The clavicle, or collarbone, is the strut that connects the arm and shoulder to the chest. It is one of the most commonly broken bones in the body. Most clavicle fractures occur in the middle third of the bone, the midshaft, from a direct fall onto the shoulder, a sports collision, or a cycling crash.
The historical teaching was that nearly all clavicle fractures should be treated in a sling and left to heal. That has been refined. Many fractures still heal well non-operatively, but for significantly displaced, shortened, or comminuted fractures, modern plate-and-screw fixation improves the reliability of union and allows earlier, more comfortable motion. The decision turns on the fracture pattern and the patient.
Symptoms of a clavicle fracture
A broken collarbone typically produces:
- Sharp pain over the collarbone, worse with arm movement
- Swelling, bruising, or a visible bump or deformity
- A grinding sensation when the shoulder moves
- Tenting of the skin over a sharp fracture fragment in displaced fractures
- Difficulty lifting or rotating the arm
How clavicle fractures are diagnosed
Diagnosis is made on exam and plain X-rays, which show the location, the degree of displacement, the amount of shortening, and whether the fracture is in multiple pieces (comminuted). The midshaft is the most common location; fractures of the distal third, near the shoulder, behave differently and can be more unstable.
A CT scan is occasionally used for complex or distal fractures to plan fixation. The imaging answers the key surgical questions: how displaced, how shortened, how many fragments, and where along the bone.
Dr. Lee treats the fracture pattern, not a blanket rule. Many midshaft clavicle fractures with acceptable alignment heal reliably in a sling, and for those, surgery adds risk without benefit. The fractures that benefit from fixation are the significantly displaced, shortened, or comminuted midshaft fractures, open fractures, fractures tenting the skin, and unstable distal-third fractures, where plating improves the reliability of union and lets the shoulder start moving sooner.
When fixation is indicated, Dr. Lee uses modern plate-and-screw constructs. As a surgeon who helped design upper-extremity plating systems, he brings particular attention to fixation technique and hardware choice. The goal is a reliable union with the least disruption necessary, and a recovery plan that returns the patient to activity as the bone heals.
Non-surgical treatment
Many clavicle fractures, particularly midshaft fractures with acceptable alignment, heal well without surgery. Treatment is a simple arm sling for comfort, early gentle motion of the elbow and hand, and a graduated return of shoulder motion as pain allows. Healing is monitored with periodic X-rays. The collarbone often develops a palpable bump at the healing site, which is normal and not a sign of a problem.
Surgical fixation
Surgery is considered for significantly displaced, shortened, or comminuted midshaft fractures, open fractures, fractures tenting the skin, and unstable distal-third fractures. The standard technique is plate-and-screw fixation: the fragments are realigned and held with a contoured plate, which improves the reliability of union and allows earlier motion. Intramedullary fixation, a rod inside the bone, is used occasionally for selected fracture patterns. Dr. Lee uses modern fixation hardware throughout.
Recovery timeline
Whether treated in a sling or with a plate, clavicle healing follows a broadly similar timeline:
- Weeks 0–2Arm sling for comfort. Early gentle elbow, wrist, and hand motion. Ice and oral pain medication. Avoid lifting and overhead activity. After surgery, the incision is monitored and the shoulder is protected.
- Weeks 2–6Progressive shoulder range of motion as pain settles. The sling is weaned. X-rays confirm the fracture is healing. Light daily activities resume.
- Weeks 6–12Bony union is typically achieved in this window, around 6 to 12 weeks. Strengthening begins. Most daily and occupational activity resumes as the fracture consolidates.
- Months 3+Return to contact sport and heavy lifting once the fracture is healed on X-ray and strength has returned, typically around three months, confirmed by the clinical and radiographic picture.
What patients commonly misunderstand
What patients often misunderstand about clavicle fractures:
- Not every broken collarbone needs surgery. Many midshaft clavicle fractures with acceptable alignment heal reliably in a sling. Surgery is reserved for significantly displaced, shortened, or comminuted fractures, open fractures, skin tenting, and unstable distal-third fractures, where fixation improves the reliability of union.
- Surgery is not just about the X-ray looking straighter. Fixation is recommended when the fracture pattern carries a meaningful risk of non-union, malunion, or prolonged disability. For fractures that will heal well on their own, plating adds the risks of surgery without a clear benefit.
- A bump at the healing site is usually normal. Clavicle fractures, especially those treated without surgery, often heal with a palpable or visible bump where new bone forms. In most cases this is a normal part of healing and not a sign that something is wrong.
This page is general educational content authored by Dr. Lee. It is not a substitute for individual medical advice. Every patient's case is different, book a consultation to discuss yours.