Non-surgical treatment is particularly suitable for closed fractures in the middle third. In 90% of the injuries there, surgery is not required. Despite the above, however, surgery is necessary in cases of open fractures and/or additional vascular injuries. The pros and cons of surgical versus conservative treatment should always be discussed with the patient and the treating physician. In addition to the clear arguments in favor of a conservative approach, there are many relative factors that must be weighed against one another (e.g., significant displacement of individual bones, pressure on soft tissues, fractures located very close to the scapula, fractures that have not healed with conservative treatment, and recurrent fractures).
Conservative Treatment of a Clavicle Fracture
Conservative treatment immobilizes the fractured collarbone. This can be done using either a sling or what is known as a backpack-style bandage: To do this, the doctor will apply a tension bandage around both of your shoulders. At the back, he or she pulls it tight and secures it. This procedure pulls the shoulders backward, thereby realigning and stabilizing the fractured bones. During the first week, the compression bandage should be tightened daily, and its position should be checked regularly.
The recovery period is six to eight weeks, during which you will need to wear a back brace or sling for three to four weeks. Afterward, physical therapy can help restore full range of motion in the shoulder.
Surgery for a Clavicle Fracture
Despite the above, however, surgery is necessary in cases of open fractures and/or additional vascular injuries.
Surgery for a clavicle fracture is performed under general anesthesia. First, the surgeon realigns the bone to its original position. In doing so, he or she treats any injured blood vessels. Next, the fracture ends are stabilized: Metal plates, for example, are suitable for this purpose, as they connect the bones using screws (plate osteosynthesis). They are usually removed after 1½ to 2 years if any abnormal findings are detected. However, in patients who are asymptomatic, the plates can also remain in the body for life.
After the surgery, you will be fitted with a so-called Gilchrist bandage for three to four days, which will immobilize your arm and thus keep the shoulder joint still.
If the clavicle fracture is located in the outer third of the clavicle, surgical treatment may also involve the use of so-called hook plates, which remain in place for approximately six to eight weeks. Until the material used to treat your clavicle fracture has been removed, you should limit the movement of your shoulder joint.
After surgery for a clavicle fracture, you should expect the healing process to take about twelve weeks.