Diagnosis and Causes of a Clavicle Fracture

Clavicle (collarbone) fractures make up 44% to 66% of all shoulder fractures. ¹ Egol K, Koval KJ, Zuckerman J. Handbook of Fractures 5th edition. China: Wolters Kluwer Health; 2014. A doctor can usually diagnose a clavicle fracture during a physical evaluation, but X-rays and other tests are usually recommended.

See The 3 Types of Shoulder Fractures

Diagnosing Clavicle Fractures

X-rays will be taken to determine the location and extent of the injury. In some cases, X-rays are necessary to distinguish between a clavicle fracture and an injury to the joint at the top of the shoulder, called the acromioclavicular joint. A CT scan may also be ordered for more detailed images.

During the physical examination, the physician may do the following:

• Note areas of tenderness
• Observe skin discoloration
• Look for deformities
• Address any open wounds
• Palpate (touch) the shoulder blade and ribs to determine if there is an accompanying injury
• Listen to the lungs with a stethoscope, and observe variations in breathing
• Evaluate the shoulder’s range of motion

A doctor may conduct a neurological examination to make sure that sensation and motor functions are normal. ² Burnham JM, Kim DC, Kamineni S. Midshaft Clavicle Fractures: A Critical Review. Orthopedics. 2016;39(5):e814-21. The clavicle is located near a series of nerves found based in the neck and shoulder called the brachial plexus. Injury to the brachial plexus is uncommon, but can occur with a clavicle break.

The physician will also ask about the patient’s medical history, how the injury occurred, and any symptoms associated with it.

Common Causes and Risk Factors of Clavicle Breaks

They may be caused by:

• An athletic event resulting in a direct hit or fall. Sports-related clavicle fractures are commonly seen in children and young adults. Caution is advised when playing contact sports—including football, rugby, and hockey—and when participating in “extreme” sports where falls can happen—such as biking and skateboarding.
• A fall on the shoulder or an extended arm.
• A direct hit to the shoulder in a motor vehicle collision.

Falling on the shoulder is the usual cause of clavicle fractures.

• Young age, reaching a high point between the ages of 10 and 19. The clavicle is not completely developed until about 20 years of age.
• Advanced age in both males and females over the age of 70. ⁴ van der Meijden OA, Gaskill TR, Millett PJ. Treatment of clavicle fractures: current concepts review. Journal of Shoulder and Elbow Surgery. 2011: 1-7. Found in Stanley D, Trowbridge EA, Norris SH. The mechanism of clavicular fracture. A clinical and biomechanical analysis. J Bone Joint Surg Br 1988;70:461-4.
• The onset of osteopenia, which is the early stage of decreased bone mass that can eventually lead to osteoporosis.

While certain people are at greater risk for a clavicle fracture, they can affect anyone.