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Anatomy

The clavicle is the bone that connects the trunk of the body to the arm, and it is located directly above the first rib. There is a clavicle on each side of the front, upper part of the chest. The clavicle consists of a medial end, shaft, and a lateral end. The medial end connects with the manubrium of the sternum and gives attachments to the fibrous capsule of the sternoclavicular joint, articular disc, and interclavicular ligament. The lateral end connects at the acromion of the scapula which is referred to as the acromioclavicular joint. The clavicle forms a slight S-shaped curve where it curves from the sternal end laterally and anteriorly for near half its length, then forming a posterior curve to the acromion of the scapula.

The location of the clavicle.

Prevalence

Clavicle fractures occur 30-60 cases per 100,000 a year and are responsible for 2.6-5% of all fractures. Fractures occur twice as much in males than females. About half of all clavicle fractures occur in children under the age of 7 and is most common pediatric fracture.

reference: http://www.drugs.com/cg/clavicle-fracture.html http://www.sportsmd.com/Articles/id/13.aspx

Risk Factors/Prevention

Those who have a low dietary intake of calcium and Vitamin D may have a higher risk of clavicular fractures. Increasing the integrity of the bone by a sufficient amount of dietary calcium and vitamin D will help to prevent fractures in the bone. Also, sedentary individuals may be at a higher risk due to weakness in muscle stabilizers of the clavicle. Also, participation in extreme sports such as mountain biking and snowboarding will increase the risk of a clavicular fracture as well.

http://www.thirdage.com/hc/c/clavicle-fracture-prevention

Mechanism of Injury

Clavicle fractures are commonly known as a breaking of the collarbone, and they are usually a result of injury or trauma. The most common type of fractures occur when a person falls horizontally on the shoulder or with an outstretched hand. A direct hit to the collarbone will also cause a break. In most cases, the direct hit occurs from the lateral side towards the medial side of the bone. The muscles involved in clavicle fractures include the deltoid, trapezius, subclavius, sternocleidomastoid, sternohyoid and pectoralis major muscles. The ligaments involved include the Conoid ligament and Trapezoid ligament. Incidents that may lead to a clavicle fracture include automobile accidents, horizontal falls on the shoulder joint, or contact sports such as football or wrestling.

Symptoms

Common signs or symptoms of a clavicle fracture consist of pain, swelling, tenderness, or bruising in the front part of the upper chest. In critical cases, the bone may puncture through the skin. In the event of a clavicle fracture, both the arm and shoulder will feel numb, tingly, and possibly weak with limited range of motion.

Treatment

The basic method to check for a clavicle fracture is by an X-Ray of the clavicle in order to determine the fracture type and extent of injury. In most cases, x-rays will be taken of both clavicle bones for comparison purposes. In more severe cases a computerized tomography scan (CAT scan) or Magnetic resonance imaging scan (MRI) will be taken. Medication can be prescribed to ease the pain as well as antibiotic or tetanus shot for any skin breaks. The arm must be supported by use of a splint or sling to keep the joint stable and decrease the risk of further damage. Usually, a figure-of-eight splint that wraps the shoulders to keep them forced back is used and the arm is placed in a clavicle strap for comfort. In severe cases, surgery may be needed in order to place bones in normal positions utilizing pins, plates, and screws to hold bones together.

Recovery

For proper recovery, a shoulder sling should be worn for two to six weeks for operative or non operative treatment based on individuals recovery level. The person is recommended to not lift obkects and to try to keep the elbow or wrist in the affected arm immobile. The next step in recovery is to recover range of motion by trying to complete overhead activities. Depending on the severity of fracture a person can begin to use the arm if comfortable with movement and no pain results. The final result is to be able to have full range of motion with no pain, therefore, if any pain exists it is best to allow for more recovery time. Depending on severity of the fracture, athletes involved in contact sports may need a longer period of rest to heal to avoid re-fracturing bone. A person should be able to return unrestricted to any sports or work by 3 months after the injury.