Treating a Clavicle Fracture

Most clavicle fractures heal with a combination of non-surgical treatments. Certain types of severe fractures may require surgery to insert plates, screws, or rods to hold the bone pieces in place.

Treatment Goals

Treatment aims to:

• Manage pain to improve comfort and function
• Keep the fractured bone immobilized and stable to promote healing

Regular physician appointments ensure that the fractured bone pieces are mending in their correct location, as the fracture can shift out of place.

Success Rates

The success rate of both surgical and non-surgical treatments for clavicle fractures is generally high,¹Waldmann S, Benninger E, Meier C. Nonoperative Treatment of Midshaft Clavicle Fractures in Adults. Open Orthop J. 2018;12:1-6. Published 2018 Jan 17. doi:10.2174/1874325001812010001^,2Axelrod DE, Ekhtiari S, Bozzo A, Bhandari M, Johal H. What Is the Best Evidence for Management of Displaced Midshaft Clavicle Fractures? A Systematic Review and Network Meta-analysis of 22 Randomized Controlled Trials. Clin Orthop Relat Res. 2020;478(2):392-402. doi:10.1097/CORR.0000000000000986and most people make a full recovery with appropriate treatment.

Individual outcomes vary depending on factors such as the severity of the fracture, the patient’s overall health, the physician’s skill and expertise, and adherence to treatment plans.

When Non-Surgical Treatment Is Recommended

Most cases of clavicle fractures are treated without surgery. Non-surgical treatment is typically the preferred option for group I midshaft clavicle fractures – which are the most common type and often heal well with non-surgical care.³Bentley TP, Hosseinzadeh S. Clavicle Fractures. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507892/

Types of Non-Surgical Treatments

Non-surgical management of clavicle fractures typically involves:

• Medication: Over-the-counter or prescription pain-relieving medication help reduce pain and include:
  • Acetaminophen (Tylenol): for mild pain
  • Codeine and acetaminophen (Tylenol with Codeine): for mild to moderate pain
  • Propoxyphene and acetaminophen (Darvocet N-100, Propacet): for mild to moderate pain
  • Hydrocodone and acetaminophen (Lortab, Norcet, Vicodin): for moderate to severe pain

NSAIDs are typically avoided because they reduce inflammation, which can delay or inhibit bone healing and fusion.

• Immobilization: An arm sling or figure-of-eight bandage is typically worn after the break occurs to prevent arm movement as the collarbone heals and fuses. The sling is usually worn for several weeks until the broken ends of the collarbone have completely healed, which is confirmed on an x-ray.
• Physical therapy: Therapeutic exercises are recommended once the collarbone begins to heal.
  • Initial exercises include mild movements to ease stiffness.
  • More intense exercises are recommended after the bone fuses.

Physical therapy often continues for several weeks after the bone has healed to strengthen the shoulder muscles and reduce the risk of future injury.

When Surgery Is Necessary for a Clavicle Fracture

Surgery is typically required in cases where there is a high risk of complications or when the displaced bone cannot heal non-surgically. These situations include³Bentley TP, Hosseinzadeh S. Clavicle Fractures. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507892/:

• Neurovascular compromise: Damage to nerves or blood vessels in the area
• Open fractures: When the bone breaks through the skin
• Tenting of the skin: When the skin is pulled tightly in a conical shape over the fracture site
• Severe angulation or displacement: Significant misalignment of the broken bone ends
• Break in the skin near the fracture: Open wounds, which raise the risk of infection

While not always required, surgery may be recommended in the following cases³Bentley TP, Hosseinzadeh S. Clavicle Fractures. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507892/:

• Group II or lateral fractures: These happen near the end of the collarbone closest to the shoulder and are at a higher risk of complications
• Fracture shortening above 1.5 cm: When the clavicle becomes “shorter,” which occurs when the clavicle heals with angulation or overlapping of fractured ends
• Floating shoulder: A complex injury involving multiple shoulder fractures
• Polytrauma: Multiple injuries occurring simultaneously due to high-intensity trauma

Some patients or parents of children with a fractured clavicle opt for surgical treatment when the cosmetic appearance of the shoulder is significantly affected.

Clavicle Fracture Surgery

A common surgical procedure for clavicle fracture is open reduction and internal fixation (ORIF). This surgery involves exposing the fracture, realigning the bone fragments, and stabilizing them with plates, screws, pins, or rods.

Read more about Surgery for Clavicle Fracture (Broken Collarbone)

Post-Surgical Rehabilitation

The physician provides specific post-surgery instructions to fit the patient’s individual needs and goals. General guidelines include:

• Wearing a sling for 3 or 4 weeks after surgery.
• Icing the shoulder for 15 to 20 minutes several times a day to reduce swelling.
  Wrap the ice pack in a towel or cloth to prevent ice burn and wait for at least 2 hours before re-applying the pack.
• Restraining from lifting objects weighing over five pounds during the first six weeks post-surgery.
• Following up with the physician and getting the appropriate x-rays to confirm healing.
• Participating in physical therapy and exercises as formulated by the therapist.

Healing is generally slower in people who have diabetes or who use nicotine-based products (smoking, vaping, or chewing tobacco) since nicotine inhibits bone healing.

See Rehabilitation and Recovery After Clavicle Fracture Surgery