Clavicle Fracture, AKA Broken Collar Bone:
Clavicle Fractures are among the most common broken bones in kids. These usually happen after a fall on the shoulder or arm, with falls off a bicycle being a particularly common cause of the injury.
It is usually easy to tell if it’s broken; there is pain over the collarbone and there may be obvious deformity such as the ends of the broken bone pressing up on the skin. An x-ray will confirm the diagnosis.
The treatment of a clavicle fracture is quite simple. It is often said that if the ends of the broken collarbone are in the same room, they will heal! All that is usually required is a sling for comfort or perhaps a clavicle strap, a form of brace that puts pressure over the collar bone and provides some stability for comfort during healing. Clavicle fractures heal by making a “lump” of bone known as fracture callus, which serves to knit the two ends of the bone back together. Over time, the lump of bone will go away as the clavicle remodels back into its original shape.
Clavicle fractures in children almost never require surgery, and are generally well on their way to healing by 3 weeks (which is about as long as you can continue to keep your child in a sling, anyway). There are a few exceptions; if the bone comes through the skin (rare), it will need surgery right away. In the rare instance that the fracture does not heal on its own, we often think that there might be a rare condition known as congenital pseudoarthrosis of the clavicle (which is always on the right side). This is shown in the next two pictures, and surgery with a plate and screws is often needed to fix this problem.
This is the pre-operative xray of a clavicle fracture that has not healed. Notice how the ends of the bone are rounded and remodeled and there is still a gap between the two ends of the fracture.
While this procedure is rarely used, this is an example of surgery in which a plate and four screws were used to stabilize the fracture fragments, close the gap between them, and allow for ultimate healing of the broken bone.