Clavicle fracture

Clavicle fracture typically presents in young age groups (<30 years), particularly active males, with moderate to severe pain at the fracture site following a direct fall on the shoulder (e.g., while playing sports), a road traffic accident, or other high-energy injury. The pain is worsened by shoulder range of motion or trying to use the injured extremity.

Older age (≥65 years) is a risk factor for low-energy mechanism clavicle fractures (e.g., a fall onto an outstretched hand from ground level). In this group, clavicle fractures are more common in women than in men.

Once a trauma survey has been completed, perform a focused examination of the clavicle and shoulder girdle. Assess any soft tissue swelling and ecchymosis in the area of the clavicle. Determine point tenderness on palpation; gross deformity may be present if the fracture is displaced and/or angulated.

Order clavicle x-rays for all patients with suspected clavicle fracture. You may also need to include chest and scapula x-rays.

Immediately consult an orthopaedic surgery specialist for open fractures, which should be treated with urgent surgical intervention.

For closed injuries, decisions on surgical versus conservative management will be based on clinical factors, such as the fracture location and any displacement or shortening, combined with patient factors and preference.

A clavicle fracture is an abnormal disruption in the continuity of the clavicle bone and is often referred to as a broken collarbone.