If you or a family member have broken your collar bone, you may be wondering if it will require surgery and when you can return to normal activities. These are common questions, and we can help address them, as well as outline a few important things you should know.
Your collar bone, also known as the clavicle, is a long, narrow bone, at the top of the shoulder that goes from the sternum (or the chest) to the tip of the shoulder (or the acromion). It is one of the more commonly fractured bones in the upper extremity. Traditionally, these have been treated without surgery. More recently, though, it has been common to treat these surgically with better results.
Where and How Do They Typically Occur?
The most common clavicle fractures occur in the middle portion. They can also occur toward the end of the tip of the shoulder or toward the chest, which is uncommon. These fractures are usually the result of a high-energy mechanism, such as a sport or motor vehicle accident. It is extremely rare to have an associated injury to the nerves or blood vessels in conjunction with a clavicle fracture.
What Are Treatment Options?
In the past, the majority of clavicle fractures were treated nonoperatively with a sling for approximately six weeks. The patient was allowed to resume normal activities once there was good healing, which is typically three to four months.
More recently, there has been a trend toward treating these surgically. Some of the indications for surgical treatment are if the fracture is displaced, significantly separated, or if it is significantly shortened.
A recent study comparing patients with displaced clavicle fractures around the middle portion, receiving either surgical treatment or nonsurgical treatment, showed that the patient in the surgical group had a statistically significantly improved outcome with regard to function with very few complications.
What Are the Pros and Cons of Nonoperative Treatment?
The advantages of nonoperative treatment are that the patient is not exposed to the risk of surgery. such as infection or damage to nerves, blood vessels, and tendons. Although, these are extremely rare complications. The disadvantage of nonoperative treatment is that the fracture may heal in a nonanatomic position, and the patient may experience significant pain during the healing process as it is difficult to completely immobilize the clavicle.
What Are the Pros and Cons of Surgical Treatment?
The advantages of surgical treatment are that the surgeon uses a plate and screws to stabilize the clavicle allowing a more anatomic healing scenario. With the plate and screws, there is immediate stability of the clavicle, which results in improved pain once the pain from the surgery has subsided. The disadvantage of surgery is the risk of infection and/or damage to nerves, blood vessels, and tendons, which we have not seen in our practice.
We’re the Experts in Total Shoulder Care.
At Advanced Orthopedic Specialists, our shoulder surgeons take care of a large number of high-level athletes, as well as recreational athletes. These athletes have typically sought surgical treatment of their clavicle fracture to improve the function of the upper extremity, to diminish the pain, and allow them to return to their desired level of sport in a quicker fashion.
What Should You Expect from Surgery?
This surgery typically takes about one hour. It is done in an outpatient setting. The fracture is reduced anatomically, and the plate is affixed to the fracture to hold it securely. The patient wears a sling until the wound is healed, which is typically 10 to 14 days. Once the wound is healed and the sling is discontinued, physical therapy is started and the patient is allowed to begin running. We begin light strengthening at approximately four to six weeks and allow a return to sports at approximately 7 to 12 weeks, depending on the amount of healing needed. The disadvantage is that some patients do elect to have the plate removed at some point.
If you sustain a clavicle fracture, understand there are options to help you get you back into your sport or normal life activities as soon as possible. Getting you back to your personal best is our ultimate goal.
If you have specific questions or would like one of our physicians to take a look at your collar bone injury, feel free contact us and set up an appointment right away.