CLAVICLE FRACTURE TREATMENT
MELBOURNE

Clavicle Fracture Treatment Melbourne

A Patient’s Guide:

 Dr Christopher Pullen – BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

“I may recommend surgery if you have a painful condition that does not respond to nonsurgical treatment including rest, physical therapy, medications and injections.

Prior to recommending surgery, I will undertake a thorough clinical examination, discuss your diagnosis and detail the treatment options to ensure you understand the benefits and potential complications.”

PATIENT CARE PROCESS – DR CHRISTOPHER PULLEN
Dr Pullen’s approach to your care:

1. First Appointment

Referral, consultation & testing.

2. Diagnosis

Diagnosis & treatment options.

3. Treatment Plan

Non-operative VS operative.

4. Follow up & care plan

Monitoring, pain relief & care plan.

SHOULDER JOINT ANATOMY

What are the joints, muscles and ligaments in your shoulder?

The shoulder is made up of three bones:

(1) The Scapula (shoulder blade), (2) Clavicle (collarbone) and; (3) Humerus (upper arm bone)

The shoulder joint is formed where the humerus (upper arm bone) fits into the scapula (shoulder blade), like a ball and socket.

Other important shoulder bones include:

The acromion – The bony projection off the scapula.
The clavicle (collarbone) – This meets the acromion in the acromioclavicular joint.
The coracoid process – The hook-like bony projection from the scapula.

The humerus fits relatively loosely into the shoulder joint, allowing the shoulder a wide range of motion.

Shoulder Anatomy

Figure 1

CLAVICLE FRACTURE

A clavicle fracture (or broken collarbone) is a very common injury usually resulting from a fall, contact sports or traffic accident.

The clavicle bone is divided into 3 main parts:

Medial end – Closest to the sternum

Midshaft – Middle of the clavicle (most commonly fractured)

Distal end – Outside part of the clavicle closest to the shoulder joint.

Clavicle fractures are usually the result of a direct blow to the shoulder from a fall onto an outstretched arm or a collision during contact sports.

Clavicle Fracture

In some instances a broken clavicle bone may heal without surgery. If the bone ends have shifted out of place (displaced) surgery may be recommended to align the bone ends and hold them stable during healing.

CLAVICLE FRACTURE DIAGNOSIS

In a clavicle fracture (broken collarbone), there is usually shoulder pain, tenderness, swelling and an obvious deformity, or bump, at the fracture site. The shoulder may also sag downward and forward.

Dr Pullen will undertake a medical examination to investigate how the injury occurred and will ask you about your symptoms.

He will carefully examine your shoulder to ensure that the nerves or blood vessels were not damaged when the fracture occurred. Patients will require and x-ray to confirm the diagnosis.

In some cases patients may benefit from having additional imaging tests to rule out other problems. Imaging tests may include:

  • X-rays

  • Ultrasound

  • MRI (Magnetic resonance imaging)

Clavicle Fracture Treatment Melbourne

FRACTURED CLAVICLE TREATMENT OPTIONS

Non-surgical options

If the broken ends of the collarbone have not significantly shifted out of place, you may not require surgery. Some broken collarbones can heal without surgical intervention.

Nonsurgical treatment may include:

Pain Medication – Pain medication such as paracetamol may help reduce pain and inflammation as the fracture heals.

Sling/Arm support – A sling can be used after the break for support and comfort.

Physical therapy – Dr Pullen may recommend seeing a physiotherapist to help implement a rehabilitation program to help maintain arm motion and prevent shoulder and elbow stiffness.

Follow up appointments – In some cases, a clavicle fracture may move out of place before it heals (displace). Additional appointments with Dr Pullen and follow up imaging tests (x-rays) may be necessary to ensure the collarbone has stayed in the correct position during the healing process.

Clavicle Fractures

Surgical options

If the broken ends of the collarbone have significantly shifted out of place (displaced) or the fracture presents more complications, Dr Pullen may recommend surgery.

Surgery typically involves putting the broken pieces of bone back into position and preventing them from moving out of place until they are healed.

Surgery approaches

A clavicle fracture can be fixed using the following wethods:

Plate with screws – This can be performed as a day surgery or an overnight hospital stay, depending on your unique situation. The surgery is performed under general anaesthetic.

The operation – A small incision is made above the clavicle and the fractured bone ends are exposed, prepared and realigned to their normal position. If the fracture is in multiple pieces numerous screws in different directions may be required.

