Collarbone (Clavicle) Fracture

What Is It?

When a bone breaks or cracks, the injury is called a fracture. In the collarbone (clavicle), fractures can happen in three separate areas:

• The outer third of the collarbone is near the tip of the shoulder. Fractures here usually are caused by an accidental fall or some other type of direct impact (football tackle, hockey check, car collision) that transmits force to the side or top of the shoulder. Fractures in this area account for about 15 percent of all collarbone fractures.
• About 80 percent of all collarbone fractures occur in the middle third of the bone. A fracture here usually is related to a fall on an outstretched arm. This area also can be fractured by a direct impact to the middle of the collarbone, especially during stick sports, such as hockey or lacrosse.
• The third nearest the breastbone fractures rarely. Fractures in this portion of the collarbone almost always are caused by a direct blow to the front of the chest, often from a steering-wheel impact during a car crash.

The collarbone is broken more often than any other bone in the body. About 64 out of every 100,000 people in the United States break their collarbones every year. In most collarbone fractures, the ends of the fractured bone do not move apart widely, and the area of tissue damage involves only the collarbone. In rare cases, a sharp portion of the fractured bone either will pierce the surface skin (an open fracture), or cut into one of the large nerves or blood vessels that travel through the shoulder. In severe impact injuries, it is also possible for a portion of the fractured collarbone to penetrate the upper portion of the lung, causing serious breathing problems.

Symptoms

Common symptoms of a fractured collarbone include:

• Pain, swelling and tenderness along your collarbone
• Pain when you try to move your shoulder or arm
• Slumping of your shoulder downward, forward and inward
• Abnormal contour of your collarbone — The fractured area may cause an abnormal bump along the length of your collarbone, or it may poke forward to produce a sharp point under the skin at the front of your shoulder. In rare cases, the end of the broken collarbone may penetrate through the surface skin and be exposed.
• Bruising or abrasions along your collarbone, or at the top or side of your shoulder

Diagnosis

Your doctor will examine your collarbone, shoulder and upper chest for swelling, deformity, abrasions, bruising and tenderness along the length of your collarbone. Your doctor also will press and feel the injured area gently to determine the position of any broken bone fragments under the skin.