The clavicle (collarbone) is one of the most frequently fractured bones in the body. It is the bone that connects the entire arm and shoulder to the rest of the body. It was once assumed that all clavicle fractures healed without any problems except for a bump. Research has demonstrated that certain types of clavicle fractures are less likely to heal. As a result, all clavicle fractures should be carefully evaluated and the treatment options discussed. Rarely is this fracture an emergency. As a patient you have 2-3 weeks to make a decision as to whether or not surgery is appropriate.
When the decision to proceed without surgery is made, we recommend obtaining x-rays for the first few weeks after the injury. The purpose is to make sure the bone doesn't continue to separate. This is not uncommon because as you start to move around the weight of the arm pulls down and the muscles that connect to the clavicle tend to pull it up. Most patients are treated in a sling during this period. Most people notice some improvement in pain as the fracture begins to heal. We allow movement of the shoulder as tolerated. However, weight lifting restrictions are placed until the bone has healed. It is common to see it written that it takes 6 weeks to heal. We have not found this to be the case except in younger children. Most people take significantly longer to heal.
If the decision to proceed with surgery is made, a plate and screws are used to fix the bone. Most patients go home the same day. While we place restrictions on weightlifting, there are no restrictions on motion. Patients do return to normal activities of daily living sooner when the fracture is fixed. However, we don't allow full return to jobs requiring physical labor or participation in sports until the fracture heals. Again, this is not the 6 weeks that is typically reported. These fractures usually take 3 months to heal.