A fractured collarbone (clavicle) can be treated either conservatively (i.e. non-surgically) or surgically. The doctor who examined the fracture on the x-ray will decide which form of treatment is most suitable.
Non-surgical treatment is particularly appropriate for closed fractures in the mid-shaft region. 90% of fractures in this area do not require surgery. However, despite the remarks above, surgery will be required if the fracture is open and/or additional blood vessels have been injured. The pros and cons of surgical or conservative procedures must always be discussed with the patient and attending physician. Along with the obvious arguments in favour of a conservative approach, there are many relative conditions that must be weighed against each other (e.g. significant displacement of the individual bones, pressure on soft tissue, fractures right next to the shoulder blade, fractures that have not healed with conservative treatment, recurrent fractures etc.).
Conservative treatment consists of immobilising the fractured collarbone with a sling or a so-called clavicle bandage. For this, the doctor places a traction bandage around both shoulders, pulls it tight at the back and fastens it. This procedure pulls the shoulders back, aligning the broken ends and holding them in place. During the first week, the clavicle bandage should be tightened daily and its position checked regularly.
The fracture will take six to eight weeks to heal, although you will only have to wear the sling or clavicle bandage for three to four weeks. Afterwards, physiotherapy will help restore the shoulder’s full range of movement.
However, despite the remarks above, surgery will be required if the fracture is open and/or additional blood vessels have been injured.
Collarbone surgery takes place under general anaesthetic. The surgeon starts by putting the bone back in its original position and repairing any damaged blood vessels. Afterwards, the ends of the break are fixed, for example by screwing metal plates to the bone (plate osteosynthesis). If the plates cause difficulties, they are usually removed after 1 ½ to 2 years. However, if the patient has no symptoms, the plates can stay in their body for the rest of their life.
After the surgery, the patient receives a so-called Gilchrist bandage which fixes the arm and thus immobilises the shoulder.
If the fracture is located in the outer third of the collarbone, the surgery may also involve the implantation of so-called “hook plates”, which will remain in place for six to eight weeks. After the operation to repair the fracture, the range of motion in your shoulder will be limited until the plates are removed.
If a collarbone fracture is treated surgically, you can expect the healing process to take about twelve weeks.
Here you will find the ICD-10 code for “Fracture of clavicle”
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University Hospital Zurich
Department of Traumatology