June 29, 2012
Dear Mayo Clinic:
I broke my collarbone in a car accident four months ago. It is healing very slowly and hurts somewhat on the break, but even more when I move my shoulder. Is this normal for a collarbone break? Is there a chance I'll need surgery if the pain doesn't go away?
A broken collarbone can take several months to heal completely. Until then, moving your shoulder will tend to move the area where the bone was broken, and that can be painful. Most broken collarbones heal quite well and do not require surgery. But when healing seems to be slow and pain continues, as in your case, it is a good idea to follow up with an orthopedic surgeon to make sure the collarbone is healing properly.
The collarbone, or clavicle, connects the upper part of the breastbone, called the sternum, to the shoulder blade. A broken collarbone is a very common injury, particularly in children and young adults. One reason is that young people are more likely to participate in sports that increase the risk of a broken collarbone, such as football, basketball, wrestling, rugby, hockey, skiing and snowboarding. Sports injuries are among the most common causes of a broken collarbone. Other frequent causes are falls and car, motorcycle or bike accidents.
The time for a broken collarbone to fully heal depends on the severity of the injury. In children, complete healing may take as little as three to six weeks. In adults, six to 16 weeks or more are often necessary for a collarbone to heal solidly.
Unfortunately, during that time there is no way to completely immobilize a collarbone fracture to keep it from moving and, thus, speed healing, as can be done using a cast on other broken bones, such as a wrist, arm or leg. Because of the broken collarbone's location in your body, a cast is not an option. However, a shoulder sling can help keep a collarbone fracture in place, reduce pain and allow for healing. The broken bone will move a bit whenever you move your shoulder, and that can often be painful during the healing process. A significant amount of shoulder movement may slow healing.
If you have not had X-rays since you broke your collarbone, then new X-rays to check the progress in healing would be a good idea at this point in your recovery. Some collarbone fractures heal very slowly. Others may not heal at all and require additional treatment, although that is uncommon. Severe fractures that cause the bones to be significantly out of position or result in an overlap of the broken bone fragments may require surgery to properly reposition them. But, in most cases, surgery is not needed for a broken collarbone, even one that is healing slowly.
See an orthopedic surgeon to discuss your case. Perhaps the surgeon can suggest ways to better manage the pain. A surgeon can also help you decide if you should consider further treatment to aid in the healing process or if your collarbone simply needs more time to heal.
— Scott Steinmann, M.D., Orthopedic Surgery/Shoulder, Elbow, and Hand Surgery, Mayo Clinic, Rochester, Minn.