Fractured Clavicle
Date issued: December 2021
For review: December 2023
Ref: A-404/MY/Physiotherapy/Fractured clavicle v3
PDF: clavicle fracture leaflet final March 2019.pdf [pdf] 875KB
Anatomy
The collarbone (clavicle) is located between the breastbone (sternum) and the shoulder blade (scapula), and it connects the arm to the body.
Three types of fractured clavicle:
1. Middle one third of the clavicle (the shaft) generally treated conservatively (without surgery).
2. Lateral one third of the clavicle (the acromial end) - treated with immobilisation, but can require surgery.
3. Medial one third of the clavicle (the sternal end) generally treated conservatively (without surgery).
The fracture can be described as:
Nondisplaced. The pieces of the fractured bone remain lined up.
Displaced. The two parts of the fractured bone do not line up.
Comminuted. Splinters or small pieces of bone are found at the fracture site.
Compound. When the bone pierces (goes through) the skin.
Precautions:
No arm raising: Do not raise the arm above shoulder height for approx. 6 weeks.
No lifting: Do not lift anything over 2kg/5lbs for approx. 6 weeks
Use ice: Ice the injured shoulder for 15 minutes 3-4 times per day as needed to help reduce pain, swelling and inflammation.
Sling advice: You may be given a sling to wear for comfort during the day for up to 2 weeks. At night you can use pillows to help support the arm for comfort. You will gradually start to wean out of the sling as directed by your Physiotherapist or Consultant.
You will be guided on all the above in Fracture Clinic.
You may experience the following symptoms:
· Pain or discomfort
· Stiffness and reduced range of movement.
· Decreased strength and loss of muscle bulk.
· Swelling
· Inability to perform daily activities
Daily activities
You may find certain activities difficult due to pain, or reduced mobility. The Occupational Therapist can support you by assessing you for equipment to make tasks easier. Equipment needed can be provided for discharge from hospital. If your mobility is reduced you will be seen by the Physiotherapist.
Washing and Dressing
When getting washed and dressed you will need to remove your sling. You need to avoid lifting your arm above shoulder height for approximately 6 weeks.
You will find it easier and less painful to undress your
injured arm last and to dress the injured arm first.
When you are washed and dressed you will need to reapply your sling. You may require assistance with this for up to 6 weeks.
Exercises:
To optimise recovery, start the exercises indicated in this leaflet as advised by your physiotherapist. Full recovery can continue up to nine months after initial injury. Further Physiotherapy treatment following fracture clinic is not always indicated. The main focus is to reduce pain, swelling and limit loss of movement at your shoulder joint.
· Ensure you bend and straighten your elbow, wrist and fingers through full range each day to prevent stiffness in these joints.
Frequently asked questions
When can I drive?
This can vary but you must feel confident to perform an emergency stop and able to use all your controls. You may need to inform DVLA of your injury.
When can I return to work?
You may need to take some time off work. The doctors in fracture clinic/G.P can sign you off.
When can I return to leisure activities?
This will vary dependant on your pain, range of movement and strength in your shoulder. You should avoid heavy lifting for approximately 6 weeks. You can return to sports with guidance from your physiotherapist.
Further advice and useful links:
If after 4 weeks you are struggling to regain function and range of movement you can self-refer to physiotherapy using the following link or via your GP:
http://www.plymouthhospitals.nhs.uk/ourservices/clinicaldepartments/physiotherapy/Pages/SelfReferral.aspx
Further advice on health related issues can be found on the NHS Choices website: http://www.nhs.uk/pages/home.aspx
