Broken collarbone

One of the most common injuries is a broken collarbone, which usually occurs during a fall or after an impact. A fracture can occur anywhere in the clavicle, but is most often localized in the area of the diaphysis (central part), less often in the area of the sternal end and acromial end of the clavicle. It should be noted that a fracture of the acromial end of the clavicle can be combined with dislocations and rupture of ligaments, as well as with a fracture of the scapula.

Causes of fracture

A fracture of the collarbone occurs due to injury — a direct blow, a fall on the arm or elbow. Clavicle fractures are common in children, athletes, and sometimes in newborns during passage through the birth canal.

Types of fractures

As noted above, fractures of the diaphysis, sternal and acromial ends are distinguished. There are also comminuted, multi-comminuted fractures, with an oblique or perpendicular fracture line, etc. Note that it is very important to classify injuries correctly, because the choice of optimal treatment and its success depend on it.

Often, under the influence of muscle strength, a dislocated clavicle fracture is observed, which is very dangerous: the ends of displaced fragments can damage the pleura, blood vessels, nerves and skin.

A broken collarbone. Symptoms

• pain;

• inability to raise a hand;

• shoulder displacement;

• crunching when trying to raise your hand.

Diagnostics

It is quite easy to identify a clavicle fracture: there is a sharp pain in the fracture area, often fragments of the clavicle stretch the skin in the form of a tent, less often they break through it. There may be a crunch when trying to raise your hand.

In most cases, the unevenness or deformity is obvious, and the diagnosis is beyond doubt, but it is necessary to undergo an X-ray examination, which will provide accurate information about the nature of the injury, after which the most optimal treatment option is selected.

Treatment

This injury is dangerous because blood vessels and nerves can be damaged, so if you have a broken collarbone, treatment should be immediate. Currently, conservative and surgical treatment are distinguished.

Conservative treatment of a clavicle fracture

With this method of treatment, the fracture is immobilized, i.e. it is fixed for several weeks in a special bandage, depending on the patient's age and the severity of the fracture. Although conservative treatment sometimes allows you to heal a bone without surgery, it has a number of disadvantages.:

• the upper arm may be shortened or deformed due to the unrepaired length of the collarbone;

• hypertrophied callus formation is possible;

• cosmetic "defect" of the upper arm

Surgical treatment

Osteosynthesis is an operation in which the displacement of fragments is eliminated and the bone is fastened with a metal structure.

Osteosynthesis with screws and plates having a wide variety of shapes is currently widely used: hook-shaped, S-shaped, curved, etc.

In addition to plates, sometimes a flexible pin is used to treat a fracture, which is inserted into the bone.

Both techniques allow for early active movement development and do not require immobilization after surgery.

Although surgical treatment in most cases makes it possible to completely eliminate the displacement of fragments and fix them securely, in rare cases the following consequences of a clavicle fracture are possible:

• non-fusion of the clavicle due to the multi-jointed nature of the fracture or the incorrect choice of the retainer;

• infectious complications.

Note that in case of a dislocated clavicle fracture, treatment is usually performed surgically.