Do You Need Clavicle Fracture Repair? Surgery vs Immobilization For A Collarbone Injury

How To Treat A Broken Collarbone

The clavicle is an important bone in the shoulder that runs between the ribcage and shoulder blade. This bone connects and stabilizes the arm to the rest of the body. Clavicle fractures often occur when someone gets into a collision or falls on an outstretched arm, causing the bone to snap. Any individual with this injury should see a doctor immediately, who will decide the best course of treatment. In some cases, immobilizing the joint is best, while other injuries require surgery.

Symptoms and fracture types

All clavicle fractures are not the same. The long length of the bone means the injury can occur in either the medial, midshaft, or lateral regions. About 80% of injuries happen in the midshaft region. Lateral fractures can occur with or without the clavicle’s ligaments still attached to the shoulder blade. Finally, medial fractures are located near the ribcage, a rare occurrence that doesn’t typically require surgery. Collarbone fractures often cause severe pain, swelling, instability, and reduced function. Other symptoms include difficulty raising the hand, a bump or swelling at the fracture site, and clicking of the shoulder.

Let’s keep it in place

Any person with a suspected fracture should see a doctor immediately. The medical team will perform x-rays and physical tests to confirm the location and severity of the fracture. In almost all cases, the team will use immobilization for a collarbone injury. This method holds the arm in a specific position to encourage the bone to fuse and heal naturally. The doctor will set the bone and then use a sling to keep the shoulder in place. The patient will then receive pain medication and physical therapy (PT) as the bone heals.

Time for surgery?

Sometimes, the fracture may be too severe for immobilization. For instance, if the clavicle is broken in multiple places or the bone has shifted too far out of place, an operation may be required. Studies also show that 30% of immobilization cases fail to fuse or do so incorrectly. When this happens, surgery is best. An orthopedic surgeon will perform open reduction and internal fixation (ORIF) to help with repair. With ORIF, the bone is manually set back to the original position. Next, the surgeon will use metal plates, screws, or pins to hold the bone in place. The bone will heal with time, and the patient can gradually resume normal activities.

Which option is best?

In most cases, the patient does not need clavicle fracture repair. Immobilization, PT, and pain management are quite effective for healing. However, surgery is best if the injury is severe or immobilization fails. With minimally invasive surgery (MIS), the patient can resume activities faster thanks to smaller scars and faster healing time. With clavicle fractures, the goal is to act immediately, which can help avoid surgery. At the same time, don’t be afraid to have a clavicle repair performed if the doctor believes this is the best course of action.