Clavicle fracture. Information for patients who need a follow up appointment 6 weeks after their injury.

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What is this information about?

This information is about collar bone (clavicle) fracture.

It tells you:

• How to look after yourself when you go home from hospital with a clavicle fracture   
• What exercises you can do to help heal and strengthen your arm    
• What follow-up treatment you might have    
• Who to contact if you need further help and support.  

What is a clavicle fracture?

A clavicle fracture is a break in the collarbone. Along with your shoulder blade (scapula) your collarbone forms the ‘shoulder girdle’. This is a bony link that connects your upper arms to the main part of your body.    

Most breaks to the collarbone happen around the middle section of the bone.   

Do I have a fracture or a break?

If you have a fracture, it means you have a broken bone. ‘Fractured bone’ and ‘broken bone’ both mean the same. 

How long is it likely to take for my injury to heal?

It usually takes 6 to 12 weeks to heal.   

Once your collarbone has healed you may have a small, painless lump over the fracture site. This should not affect your ability to do things. 

Will smoking or vaping slow down my child’s healing?

Yes. Smoking slows healing so if your child smokes or vapes they should try to stop or cut down. This is most important in the first 2 weeks after their injury. If they would like help to stop smoking they can talk to their GP or visit  Quit smoking – NHS (www.nhs.uk)  for further information.  We have included this information as we are aware that some older children and young adults do smoke. 

What should I do if I am in pain after my clavicle fracture?

If you are in pain, take your usual painkillers or painkillers given to you in the emergency department. Follow the dose instructions on the packet. If you are struggling with pain do speak to your GP or pharmacist.   

Put ice or a cold pack over the painful area for short term ice pain relief.  

When should I be wearing my arm sling?

Use your sling for 3 weeks. You can take it off to wash, dress and do your exercises. It does not need to be worn at night. 

What should I do if I am struggling with my sling?

When should I start exercising?

It is important to start gentle exercises straight away. This helps to prevent stiffness when you are doing the exercises which are shown later in this information.   

Will I have further (follow up) appointments?

You have will have an appointment with an upper limb specialist in 6 weeks. They may organise another X-ray to check the position of the clavicle fracture. The specialist will talk you through the next stage of your management. You will be sent an appointment time and date by post.

What should I do from week 1 to week 2 after my injury?

• Rest your arm for the first 24 to 72 hours (1 to 3 days). However, it is important to keep moving around.     
• Move your fingers, wrist, and shoulder, so they do not get stiff.  Do this gently, without causing too much pain.    
• Apply cold packs (ice pack or frozen peas wrapped in a damp towel) to the sore area for up to 15 minutes, every few hours. Cold pack applications can provide short-term pain relief. However, the ice must never be in direct contact with the skin.    
• Use your arm sling. Take your arm out of the sling to wash, dress and do your exercises. You do not have to wear your sling at night. You may find it more comfortable to sleep propped up on pillows.   
• Aim to do all the exercises 5 times a day. These exercises should not cause too much pain.  Do fewer if they are making your pain worse. 

Hand, wrist and elbow exercises

Finger and wrist bending and straightening: open and close your hand as shown 10 times. Then move your wrist up and down 10 times.     

After around 3 to 5 days progress to holding a soft ball or ball of socks. Squeeze the ball as hard as possible without pain. Hold for 5 seconds and repeat 10 times.  

Elbow Bending to Straighten: bend and straighten your elbow as far as you can without pain. You should not feel more than a mild to moderate stretch. You can use your other arm to help if you need to. Repeat 10 times if there is no increase in pain.     

Forearm Rotations: keep your elbow at your side and bent to 90 degrees. Slowly turn your palm up (supination) and down (pronation). You should not feel more than a mild to moderate stretch. You can use your other arm to help if necessary.  Repeat 10 times if there is no increase in pain.     

Posture Exercise: 

Bring your shoulders back and gently squeeze your shoulder blades together. Hold for 30 seconds. Repeat 5 times.  

