Most patients who suffer a clavicle fracture after a fall directly onto the shoulder. The vast majority of fractures will result from a simple fall, a fall from a height, a fall during a sports activity, or a motor vehicle accident .
The incidence of clavicular fracture decreases from age 20 to 50 and then increases again above age 70. These values do not include children. For the older age groups, lower energy injuries become a more common cause . Fracture is more common in men than women up to approximately age 50.
Diagnosis of Fracture
Given its subcutaneous position, fractures of the clavicle are easily diagnosed by examination. Initial observation often reveals the diagnosis.
The affected region might have swelling, ecchymosis and deformity. Abrasions marking of site of application could also be present.
Open fractures of the clavicle are extremely rare . If there is a concomitant injury of rib and scapula, patient should be evaluated for pneumothorax.
Vascular injuries associated with clavicle fracture, although rare, and when present may be life- or limb-threatening. If initial vascular examination leaves doubt, comparison of blood pressure in the two upper extremities is necessary. If uncertainty still exists, angiography is required.
Radiographs
The diagnosis of clavicle fracture is typically made on a single anteroposterior (AP) radiograph (see figure).
Fractures of the medial and lateral ends are more difficult to visualize. Ultimately, medial fractures in doubt require a computed tomography (CT) scan for adequate visualization .
Special Radiographic Views Used In Clavicle
Apical oblique radiograph:
To obtain this view, a bump or roll is placed under the contralateral scapula, which places the involved scapula flat against the radiographic cassette (a true AP). The beam is then angled 20 degrees cephalad, which brings the clavicular image away from the thoracic cage. This is done if better study of position of fracture fragments is desired.
Serendipity view
This view is done for the rare medial fractures, particularly those that extend into the sternoclavicular joint to view anterior or posterior displacement.
Axillary View
For visualization of intraarticular fractures of the acromioclavicular joint.
Popularity: 2% [?]
Related posts:
i met with an accsedent before 3days on 2wheeler i sufferd from left clavical fracture. i am using supporting shoulder belt on my 2 shoulders. the belt position is not fix it changes with the every movement. so, how it will effect on my clavical. in this situation how many days i wil have to weare a belt and
jeneraly how maney average days take to recover from this clavical fracture.
Dear Amit,
Fracture clavicle is a very common fracture to occur in motor vehicle accidents.
From your description, it appears that you have been given clavicular brace for immobilization of the fracture.
It is the right treatment for a simple clavicular fracture. Usually fracture clavicle takes about 4 weeks to get united. You are advised to keep brace for that period.
You would feel slight movements in spite of immobilization. Do not worry about that.
Most of the fractures unite without any consequence.
Get well soon.
i fractured my collar bone on may 25 2010 while riding bicycle. my collar bone has not healed i am going on my third month. is this normal ? does my age have anything to do with the healing process iam 50 years old. i am getting extremely inpatient and agravated with the situation iam in. iam not used to relying on others and it’s getting to me. sometimes i find it impossible not to move my arm.i find myself moving my arm even with the sling please give me some advice on how to cope with this predicament.
Dr Arun Pal Singh Reply:
July 28th, 2010 at 5:02 pm
@julianne magan,
Clavicle non union is not that common but it does occur. If clavicle has not united by three months there is a good chance that it is going into non union.
Talk with your doctor.
Though non union of the clavicle should not cause any functional problem with proper rehabilitation but some people do not like it and only option for them is surgery.
I fractured my lt clavicle on 3rd of may. Doctor gives me clavicle brace but it did not hold the bone correctly. Now it enters 4th week but still i feel bone is not united. Im a defence personnel, im on sick leave. So what should i do?
Dr Arun Pal Singh Reply:
June 10th, 2011 at 2:44 pm
@Bhagwan dass sharma,
Get an xray and confirm if union is there.
I had a calvical fracture 4 weeks ago i am using brace but still i feel bones not yet joined
Dr Arun Pal Singh Reply:
June 11th, 2011 at 2:05 pm
@Aru,
Please get an xray to confirm the status.
fractured my clavicle from motorvehicle 5 weeks ago.now i dont fell any pain.on sitting or walkig time my collarbone well positioned(straight).but on sleeping time its come to seperate position.is this common
Dr Arun Pal Singh Reply:
August 13th, 2011 at 12:10 pm
@shynoj,
It is advisable to sleep on reclining chair. The immobilisation mechanism works only when torso is upright.
Hi there,
About 3 months ago I fractured my right clavicle. My fracture resembles very much to the one in the picture above. I have noticed lately that the shoulder side of the broken clavicle seems longer than the other side, and since I also broke a link in my lower back my doctor haven really spoke to me about it.
I just wanted to know, is it normal that the broken clavicle shoulder looks longer? And how long does it takes for the bones to completely heel and go back to it’s place?
Dr Arun Pal Singh Reply:
September 14th, 2011 at 12:39 pm
@Maya,
I am not able to understand your description.
What is long shoulder?