Clavicle Fracture Info
Last reviewed
Clavicle fractures — when conservative management is fine and when fixation is indicated.
What you're feeling
Most of the time, you will feel pain after falling on your shoulder or taking a direct blow. You might have hurt yourself in a car crash, a sports game, or a fall. The pain is usually right on the collarbone. It often feels worse when you move your arm or try to lift anything heavy. Simple tasks like reaching behind your back to fasten a bra or tucking in your shirt can become very difficult.
You may find it hard to sleep at night. Lying on the injured side usually hurts, so you might struggle to find a comfortable position. The pain can also flare up when you wake up in the morning. Even though the injury is in your shoulder area, the pain often travels down your arm. This happens because the collarbone connects your arm to your chest.
If you are a teenager, your pain might be more intense if you were playing sports like football. Most of these injuries happen on the side of your body you do not use for writing. While the pain can be sharp at first, it often settles down with rest. Your surgeon will check if there are any other injuries to your shoulder area. Most people find that their symptoms improve as the bone heals, though some may feel a lump where the bone joined.
What's actually happening
Most of the time, you break this bone after falling on your shoulder or taking a direct hit. This injury often happens during car accidents, sports, or simple falls. The bone is a long strut that connects your chest to your shoulder, and when it snaps, that connection is broken.
The good news is that your body can heal this well. Whether you choose surgery or rest, most people recover fully. Even if the bone heals in a slightly crooked position, it rarely causes long-term pain or stiffness in the shoulder joint later on. The main risks are that the bone might not knit together at all, or it might heal in the wrong shape.
For younger patients, the body is very strong and usually heals best with just a sling and rest. Surgery is reserved for cases where the bone is broken into pieces, shifted far apart, or shortened by 2 cm or more. Your surgeon will look at exactly how the bone is broken and what you need to get back to your daily life before deciding on the best path for you.
What we can do about it
Most clavicle fractures heal well without surgery. You can start with rest and gentle movement to manage pain and keep your shoulder mobile. Physiotherapy aims to restore your range of motion and strengthen the muscles around the collarbone. Your surgeon may suggest close follow-up visits because the bone can shift slightly in the early weeks after injury. For most patients, this conservative approach leads to excellent results over time.
Pain medication and anti-inflammatories help you stay comfortable while the bone heals. If you have a nonunion where the bone fails to join, your surgeon might discuss bone marrow injection. This treatment shows promise with low risk and early success in helping the bone knit together. For other shoulder issues, cortisone or hyaluronic acid injections may be used to reduce swelling and pain, though the evidence for clavicle fractures specifically focuses on non-surgical healing. Once the fracture has healed, further imaging does not provide useful information.
Surgery is considered when conservative care is not enough or when specific risks exist. Your surgeon may recommend fixing the bone with a plate and screws if you have a completely displaced fracture with shortening of 2 cm or more. This option is also discussed for older adolescents with less growth remaining or cases where the bone fails to unite on its own. While surgery offers higher union rates and better early results for some adults, long-term outcomes often remain similar to non-surgical care.
When to see someone
See your GP if you have persistent pain that does not improve with rest, or if your shoulder feels weak or unstable. Ask for a specialist review if you experience locking, a feeling that the joint is giving way, or symptoms that stop you from sleeping or working. Seek immediate help if your pain suddenly gets worse. Most fractures happen after a fall onto the shoulder or a direct blow. While many heal well, some people face complications like non-unions where the bone does not join. If you have a medial fracture, close follow-up is important because a high proportion of patients may die within 3 years of the injury. Once the fracture has healed, further imaging usually does not provide useful information.
