Collarbone fractures, also known as clavicle fractures, are among the most common fractures in the human body. A fracture of the collarbone (clavicle) is usually caused by a fall on the shoulder or on the outstretched arm.
Below you will find further information and selected clavicle fracture specialists.
The clavicle (collarbone) fractures either as a result of direct impact trauma or when falling on the outstretched arm. In the latter case, an indirect mechanism with axial compression can occur, which leads to the fracture.
The clavicle often breaks in the middle area (70 percent) or in the medial third. Medial refers to the end of the bone towards the center of the body. Lateral, on the other hand, refers to the end further away from the center of the body.
According to Jäger and Breitner, fractures of the lateral third are divided into
Typically, the medial fracture protrudes upwards and can even protrude through the skin. In the case of a collarbone fracture, there is also pain when moving the shoulder.
The blood vessels or nerves may also be affected. The doctor should therefore check the patient's pulse and the function of the median, radial and ulnar nerves.
The doctor will examine the patient and may take x-rays of the clavicle in 2 planes (a.p./axial).
Clavicle fractures in conjunction with scapula fractures (scapula = shoulder blade) in the glenoid neck area lead to the so-called "floating shoulder". In this case, surgery is absolutely indicated.
In milder cases, conservative treatment, i.e. without surgery, may be sufficient to treat the collarbone fracture. These include simple shaft fractures in the medial and middle third with barely displaced fracture ends.
Immobilization can be achieved with an arm sling or a backpack bandage. The pulse status and sensitivity must be checked after the backpack bandage is applied and each time it is tightened. Re-tensioning should be carried out once or twice a day in the first week and once a week in the second and third week. The shoulder should be released after three weeks.
Type I and IV lateral fractures according to Jäger/Breitner are also treated conservatively. The backpack bandage does not work on the lateral clavicle. Lateral fractures can therefore only be immobilized with an arm sling.
Surgery is indicated if
Type II and III lateral clavicle fractures according to Jäger/Breitner must also be treated surgically due to the high instability.
During surgery, plates and screws can be used to fix the fracture sites. This is known as osteosynthesis.
All fracture types can be primarily immobilized if the affected extremity retains sensitivity and pulse.
In conservative therapy, attention must be paid to
should be noted. As a rule, osteosynthesis material removal is necessary after surgical treatment due to the thin soft tissue mantle over the clavicle.
The clavicle fracture heals stably with conservative and surgical treatment. Remodeling of the bone can take up to two years.
Surgical treatment of a clavicle fracture has a higher risk of pseudarthrosis(two to nine percent).
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