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Fixation of Clavicle Fractures: A Complete Guide

Collarbone, also known as the clavicle, is commonly fractured bone in the body after a collision or fall onto the shoulder. Our body has two collarbones and each clavicle joint with the top of the sternum to the shoulders. The clavicle bone is a slight S-shape that can be easily seen in many people. It joints to the sternum with cartilage called the sternoclavicular joint. The shoulder area at a part of the scapula is called the acromion at the other end. This fracture is so common that it accounts for about 5% of adult fractures. 

By wearing a sling to keep the arm and shoulder from moving while the bone heals, many clavicle fractures can be treated. In some cases, when the injury occurs, the pieces of bone move far out of place. In such cases, surgery is done to realign the collarbone.

Common causes of clavicle fracture

A direct blow to the shoulder is the most often cause of clavicle fractures. It generally happens due to accidents when a person falls onto the shoulder like a car collision. Sometimes a sudden fall onto an outstretched arm can also cause a clavicle fracture. In infants, this happens during the passage through the birth canal. Let’s see some common causes of clavicle fractures.

  1. Falls onto your outstretched hand or puts pressure on your shoulder. 
  2. Common sports injuries on the ground as a direct blow to your shoulder on the field, rink, or court.
  3. Vehicle accident trauma due to car, motorcycle, or bike accident.
  4. Birth injury during passing through the birth canal.

How do you find out about a clavicle fracture?

symptoms of calvical fracture

Swelling results from bleeding from the blood vessels inside and surrounding the bone when it breaks. Additionally, the broken bone hurts because minuscule nerve endings near the bone have been damaged. The angle between the broken ends of the bone can occasionally induce a malformation down the length of the bone. Typically, a broken collarbone causes intense agony and swelling, as well as the possibility of a noticeable deformity. Any attempt to move the arm is frequently met with agony at the fracture site. Obtaining an X-ray of the area is the only way to determine whether there is a fracture.

Symptoms of clavicle fracture

Collarbone gets cracked in Clavicle Fracture and it is very painful. The patient may feel swelling or tenderness around that injured part. The paint can also feel bruising to the skin. This is rare but also possible that a patient may have bleeding if the bone has damaged the tissue and skin. If nerves in the arm are hurt, then the patient may have numbness or pins. The shoulder of the patient may be slumped forward or downward due to the weight of the arm as the collarbone is not providing support. It is also seen that the patient is feeling snapping or grinding noise in clavicle fracture. If the case is severe then the bone may poke through the skin.

Differential diagnosis of clavicle fracture 

Acromioclavicular joint damage, rib fracture, scapular fracture, shoulder dislocation, rotator cuff injury, and sternoclavicular joint injury are among the conditions that might coexist with a clavicle fracture. It is crucial to thoroughly assess any potential side effects of clavicle fractures, such as pneumothorax, brachial plexus injury, and subclavian vascular injury. A neoplastic or inflammatory condition could resemble a clavicular stress fracture.

Treatment of clavicle fracture

With a straightforward triangle sling to support the arm and keep the bones together in their natural position, most fractured collarbones are allowed to heal on their own. Once the X-ray confirms clavicle fracture, the sling is usually fitted in the hospital. The painkillers will be given to you to relieve the pain.  

Implants used in clavicle fracture

Only serious injuries, such as those where the bone has broken through the skin, or situations where the bones have failed to line up and are severely overlapping, necessitate surgery under a general anesthetic. The collarbone can be repaired using a variety of methods. The most typical way of repair is to use a plate and screws to secure the break. Your surgeon will discuss the benefits and drawbacks of the approach they plan to use.

When should you refer to orthopedics?

With a sling and analgesics, the majority of clavicle fractures are quickly treated. If you notice such Indications, go to immediate consultation. 

  1. Open fractures
  2. Displaced medial third fractures
  3. Neurovascular injury with fracture
  4. Skin integrity at risk over the fracture
  5. Displaced lateral third fractures
  6. Pathological fractures

Middle-third fractures in older adolescents should also have an orthopedic assessment when there is:

  • Severe comminution or
  • Complete displacement (off-ending)
  • Shortening >2cm

What is the recovery time of clavicle fracture?

A fractured collarbone normally heals in adults in 6 to 8 weeks, however, it might take longer. Healing often takes 3 to 6 weeks in children. However, it will take at least that long again for your shoulder to regain its full strength. Your collarbone may develop a lump when the fracture heals. This is typical, and things usually get better during the coming months. On rare occasions, the fracture may not heal, necessitating surgery. Your surgeon should be consulted about this.

Suggestions to help you in recovery

  • If you have trouble sleeping, use more pillows at night to keep yourself more upright.
  • If pain and swelling persist while your arm is in a sling, try cold packs and pain relievers.
  • As soon as it’s comfortable, move your elbow, hand, and fingers frequently.
  • If it is not too painful, temporarily remove the sling (when you think the fracture has started to heal)
  • After the injury, refrain from participating in contact sports for at least 10 to 12 weeks. Your doctor will let you know when you can return to work and your regular activities.

Different orthopedic implants used in clavicle fracture

Bone is a special type of tissue that can regenerate after suffering harm. The correct alignment and healing of some fractures and abnormalities, however, necessitate professional intervention. Careful evaluation of the material used to make the implants needed to treat these issues is required, just like with any implant. If the wrong material is used, the implants themselves may result in bone fractures, deformities, or incomplete bone healing.

Plate osteosynthesis and intramedullary nail fixation are the most common surgical method to treat clavicle fractures. If we look into history, intramedullary nailing or plates have more successful and long-term results. Plate osteosynthesis can be performed minimally invasively (less invasive stabilization system [LISS] or minimally invasive plate osteosynthesis [MIPO]) by using dynamic compression (DCP) or anatomic plate, locked or unlocked. 

Conclusion

After seeing the wide usage of implants and the necessity of manufacturing them with the best quality, Zealmax Ortho steps in to provide required standard quality implants to the world, e.g. LCP Clavicle Hook Plate 3.5 mm, LCP Superior Anterior Clavicle Plate with Lateral Extension 2.7/3.5mm and LCP Clavicle Hook Plate 3.5 mm. We follow the WHO standard to produce high-quality, precise, and uniform orthopedic implants for clavicle fractures.

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