A broken collarbone is a common injury, particularly in children and young adults. Your collarbone connects the upper part of your breastbone to your shoulder blade. Common causes of a broken collarbone include falls, sports injuries and trauma from traffic accidents. Infants can sometimes break their collarbones during the birth process.

Seek prompt medical attention for a broken collarbone. Most heal well with ice, pain relievers, a sling, physical therapy and time. But a complicated break might require surgery to realign the broken bone and to implant plates, screws or rods into the bone to hold the bone in place during healing.

Signs and symptoms of a broken collarbone include:

• Pain that increases with shoulder movement
• Swelling
• Tenderness
• Bruising
• A bulge on or near your shoulder
• A grinding or crackling sound when you try to move your shoulder
• Stiffness or inability to move your shoulder
• Newborn children will often not move their arm for several days following a birth-related collarbone fracture.

When to see a doctor

If you notice signs or symptoms of a broken collarbone in you or your child, or if there's enough pain to prevent normal use, see a doctor right away. Delays in diagnosis and treatment can lead to poor healing.

Common causes of a broken collarbone include:

• Falls, such as falling onto your shoulder or onto your outstretched hand.
• Sports injuries, such as a direct blow to your shoulder on the field, rink or court.
• Vehicle trauma from a car, motorcycle or bike accident.
• Birth injury from passing through the birth canal.

Your collarbone doesn't harden completely until about age 20. This puts children and teenagers at higher risk of a broken collarbone. The risk decreases after age 20, but then rises again in older people as bone strength decreases with age.

Most broken collarbones heal without difficulty. Complications, when they occur, might include:

• Nerve or blood vessel injury. The jagged ends of a broken collarbone may injure nearby nerves and blood vessels. Seek immediate medical attention if you notice numbness or coldness in your arm or hand.
• Poor or delayed healing. A severely broken collarbone might heal slowly or incompletely. Poor union of the bones during healing can shorten the bone.
• A lump in the bone. As part of the healing process, the place where the bone knits together forms a bony lump. This lump is easy to see because it's close to the skin. Most lumps disappear over time, but some are permanent.
• Osteoarthritis. A fracture that involves the joints that connect your collarbone to your shoulder blade or your breastbone might increase your risk of eventually developing arthritis in that joint.

During the physical exam, your doctor will inspect the affected area for tenderness, swelling, deformity or an open wound. X-rays determine the extent of a broken collarbone, pinpoint its location and determine if there's injury to the joints. Your doctor might also recommend a CT scan to get more-detailed images.

Restricting the movement of any broken bone is critical to healing. To immobilize a broken collarbone, you'll likely need to wear an arm sling.

How long immobilization is needed depends on the severity of the injury. Bone union usually takes three to six weeks for children and six to 12 weeks for adults. A newborn's collarbone that breaks during delivery typically heals with only pain control and careful handling of the baby.

Medications

To reduce pain and inflammation, your doctor might recommend an over-the-counter pain reliever. If you have severe pain, you might need a prescription medication that contains a narcotic for a few days.

Therapy

Rehabilitation begins soon after initial treatment. In most cases, it's important to begin some motion to minimize stiffness in your shoulder while you're still wearing your sling. After your sling is removed, your doctor might recommend additional rehabilitation exercises or physical therapy to restore muscle strength, joint motion and flexibility.

Surgery

Surgery might be required if the fractured collarbone has broken through your skin, is severely displaced or is in several pieces. Broken collarbone surgery usually includes placing fixation devices — plates, screws or rods — to maintain proper position of your bone during healing. Surgical complications, though rare, can include infection and lack of bone healing.

Applying ice to the affected area for 20 to 30 minutes every few hours during the first two to three days after a collarbone break can help control pain and swelling.

Depending on the severity of the break, your family doctor or the emergency room physician may recommend that you or your child see an orthopedic surgeon.

What you can do

It might be helpful to write a list that includes:

• Detailed descriptions of your symptoms and the event that caused the injury
• Information about past medical problems
• All your medications and dietary supplements
• Questions you want to ask the doctor

What to expect from your doctor

Your doctor will likely ask some of the following questions:

• How did the injury occur?
• Have you ever had a broken bone?
• Have you been diagnosed with weakened bones?