Trauma and Orthopaedics
Introduction
This leaflet is for people who have a broken collarbone. This is known medically as a fractured clavicle. It includes information about what causes a broken collarbone, how it is treated and what to do when you get home.
What causes a broken collarbone?
It is a common injury that usually happens after a fall or a blow to the shoulder. The two collarbones, or clavicles, are long slender bones that run from the breastbone to each of the shoulders. You should be able to feel it each side at the top of your chest, just below your neck.
How is it treated?
Most broken collarbones are left to heal naturally. For closed clavicle fractures with no skin tenting, open wounds and no apparent damage to blood vessels or nerve, a sling is used to support the arm.
The sling is usually fitted after you have had an X-ray to confirm the collarbone is broken. We will give you painkillers to relieve the pain, if required.
Surgery, using a general anaesthetic, is only needed if the injury is severe; for example, where the bone has broken through the skin, compromising the skin or seems to be damaging a blood vessel or nerve. If you need surgery, you will be referred to the orthopaedic doctor who will discuss this with you.
What should I do at home?
Adults and children aged 12 years and older.
• Take painkillers such as paracetamol and ibuprofen to relieve the pain if you can take it (always read the label; do not exceed the recommended dose).
• Take your sling off at night.
• Take your sling off when resting, for example, when sitting watching television. Place a firm pillow under your arm. This will continue to take the weight of the arm off your injured collarbone/shoulder and make you more comfortable.
• Gently exercise your neck, elbow, wrist, and hand as pain allows. This is to prevent these areas from becoming stiff and painful.
• Avoid lying flat. This will make the pain worse in your collarbone/shoulder.
• Avoid contact sports and swimming for at least 12 weeks after the injury.
Children aged less than 12 years old.
• Give your child painkilling medicine, such as paracetamol and ibuprofen, if they can take it (always read the label; do not exceed the recommended dose).
• Never leave young children unsupervised when wearing a sling due to the risk of a strangulation injury.
• Sling use: Note that the broad arm sling is provided purely for comfort and is normally required for 2 to 3 weeks. Remove your child’s sling when they go to bed.
• Take your child’s sling off when they are resting, for example, when they are sitting watching television. Place a firm pillow under your child’s arm. This will continue to take the weight of the arm off your child’s injured collarbone / shoulder and make them more comfortable.
• If your child is restless or in pain during the night, try to sit them more upright. Lying flat increases their pain. Try putting a pillow under the mattress in younger children.
• Encourage your child to gently exercise their neck, elbow, wrist and hand as pain allows. This is to prevent these areas from becoming stiff and painful.
• Activity Restrictions: Avoid PE, heavy lifting, rough games, and contact sports (including swimming) for 6 weeks after the injury to allow the bone to strengthen.
Will my child, aged less than 12 years old, make a full recovery?
In children under 12, it usually takes about three to six weeks for the bone to heal.
While the fracture heals, a bony lump where the fracture was is often felt. This lump is a normal part of the healing process and will initially get bigger because of bone healing. Parents should be reassured that this is temporary and, in most children, the bump completely goes away by adulthood as the bone remodels and grows.
Follow-up care & Open Access.
For adults and children aged 12 years and older, a formal review appointment by the orthopaedic specialist is needed, usually via the virtual fracture clinic (VFC) appointment. The VFC appointment will need to be made by you at the Emergency Department reception before you leave.
Children under 12 who meet the criteria (no open wounds, no compromised skin, no damage to nerves or blood vessels), can be safely discharged from the ED without routine clinic follow-up.
If your child was discharged from ED without follow-up, and you have ongoing concerns, particularly if significant pain and/or limited movement persists 4 weeks or more after the injury, we provide an open access track to our ED clinic – you do not need to go to your GP.
You can book an appointment freely by calling the ED secretaries directly during working hours on 01384 456111 (Ext. 3140).
If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on (01384) 456111 and ask for the relevant department who issued this leaflet.
This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.