Repair of Fractures

Clavicle fracture

The collar bone or clavicle is a long bone, connecting the chest breast bone to the shoulder blade.

A fracture of collarbone or clavicle fracture is a common in people of all ages. It may be caused by a direct blow to the shoulder, a fall on the shoulder, road traffic accident or a fall onto an outstretched arm.

The clavicle fracture can be very painful, and aggravated by shoulder movements. The patient can also notice swelling and tenderness over the fracture site. Sagging of the shoulder may also be noticed. It may be associated with a deformity or ‘bump’ and bruising over the fracture. Movement of shoulder may produce a grinding or cracking sound.

Diagnosis

The diagnosis of a clavicle fracture comprises of physical examination and X-ray.

Sometimes a CT scan may be used to evaluate the type, severity of fracture and other associated injuries.

Treatment

The management of clavicle fracture comprises of conservative and surgical approach. The choice of treatment depends on the type and location of fracture, and the needs of the patient.

Conservative management

Immobilisation

Immobilisation of the fractured by an arm sling is the common and preferred non-surgical modality of treatment. A sling supports the arm for comfort.

Medications

Pain relieving medications can be used to reduce pain from the fracture.

Physiotherapy

Prolonged immobilisation of fractured site may cause stiffness, reduction in muscle strength and the range of motion. Physiotherapy may be of value for some patients.

Surgical management

Surgery may be considered in patients with a displaced fracture or in cases where the bone has fragmented into several pieces. The common fixation procedures for clavicle fracture include plate and screw fixation method and pin fixation method.

In this surgery, the bone fragments are realigned into their normal position and held in place with the help of metal plates, attached to the outer surface of the bone, or a pin within the canal of the bone.

Surgical complications

Some of the patients may develop complications, after the surgery. Use of tobacco products, diabetes and advanced age increases the risk of complications. The common complications include infection, bleeding, pain, difficulty in bone healing and hardware irritation. Damage to blood vessels and nerves are rare but can be serious.

Rehabilitation

Post-operative rehabilitation includes a specific exercise program to restore movement and strengthen the shoulder. The exercise program involves gentle motion exercises and strengthening exercises to improve the quality of life of the patient, post-surgery.