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Clavicle fracture

December 4, 2011 | 15,00 EUR | answered by Dr. med. Ralf Berg

I have a fractured collarbone (complete fracture, lateral: near the shoulder joint), with one part of the collarbone now lying above the other and the shoulder appearing shortened and drooping. Surgery is now recommended (a splint will be inserted). However, I have read online about the "conservative" method, where the collarbone is supposed to realign itself with immobilization. This is confusing now.

Dr. med. Ralf Berg

Good evening esteemed questioner,

I can help clear up the confusion for you. Thankfully, you have accurately described the medical localization of the clavicle fracture (lateral/near the shoulder joint, shortening due to overlapping fracture ends).
This is the reason for the course of action that was suggested to you. Most clavicle fractures occur in the middle or medial third. Typically, these can be treated "conservatively" with just an external bandage, even if the ends do not align perfectly. Since these fractures are located away from the shoulder joint, a slightly inaccurate alignment does not have a significant impact on shoulder joint mobility. The clavicle will "grow back" until the lateral end is approximately back where it was before the fracture. However, in your case, as the fracture is near the joint, there is almost always shortening and overlapping, as you described. This can worsen during healing and lead to misalignment and dysfunction of the shoulder joint. Internal bracing is necessary to ensure that the shoulder joint is anatomically in the correct position. External bandaging alone is not sufficient to properly stabilize these lateral (often referred to as distal) fractures.
Clear now? I hope my answer can help clear up your confusion.

With best wishes and hoping for a lovely Advent Sunday evening and a speedy recovery, R. C. Berg