After being repositioned into normal alignment, the bone fragments are held in place with screws and metal plates attached to the outer surface of the bone.

The fracture when fixed, is x-rayed to ensure it is in an optimal healing position. Once the fracture is secured the wound is then closed and dissolving stitches are used to close the skin. The patient’s arm is then placed in a sling for comfort.

CLAVICLE FRACTURE RECOVERY TIMELINE

The clavicle will take a minimum of 6 weeks to heal and can take longer to fully heal. Healing is determined by successive X-Rays and clinical examination.

The recovery period varies from patient to patient and depends on the nature and complexity of the surgery and individual patient anatomy and health factors. A typical recovery timeline may include:

Timeline – After Surgery Description
The day of surgery For some patients it is a day procedure, other patients may stay overnight. It depends on your pain levels. Your arm will be in a sling for 1-3 weeks.
1 -2 weeks A follow up appointment is organised 1-2 weeks after surgery to check on progress, remove the dressing and check the wound. You may have an x-ray to check the position of the plate and screws. The sutures buried beneath the skin will dissolve.
3-6 weeks A follow up appointment is required approximately 6 weeks after your operation. An X-ray will be requested to help Dr Pullen assess the clavicle healing process. He will also assess your shoulder movement to ensure that it is returning to normal. At each of these visits he will discuss with you the activities for you to resume.
7-12 weeks A further follow up appointments may be required 12 weeks after your operation. Most patients can resume normal activities after 12 weeks and lift their arm overhead. Avoid contact sports until 12+ weeks after the injury and clearance from Dr Pullen.

FREQUENTLY ASKED QUESTIONS

Clavicle Fracture Treatment Melbourne

The length of time in a sling depends on the age of the patient, how many pieces the fracture was in and the stability of the fracture fixation at the end of the surgery. Some patients are really only in a sling for a week and some patients need to be cautious for up to 6 weeks.

Dr Pullen advises that you wear the sling if you are going out anywhere where there is a crowd and thus a risk of being bumped or pushed.

Following your surgery most patients can gradually start to use their arm for very light activities, but avoid raising the arm above shoulder height, lifting anything heavy or putting the arm behind your back.

Formal physiotherapy programs may not be required. Please consult with Dr Pullen regarding your rehabilitation progress.

On average your surgical scar will be between 6 to 10 centimetres long but the size will depend on the size of the plate needed to fix your clavicle properly.

Most patients can usually return to driving between 4 to 6 weeks after surgery. We advise you to get a clearance to drive with Dr Pullen or your physiotherapist before driving.

Most people can return to sporting activities at the 6-8 week mark after surgery as long as the bones have healed adequately.

Every fracture is different and some athletes return earlier or later depending on the individual circumstances and commitment to the rehabilitation process with Dr Pullen and your physiotherapist.

Office worker – If your employment is a desk based job you may be able to return to work within a week after surgery.

Manual worker (lifting and carrying etc.) – If your job involves physical work it could take 6 to 8 weeks until you are able to return to work.

Please note – The recovery period varies from patient to patient and depends on the nature and complexity of the surgery and commitment to your recovery program.

If the plate and screws bother you they can be removed

POTENTIAL COMPLICATIONS

The surgery complications which may occur after collarbone surgery may include:

  • Pain
  • Shoulder stiffness and/or restricted movement
  • Infection
  • Bleeding – Damage to blood vessels or nerves
  • Problems with wound and/or bone healing (nonunion)
  • Blood clots
  • Reaction to anaesthesia
  • Hardware irritation

Dr Pullen will discuss with you in detail the potential complications and risks in relation to the surgical and non-surgical approaches.

Mr Troy Keith
Dr Christopher Pullen
BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

If you have any questions please contact my team:

Clavicle Fracture Treatment Melbourne:

Dr Christopher Pullen – Orthopaedic Surgeon

If you have any questions or would like to make an appointment, please feel free to contact my team:

Proud member of Royal Australasian College of Surgeons and Australian Orthopaedic Association.

HOME

ABOUT

SHOULDER ARTHROSCOPY

APPOINTMENTS & FEES

CONTACT

Clavicle Fracture Treatment Melbourne

Dr Pullen treats patients from all over Victoria in relation to shoulder injuries and clavicle fractures. He consults with patients at the following practice locations in Melbourne including East Melbourne and Ringwood.