Clavicle Fracture
Treatments

Nonsurgical Treatment

Bone fractures generally take six to eight weeks to heal, though the pain from a clavicle fracture subsides after two to three weeks. Patients need to use a brace or sling for several weeks, even after the pain lessens, until a doctor says it's safe to discontinue its use. People who don't need surgery typically take between three and four months to make a safe return to full activity, including contact sports.

As part of the healing process, new bone will form around the fracture site, which often leaves a bump under the skin. This bump will remodel over the course of the following year and will decrease in size, but rarely disappears.

Surgical Treatment

Surgery is the best option if the clavicle's broken ends are pushing on the skin, if the ends are significantly overlapping, or if the ends are widely displaced. Surgery consists of repositioning the fragments and securing them in place with a plate and screws. This procedure, usually performed at the UCSF Orthopaedic Institute, takes about an hour and a half, with most patients able to return home the same day. Patients are under general anesthesia (completely asleep) and given a nerve block (an injection that interrupts pain signals in the area), which lessens post-op pain. While surgery does decrease the deformity created by a healed fracture, it will leave a scar on the skin.

After surgery, patients must wear a sling at all times for approximately four weeks and while standing up and moving around for two more weeks after that. Driving isn't allowed until patients no longer need a sling.

During weeks one to six, patients do a light physical therapy regimen to maintain range of motion in the shoulder, either in person with a physical therapist or by following a prescribed home exercise program. At six weeks, new X-rays are taken, and if the healing is acceptable, the sling is removed and more active range-of-motion and strengthening exercises are begun. X-rays are taken again at 12 weeks, and in a majority of cases, patients are allowed to return to sports and other physical activities.

Most patients live comfortably with the plate that was placed during surgery, but for about 15 percent of patients, especially those who are very thin, the plate is bothersome. In those cases, the plate can be removed after the fracture is completely healed, which ranges from six to nine months post-op.