1. The Clavicle Protects Vital Structures
The clavicle, or collarbone, lies over some very important structures. The subclavian artery and vein are the major circulatory structures supplying the arm with blood. The brachial plexus are the nerves coming out of the neck and going to the arm. Clavicle fractures can injure any of these structures, but luckily, they very rarely do so.
2. Shoulder Injuries
When you fall on your shoulder, the force can be transmitted to the clavicle. Because it does not have much surrounding muscle, it is in a vulnerable position and can be easily broken. Most fractures occur in the middle one-third of the bone.
3. Bumps
When the bone breaks, the muscle forces cause the bone to overlap, and the proximal part of the bone nearer the neck is pulled up. The distal part of the bone is pulled down by the weight of the arm. This causes a bump; however, most people with such a bump heal relatively quickly and are not limited in their functional capabilities.
4. Healing
Over 90 percent of these fractures heal without surgery. The two main options are to use a sling or a figure "8" splint. Both of these keep the fragments relatively still while they are healing. The figure "8" splint looks like two backpack straps from the front, and it crisscrosses in the back. This helps to keep the shoulders back, theoretically helping with the alignment of the bones. Either way, clavicle fractures usually heal in 6 to 8 weeks. As the bones are mending, you can start early active motion once the pain is under control. This helps prevent a frozen shoulder.
5. Options for Surgery
If you and your surgeon decide that surgery is needed, there are two main ways of surgically fixing a clavicle fracture: a threaded pin or a plate with screws. Previously, smooth pins around the shoulder were found to migrate to the inside of the heart or lungs. Newer designs use a threaded pin and a nut to prevent this from happening. Another option is a plate and screws. Newer designs are pre-contoured to follow the S-shape of the clavicle. All pins and most plates will need to be removed at some point because the metal is very prominent; there really is no muscle covering the bone and the metal becomes symptomatic.
Member Comments