What is the collarbone?

The collarbone (clavicle) is one of the main bones of the shoulder joint. It holds the shoulder up and, along with the shoulder blade (scapula) and acromioclavicular (AC) joint, provides stability and strength to the shoulder. The collarbone also protects nerves and blood vessels from the neck to the shoulder.

What causes a broken collarbone?

A broken collarbone is usually caused by falling on an outstretched arm or by direct contact to the collarbone or to the shoulder. This often occurs when playing sports such as football, wrestling, or ice hockey.

The collarbone is one of the most commonly broken (fractured) bones. Young men ages 13 to 20 break it most often. Younger children have greater chances of a broken collarbone during play.

What are the symptoms?

Symptoms of a broken collarbone include:

• Immediate pain after falling or being hit on the collarbone or in the shoulder area.
• Inability to raise the affected arm because of pain.
• A grinding feeling when trying to lift the affected arm.

The affected shoulder does not always appear out of position, but if a deformity is present, it appears as a bump or swelling along the collarbone at the AC joint. The bone rarely breaks through the skin, but it may push the skin out, causing a tentlike appearance.

A broken collarbone usually is not a serious injury. In rare cases, a broken collarbone can injure a lung or rib or pinch nerves or blood vessels. This may cause the arm to turn pale, tingle, and feel cool or numb.

How is a broken collarbone diagnosed?

Your doctor can usually diagnose a broken collarbone by asking you questions and examining you. Your doctor will check:

• The affected area and look for a lump or bump.
• Blood flow, by taking your pulse and checking your skin color and temperature.
• For damage to your nerves and blood vessels.
• How well you can move your shoulder and other joints.
• The muscle strength of your shoulder.

Your doctor will usually do an X-ray to pinpoint the location and severity of the break.

How is it treated?

Most broken collarbones heal on their own, and surgery is rarely needed. You will use a sling to keep your arm and shoulder from moving while the bone heals. An adult wears a sling for a few days or up to a week; a child may need one for 3 to 4 weeks. A figure-8 strap may also be used, especially in children. The strap may need to be adjusted occasionally to keep the shoulder in the correct position.

You can begin simple exercises immediately and move on to strengthening exercises if they don't cause pain. Ask your doctor when it is safe to begin to exercise. If you start too soon, the broken collarbone may not heal well. If you are active, do not play sports or other activities until you can move your shoulder easily and it feels strong.

To help relieve pain, try acetaminophen or a nonsteroidal anti-inflammatory drug, such as aspirin, ibuprofen, or naproxen. Do not give aspirin to anyone younger than 20 because of the risk of Reye's syndrome.

Occasionally, surgery may be recommended for severe breaks.