:

o Most patients return to full daily function

o Sport or heavy lifting may take longer depending on healing and activity type

 

What are the expected outcomes of surgery?

· Surgery provides stable fixation and allows more predictable healing

· Most patients regain full function without long-term limitations

· Occasionally, hardware (plates and screws) may be removed if they cause irritation

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What are the risks of surgery?

General surgical risks

· Infection: ~1–2%

· Bleeding or haematoma: <1%

· Wound healing problems or scarring

· Anaesthetic risks

Specific to clavicle fixation

· Hardware prominence/irritation: up to 20–30% (most common; may require later plate removal)

· Non-union (bone not healing): ~1–5%

· Malunion (healed in less-than-ideal position)

· Nerve or vessel injury: <1% (brachial plexus, subclavian vessels – rare but serious)

· Pneumothorax: <1% (very rare, due to proximity of lung)

· Stiffness of the shoulder joint or discomfort around the scar

· Painful scar or altered skin sensation around incision (due to supraclavicular nerve irritation)

Long-term risks

· Implant failure (broken plate/screws): uncommon, <2%

· Refracture after plate removal: ~1–5%

· Residual shoulder weakness or discomfort with heavy activity

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What does the rehabilitation/recovery involve?

To find out more about rehabilitation and recovery after shoulder surgery please see our Rehabilitation Protocols here.