Injury · Collarbone
Broken collarbone? The bone is the easy part.
You land on your shoulder. Something cracks. A bike, a tackle, a patch of ice. The collarbone is one of the bones people break most often, and the medicine is usually simple: a sling, or a plate and screws, and time. The hard part is the weeks in between. Sleeping. Getting a shirt on. Cutting your food. Once you plan for one-handed life, the whole recovery gets calmer.
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One detail decides sling or surgery
The collarbone (clavicle) runs across the top of your chest, from the breastbone to the shoulder. It usually breaks in a fall onto the shoulder, a fall onto an outstretched hand, or a direct hit in a crash or contact sport.
The tell-tale signs: pain when you move the arm, a shoulder that sags down and forward, and a bump or bruise over the bone. An X-ray confirms it.
Then the key question: how far out of place are the broken ends?
Still lined up? The usual plan is a sling or brace, pain relief, and time. There is no cast for a collarbone. You move your hand, wrist and elbow early, and add gentle shoulder exercises once the bone starts to heal.
Far apart, or overlapping so the bone is shorter? Surgery is more likely. The surgeon lines the pieces up and holds them with a plate and screws, or with pins. Plates usually stay in. Pins usually come out once the bone heals.
Both routes have trade-offs. Without surgery, a bone can heal slowly, partly, or out of position, and a bump may stay (it usually shrinks). Surgery can bring infection, numbness below the collarbone, or a plate you feel under a seatbelt or backpack strap. Smoking, diabetes and older age raise some of these risks.
INSIDER TIP
If you are offered a choice, ask to look at the X-ray together. Ask the clinician to point to the gap or overlap and say in plain words why this break leans one way. You decide more calmly once you have seen it yourself.
How long it really takes
Children may heal in 3 to 6 weeks. Adults may need up to 12 weeks. Full healing can take several months, often longer with diabetes or tobacco use. Most people are back to regular activities within about 3 months. Contact sports wait until the bone has fully healed and your doctor says go.
Lifting or using the arm hard before you are cleared can make the pieces move. When you restart something, build up slowly.
WHERE THIS COMES FROM
Causes, signs, the sling-or-surgery decision and the healing times are from the American Academy of Orthopaedic Surgeons' patient site, OrthoInfo, and MedlinePlus (U.S. National Library of Medicine). Links at the end.
The real work: life with one arm
For a few weeks, one arm does the job of two. This is exactly what an occupational therapist (OT) is for. They look at the tasks that matter to you and show you a different way to do them, or a tool that helps. Things worth asking an OT or your clinician about:
- Sleeping: which position is safe for the break, and whether the sling stays on at night.
- Dressing: the order to put clothes on and take them off, and which clothes make it easier.
- Washing: how to manage the sling, and whether it can come off for a shower.
- Work and driving: what is safe, and when.
Take rings off the hand on the injured side until your clinician says it is OK.
Later, physical therapy (PT) brings back shoulder motion and strength, gently at first. For how PT and OT differ, and what Medicare and other plans pay, see PT and OT after an injury.
Questions to ask:
"How far out of place is the break, and why do you lean toward a sling or surgery?"
"How long do I wear the sling, and what should I avoid until the next X-ray?"
"If I have surgery, will the hardware stay in? What happens if I choose not to?"
"Can you refer me to an occupational or physical therapist, and when should that start?"
When to call right away
- Numbness or tingling in the arm or fingers, or fingers that look pale, blue, black or white, or are hard to move
- Pain your medicine does not relieve, or redness around the collarbone
- Bone pushing against or through the skin, or a new change in the shape of the shoulder
- Trouble breathing or shortness of breath
The 60-second recap
- The medicine is usually simple. The weeks with one arm are the real work.
- Pieces still lined up: usually a sling and time. Far out of place: surgery is more likely.
- Children may heal in 3 to 6 weeks, adults in up to 12. Most are back to regular activities in about 3 months.
- An OT helps with sleeping, dressing and daily tasks. PT rebuilds the shoulder.
- Numbness, color changes in the fingers, bone near the skin or trouble breathing: call right away.