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The key (commonly called the collarbone) is a long, thin bone that connects the ribcage to the shoulder girdle on each side of the upper body. A broken collarbone is a fairly common injury, especially in children, teens, and young adults, because the bone doesn’t fully mature until age 20. Common causes of clavicle fractures are accidental falls, sports injuries, and injuries from a car accident. A broken collarbone needs immediate medical attention to diagnose its severity, but does not always require surgery. In most cases, the bone heals with appropriate home care and without surgery.
Signs of a broken collarbone
The following are signs by which a clavicle fracture can be identified. If a person falls on an outstretched arm, has a car accident, or is injured while playing sports and feels severe pain in the shoulder area, seek medical attention immediately. Collapsed collarbones cause significant pain in the front of your shoulder, closer to the base of your neck. Other symptoms include immediate swelling or bruising near the fracture, crunching sounds from arm movement, and numbness and tingling in the arm.
The victim must be given first aid at home. After that, you need to immediately call an ambulance and hospitalize the victim. The doctor will probably need to give you strong medicine to help with the pain of the injury. Next, the doctor will order an X-ray of the shoulder to help diagnose the injury. Another diagnostic tool used may include a bone scan: MRI or CT.
Most often, a fracture is diagnosed as a small, superficial crack that is not severe enough to dislodge the bone or expose the surface of the skin. Small hairy fractures of the clavicle do not often show up immediately on x-rays. It sometimes takes a week or so until the swelling is down enough to clearly see the fissure.
First aid at home
Sudden injury can happen to anyone, so it is important to know how to provide first aid to a person. It is important not to break the already painful displacement and follow all the rules.
A few practical tips on what to do with a broken collarbone:
- before the person waits for the doctor, you must fix the arm, using a towel, as a loop under the forearm and around the neck;
- the person should move the injured hand as little as possible;
- provide the victim with over-the-counter pain relievers such as ibuprofen or paracetamol to minimize pain;
- Aspirin should not be given to children under 16;
- should be applied as an alternative to an ice pack on the damaged area or a bag of frozen vegetables. The ice pack should be covered with a clean towel or cloth to prevent skin damage. The cooling effect can help reduce swelling and pain.
First aid in the hospital
Preparation for surgery is necessary only in severe cases. Although most clavicle fractures are thin cracks, in some cases the tear is severe enough to require surgery – about 5-10% of cases. Surgery is definitely needed if the broken collarbone is diagnosed as a compound fracture. This means that the bone has been shattered into several fragments, the skin has been torn, or parts of the collarbone have been displaced. The surgery involves reorganizing the bone fragments and holding them in place with special metal plates, pins or screws. The clavicle usually breaks down the middle, as opposed to the ends, which attach to the sternum. Because there is rarely fat on the collarbone, you can probably see and feel the hardware through your skin.
Plates and screws are usually not removed from the bone after healing unless they cause significant discomfort. Often, the broken part becomes stronger after surgery compared to the uninjured side.
Due to its anatomical position, a cracked collarbone cannot be cast like a broken limb. Instead, a special suspension glove or figure-eight splint is usually used for support and comfort immediately after the injury if it is just a hairline crack, or after surgery if it is a compound fracture. A figure-eight splint is wrapped around both shoulders and the base of the neck to keep the injured shoulder up and back.
Sometimes most of the material is wrapped around the webbing to keep it close to your body. You will need to wear the sling at all times until there is no pain when moving your arms, which takes two to four weeks for children or four to eight weeks for adults. Slings come in a variety of sizes, including those that are suitable for young children, because the collarbone is most often broken in them – this is the result of a fall on an outstretched hand.
Broken collarbone treatment
How seriously you take your collarbone treatment will be the result of your recovery. Once you have received the appropriate medical care, your recovery is yours. There are several recommendations that will come in handy at home and explanations of how exactly they will help you:
- apply ice to the collarbone;
- drink painkillers;
- use painkillers;
- develop a hand;
- ask the right questions.
Apply ice to the broken collarbone. After you get home from the hospital (whether you had surgery or not), you should apply an ice pack (or something very cold) to your injured collarbone to reduce swelling and eliminate pain. Ice therapy works well for acute (fresh) injuries that cause swelling because it reduces blood flow by constricting blood vessels. Apply ice to your collarbone for fifteen minutes three to five times a day until the pain and inflammation subside. Always wrap ice in a thin cloth before applying it to your body to help prevent skin irritation and frostbite. If you don’t have crushed ice, use ice cubes, frozen gel packs, or a bag of frozen vegetables (like corn).
Take over-the-counter medications. In addition to the regular application of ice, you should consider taking certain medications for a short period of time.
Anti-inflammatory drugs such as ibuprofen or naproxen are the best choice for treating acute injuries that are associated with severe inflammation. It is also possible to take painkillers (so-called analgesics), but they will not affect the swelling associated with your recovery collarbone. The most common pain reliever is acetaminophen.
Anti-inflammatory drugs and analgesics should only be considered as short-term treatments for disease control and should not be taken for more than two weeks. Children should not take aspirin to control pain and inflammation, as it is associated with life-threatening Reye’s syndrome. Find an ointment that contains a natural pain blocker for your collarbone. Menthol, amphora, arnica, and capsaicin are helpful in relieving muscle, bone, and joint pain.
Exercise lightly as the pain begins to subside. After a couple of weeks, when the swelling subsides, remove the splint and carefully move the arm and shoulder in all different directions. Do not load the collarbone so that it hurts, make smooth movements with your arms and shoulders. Start gently, perhaps with a light charge. Your collarbone needs to move more during the later stages of the injury to encourage healing. Complete inactivity and immobilization of your arm for many weeks can lead to loss of bone mineral, which is counterproductive for the injured bone trying to get stronger. Certain movements and loads attract minerals to the bones, making them stronger and less prone to fracture. Once your shoulder/collarbone is painless and relatively mobile, schedule an appointment with a physical therapist to discuss rehabilitation.
Eat nutritious foods while you recover. All bones and tissues in the body need certain nutrients for proper and timely treatment. Having a balanced diet that includes plenty of minerals and vitamins has been proven to help heal broken bones of all types, including the collarbone. So focus on eating plenty of fresh foods (fruits and vegetables), whole grains, lean meats, and fish to provide your body with the building blocks it needs to properly repair your collarbone. Also, drink plenty of purified water, milk, and other dairy-based drinks to maximize the benefits of what you eat. Broken bones need enough minerals (calcium, phosphorus, magnesium, boron) and protein to become strong and healthy again.
Excellent sources of minerals/protein are found in dairy, tofu, beans, broccoli, nuts and seeds, sardines, and salmon. Important vitamins needed for bone healing: vitamin C (necessary for collagen production), vitamin D (critical for mineral absorption) and vitamin K (binds calcium to bones and causes collagen formation). Conversely, do not consume foods or drinks known to interfere with bone/tissue healing. These are alcoholic, carbonated drinks, fast foods and foods prepared with a lot of refined sugars and preservatives.
Get a referral for physical therapy. Once you recover and are able to remove your splint, you will probably notice that the muscles surrounding your shoulder look smaller and weaker. This is because muscle tissue atrophies without movement. If this happens, you will need to get a referral for physical rehabilitation. A physical therapist or sports trainer will show you specific rehabilitation exercises to restore muscle strength. Getting proper rehabilitation reduces the risk of degenerative arthritis (osteoarthritis) developing in the shoulder in the future. Most people return to their normal daily lives within three months of an uncomplicated collarbone fracture, although age, health, and activity factors affect the healing process.