Shoulder pendulum (swing) exercises

Stand next to a firm surface. Support yourself with your un-injured arm and lean forwards. Let your injured arm relax and hang down to the ground. 

Gently swing your arm, making a small movement. Try to do this forward and backward, side to side and in small circles. Keep your arm relaxed as you swing it.  

Aim to do this for 1 to 2 minutes in total.    

This exercise can cause some discomfort when you first start to do it. This will usually ease off after you have repeated the exercise a few times.    

You need to swing your arm gently so is does not cause you too much discomfort.  Remember keep your arm relaxed. 

What should I do from week 3 to week 5 after my injury?

• Continue to use your arm sling during the 3^rd week after your injury.  
• After 3 weeks you can stop using your sling and slowly return to light activities. 
• Continue to avoid avoiding any heavy lifting and loading until 6 weeks after your injury.   
• Start the new exercises below using your non-injured arm to support your injured arm. Aim to do these 5 times a day. These exercises should not cause too much pain.  Do fewer if they are making your pain worse.   

Exercises: 

Supported arm elevation    
Use your other hand to lift your injured arm up in front of you, as shown in these pictures. Repeat 10 times if there is no increase in pain.

Supported arm rotation    
With your elbow touching the side of your body, bend your injured arm as shown below. Hold onto a stick, umbrella, or something similar. Then move your injured forearm outwards aways from your body. As you do this, keep your elbow bent and tucked into your side. Repeat 10 times if there is no increase in pain.

Use your good arm to gently push the hand of your injured arm outwards. Remember to keep your elbow tucked in. If you do not have a stick, hold your injured arm at the wrist and guide it outwards with your good hand.  Repeat 10 times if there is no increase in pain.     

What should I do from week 6 after my injury?

You will have a fracture clinic appointment around 6 weeks after your injury to check how your injury is healing. 

• If we find at your appointment that your fracture is showing signs of healing well, you can return to normal activities but be guided by any pain you get. 
• When you: 
  • can do the exercises above (using your other arm to support you) 
  • can move your shoulder fully (have full range of movement) without pain, you can start to do the new exercises shown below.  

Do not use your other hand to support you while you do them. 

• Start to build up your regular activities when you have full range of movement without the support of your other arm.    
• Between 6 to 12 weeks after your injury you can try returning to doing sports if you have:   
  •  full movement   
  •  only a little pain.  

There is a small chance that your collarbone may break again in the same place if you do sports between 6 to 12 weeks after your fracture. You can reduce the chance of this happening by waiting for another two weeks before you return to doing higher impact sports such as rugby, mountain bike and horse-riding.  If you are unsure, please contact the Virtual Fracture Clinic.

Exercises: 

Arm elevation   

Lift your arm forwards in front of you. Try to raise the arm as high as you can. This exercise can cause some discomfort. You do not need to raise your arm so high or for so long that it causes to much pain. If this is too difficult, try the same movement with a bent elbow.  Repeat 10 times.  

Raising your arm out to the side   

With your palm facing forwards, move your arm out to the side in a big arc. Try to raise your arm as high as you can. If this is too difficult, try the same movement with a bent elbow. You do not need to raise your arm so high or for so long that it causes too much pain.  Repeat 10 times.   

Arm rotation   
Start with your elbow bent by your side. Move your forearm out to the side, keeping your elbow bent and near your waist. Repeat 10 times.   

When should I contact Virtual Fracture Clinic?

Please contact the Virtual Fracture Clinic if you: 

• Are concerned about your symptoms, especially 6 weeks after your injury. 
• Would like further information or support after you have read this information. 

When can I start driving?

You can return to driving when:   

• You are no longer using your arm sling      
• You can turn the steering wheel as much as you need to without it is hurting    
• You can safely deal with all emergency situations without being in pain or hesitating. For example, you must be able to stop the car quickly and in full control and safely avoid obstacles    
• You are covered by your insurance company

How can I get a note for work?

Please contact the Virtual Fracture Clinic.

How do I contact the Virtual Fracture Clinic?