Ask a Vail Sports Doc column: What you need to know about clavicle fractures
December 12, 2016
Clavicle, or collarbone, fractures often result from high-energy activities such as skiing and snowboarding. Most commonly, clavicle fractures are the result of a direct blow to the shoulder. Frequently, a fall over the handlebars of a bike or catching an edge on a snowboard and landing on the shoulder is the cause of these injuries.
The clavicle is an S-shaped bone that often breaks in the middle one-third of the bone, and it is one of the most commonly fractured bones. Fortunately, the predictable nature of this fracture pattern makes treatment pretty straightforward.
The first step if someone believes he or she may have injured the clavicle would be to seek medical attention by an orthopedic physician, urgent care or emergency department. X-rays are then usually obtained to visualize the integrity of the bone. At that point, an orthopedic physician makes the determination if the fracture can be treated conservatively, without surgery, or if surgical intervention is advised.
Fractures that are minimally displaced can be treated without surgery. The patient is constricted to a sling for a period of time, usually six weeks, to allow the bone to heal. An orthopedic physician will follow the progress of the fracture to assure bone bridging and proper healing.
If surgery is advised, this usually entails fixation of the fracture with hardware. Most commonly, the repair requires a plate and screws to hold the broken clavicle bones together so they heal perfectly aligned. The surgical hardware may remain in place forever, or it can be removed after complete healing has occurred.
Following surgery, the patient will be confined to a sling for a time to allow healing to occur without stress to the bone fragments. X-rays will be taken at follow-up appointments to evaluate bone healing.
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Some fractured clavicles do not heal and go onto what is called a nonunion. The risks of a nonunion are higher for displaced, multi-piece fractures that are treated without surgery. Occasionally, fractures treated with surgery fail to heal, but this is quite rare. There are certain risk factors for a fracture not healing, such as smoking, diabetes and some medications for autoimmune disorders.
Long term, patients with clavicle fractures treated by orthopedists usually do very well. Once healing from this type of fracture occurs, patients are able to return to their normal activities and sports.
Dr. Richard Cunningham is a board-certified, fellowship-trained orthopedic surgeon and knee and shoulder specialist with Vail-Summit Orthopaedics. Gretchen Meador, P.A.-C., is a physician assistant to Cunningham. For more information about Vail-Summit Orthopaedics, visit http://www.vsortho.com.
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