Journal of Bone Research
Open Access

Clavicle Fractures: A Comprehensive Perspective on Causes, Treatment, and Recovery

Leonor Lara^{* *}Correspondence: Leonor Lara, Department of Sports Medicine, University of the Azores, Ponta Delgada, Portugal, Email:

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Description

The clavicle, or collarbone, is one of the most frequently fractured bones in the human body. Located between the sternum and the shoulder blade, it plays an important role in stabilizing the shoulder and facilitating upper limb movement. Clavicle fractures account for approximately 5% of all fractures and are common among adolescents and young adults, especially those involved in sports or high-risk activities. Despite being a relatively common injury, the management of clavicle fractures can vary significantly based on the type of fracture, the patient’s age, and the mechanism of injury. This perspective article will determine the causes, classification, treatment options, and rehabilitation strategies for clavicle fractures, as well as recent advancements in care and outcomes.

Anatomy and function of the clavicle

The clavicle serves as a strut between the arm and the trunk, providing support for the shoulder and allowing for a range of arm movements. It acts as a lever to transmit forces from the upper extremities to the axial skeleton, making it essential for normal shoulder function. The clavicle also protects underlying nerves and blood vessels, including the brachial plexus and subclavian artery, which run beneath the bone. Due to its location and function, the clavicle is prone to fractures, particularly in traumatic events where the shoulder or chest area sustains a direct blow or sudden force.

Causes and mechanisms of clavicle fractures

Clavicle fractures typically result from a direct trauma or fall onto the shoulder, but they can also occur in sports injuries, car accidents, or during contact sports such as football and rugby. The mechanism of injury can vary, but the most common causes are:

Fall onto an Outstretched Hand (FOOSH): This is one of the most common mechanisms, where the force from a fall is transmitted through the arm and shoulder, leading to a fracture of the clavicle.

Direct blow to the shoulder: A direct impact to the shoulder, such as from a fall or collision, can break the clavicle, especially in situations where the shoulder is not adequately protected.

Motor vehicle accidents: High-impact trauma, such as during car accidents, can cause fractures to the clavicle as a result of the force exerted on the upper body.

Sports injuries: Clavicle fractures are particularly common in contact sports like cycling, skateboarding, or football, where falls and collisions are frequent.

Classification of clavicle fractures

Clavicle fractures are classified based on the location of the fracture, the severity, and whether or not the bone is displaced. The most commonly used classification system is the Allman classification, which divides clavicle fractures into three main groups:

Type I: Fractures occurring in the middle third of the clavicle, which account for about 80% of all fractures. These fractures tend to be stable, and in many cases, non-surgical treatment is sufficient.

Type II: Fractures that occur in the distal third of the clavicle, often involving the acromioclavicular joint. These fractures are more likely to be displaced and may require surgical intervention.

Type III: Fractures in the proximal third of the clavicle, near the sternoclavicular joint. These are less common and typically result from high-impact trauma. Treatment can be complex, as displacement may affect critical structures, including blood vessels and nerves.

Treatment options for clavicle fractures

The management of clavicle fractures depends on the fracture type, displacement, and the patient's age and activity level. Treatment can be either non-surgical or surgical.

Non-surgical treatment: For most clavicle fractures, particularly those in the middle third of the bone, non-surgical treatment is often sufficient. The general approach includes:

Immobilization: A sling or figure-of-eight strap is commonly used to immobilize the arm and support the shoulder during the healing process. This helps reduce movement at the fracture site and promotes proper alignment.

Pain management: Pain relief is an important aspect of managing clavicle fractures. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and ice packs are often used to alleviate pain and swelling.

Physical therapy: Once healing begins, physical therapy is recommended to restore shoulder mobility and strength. Therapy focuses on improving range of motion, muscle strength, and shoulder stability, which are essential for optimal recovery.

Surgical treatment: Surgical intervention may be required if the fracture is displaced, involves a joint, or if non-surgical treatments do not provide adequate healing. The primary surgical options include:

Open Reduction and Internal Fixation (ORIF): This procedure involves repositioning the bone fragments and securing them with metal plates, screws, or rods. ORIF is commonly used for displaced fractures, especially those in the distal and proximal clavicle.

Intramedullary pinning: In some cases, a rod may be inserted into the medullary canal of the clavicle to stabilize the fracture. This technique is less invasive and can result in a quicker recovery, though it may not be suitable for all fracture types.

Reconstruction of the acromioclavicular joint: In cases where the fracture involves the acromioclavicular joint, reconstructive surgery may be necessary to restore the joint's function and stability.

Recent advancements in clavicle fracture treatment

Recent advancements in clavicle fracture treatment include the use of newer surgical techniques and materials, such as absorbable implants, which reduce the need for hardware removal surgeries. Additionally, studies have shown that early mobilization and weight-bearing exercises, when appropriate, can speed up recovery times and improve long-term outcomes.

Conclusion

Clavicle fractures are a common injury, often caused by trauma or high-impact activities, and can significantly affect a person’s ability to perform daily tasks or return to physical activities. With a variety of treatment options available, including non-surgical and surgical approaches, patients can generally achieve excellent recovery outcomes. Advances in surgical techniques, rehabilitation strategies, and early mobilization are helping to shorten recovery times and improve function for those affected by this injury.