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Broken Collarbone (Clavicle Fracture) In Children: Causes, Symptoms, And Treatment

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The collarbone, also called clavicle, is a short bone that connects the breastbone (sternum) to the shoulder blade (1). There is a collarbone on each of the shoulders. Collarbones of children are not fully formed, and hence have a higher risk of injury.

A broken or fractured collarbone (clavicle) is common in children. However, with proper rest and medical attention, it can be treated. In this MomJunction post, we tell you about some of the common causes of a broken collarbone in children, signs and symptoms, and treatment options.

Causes Of A Broken Collarbone In Children

A fracture can occur commonly in the middle of the bone (middle third of the clavicle). The less common areas are the inner and outer part of the bone (inner third and outer third of the clavicle) (2). The following are the types of injuries that may cause a broken collarbone in the child.

  1. Hard falls: It has a direct impact on the shoulder or the collarbone. It is a common cause of broken collarbone among children who play sports such as football, lacrosse, rugby, wrestling, and soccer. It might even happen in biking, skateboarding, snowboarding, and skiing (2) (3).
  1. Falling on the arm: Falling on the arm, especially an extended one, can place pressure on the collarbone, thus leading to a fracture. Such falls can happen in sports or due to accidental slips (4).
  1. Direct blow: If the child gets a blow at the middle of the collarbone or breastbone, or the shoulder, then it may result in a fractured clavicle. It could happen due to accidents (4).

Certain symptoms after a fall or accident can imply that the child has a broken collarbone.

[ Read: Fractures In Children ]

Signs And Symptoms Of Broken Collarbone In Children

Signs And Symptoms Of Broken Collarbone In Children

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Pain in the collarbone and the arms is the immediate sign of broken or fractured collarbone in children. Some other common signs and symptoms include (2) (5):

  • Tenderness, bruising, and swelling on and around the collarbone
  • Shoulder sagging or slumping downwards
  • A crackling sound while moving the arm of the affected side
  • Difficulty in moving the arm on the same side of broken collarbone
  • A bump at the area where the bone has broken
  • Coldness or numbness in the affected arm due to an insufficient blood supply
  • In rare cases, the child may experience shortness of breath.

Take the child to a doctor if they complain of pain after a fall or injury.

Diagnosis Of Broken Collarbone In Children 

The doctor will perform a physical examination of the collarbone to feel if it seems broken. They also check the movement of the arms, hands, and fingers to determine if there is damage to muscles, nerves, and blood vessels. You will be asked about any recent injuries.

If the doctor suspects a fracture, then an X-ray is taken to confirm the diagnosis. CT scan may be required in cases of severe fracture or when other bones are also broken. The treatment is suggested based on the extent of damage to the collarbone.

Treatment Of Broken Collarbone In Children

If the fracture is minor, then it could heal in six to 12 weeks through the use of arm sling or brace for support (6). If the fracture is severe and extensive, then the following treatment steps may be adopted.

  1. Pain management:Doctors may prescribe anti-inflammatory medications to relieve pain. Meanwhile, you may apply ice packs to the affected area to reduce the swelling.
  1. Arm support: The arm is provided constant support with a sling or immobilizer to keep the shoulder intact. The time needed for healing depends on the injury and the age of the child as well. For instance, it may take two to four weeks for the clavicle to heal in younger children (7).
  1. Physical therapy: When the pain starts to subside, the doctor may recommend the child to practice some simple muscle strengthening exercises. These are suggested after the healing process. (8).
  1. Surgery: It is usually needed when the fracture is severe, with multiple breaks in the bone. Once the surgery is done, the child needs to use the sling for several weeks. It might take three months for complete healing (8).

Even after the treatment, the child needs additional care for some more weeks, and they should not be allowed to resume their normal activities soon.

[Read: Broken Tailbone In Children ]

After-care Tips For A Broken Collarbone In Children 

Here are some after-care tips to follow to help your child’s fractured collarbone heal faster.

  1. Make your child regularly do finger, hand, and elbow exercises, as suggested by the doctor.
  1. Give extra pillows to your child to support the arm when sleeping.
  1. You may remove the sling for some time as per the doctor’s instructions.
  1. Make sure your child is not playing for about 10 to 12 weeks, even after complete healing.

[ Read: Nursemaid’s Elbow In Children ]

Broken collarbones in children heal with few problems. But in a few cases, it might lead to some complications.

Complications Of A Broken Collarbone In Children 

Broken collarbone may sometimes cause the following complications.

  1. Malunion: In a few cases, the fragments of a fracture may go out of place, and there is no healing. It could be a complication as it could affect the child’s arm movement. This may need extensive treatment (9).
  1. Bump: In most cases, a bump appearing at the fracture site goes away with time. But in some instances, it may continue to be there (9).
  1. Injury to blood vessel or nerve: Rarely, fractured clavicle may injure blood vessels or nerve around it. It may cause the arm or hand to turn numb or pale (10).
  1. Osteoarthritis: There might be a higher risk of osteoarthritis with injury to the collarbone. However, it may happen only when there is an injury to a joint close to the collarbone (11).

A broken collarbone can cause a lot of pain. But the good thing is that it is easy to prevent collarbone injuries among children.

Prevention Of Broken Collarbone In Children

Precautionary measures can significantly reduce the risk of collarbone fractures.

  • Explain to your kids about the importance of wearing protective gear when playing sports. It helps in reducing major fractures.
  • Make sure to give your child adequate vitamin D and calcium to make their bones strong. You may provide supplements, if needed, after consulting a pediatrician.
  • Talk to your children about regular stretching exercises and strength training for flexible and strong muscles. Strong muscles are better at supporting bones and may reduce the risk of severe bone injuries.
  • See that your children are wearing proper shoes to prevent accidental falls that can also cause broken collarbone.

Broken bones heal when provided adequate support and care. Let your child know all the dos and don’ts during the healing process. They must give rest and support to the affected arm as much as possible. Once the bone is healed, teach the child the precautionary measures to prevent the risk of any future injuries to the clavicle.

Do you have any stories to share? Please write to us in the comment section.

References:

1. Broken Collarbone; NHS, UK
2. Broken Collarbone (Clavicle Fracture); John Hopkins Medicine
3. Broken Collarbone (Clavicle Fracture); Brenner’s Children’s Wake Forest Baptist Health
4. What is a clavicle fracture?; Northwell Health
5. Clavicle Fracture (Shaft); Montefiore Pediatric Orthopedic and Scoliosis Center
6. Clavicle Fracture (Broken Collarbone); Aurora Health Care
7. Broken Collarbone (Child); fairview.org
8. Broken Collarbone (Clavicle); C. S. Mott Children’s Hospital
9. Clavicle Fracture (Broken Collarbone); American Academy of Orthopaedic Surgeons
10. Broken Collarbone (Clavicle); Michigan Medicine
11. Broken collarbone; NCH Healthcare System