You've broken your clavicle – that's the bone that runs across the top of your chest, connecting your breastbone to your shoulder blade. It's commonly called the collarbone. While it isn’t responsible for weightbearing like your leg bones, it does help keep your shoulder in the right position and allows normal shoulder movement.

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These fractures are common and usually happen after a fall onto the shoulder or outstretched arm. Straight away, you’ll likely notice swelling, pain, and sometimes a visible bump or deformity at the collarbone. Over the next few days, bruising can appear lower down your chest as gravity draws the blood from the fracture site downwards.

 

We don’t use a cast for this injury because the clavicle sits on the chest wall and moves constantly with breathing, shoulder movement, and even when you roll in bed. Despite this, most clavicle fractures heal well without surgery, and you can expect to regain full shoulder function.

 

Once your fracture is confirmed in the Emergency Department, we’ll give you a broad arm sling to support the shoulder. You should wear this as much as possible for the first few weeks, including at night. It's fine to take it off for washing, dressing, or doing light exercises with your arm.

 

You'll usually have an appointment in the fracture clinic within one or two weeks. This visit is important to check how the bone is sitting and to make sure the skin over the area is healthy. If there are concerns about the skin or the fracture position, we may bring you back sooner.

 

Even when the fracture is out of position, we usually don’t need to operate. The exception is when the skin is very tight, pale, or broken over the fracture. That could mean the bone is pushing on the skin too much, and surgery might be needed to avoid skin damage. If the skin looks tented but healthy, we often still manage things without surgery.

 

To help prevent stiffness, we’ll encourage you to start physiotherapy early. At first, these are gentle movements, often done while leaning forwards or using your other hand to support the arm. Keep wearing the sling most of the time, but it’s fine to remove it when resting or sleeping if that helps with comfort and movement.

 

We’ll check your progress around six to eight weeks after the injury. At this stage, we’ll assess your healing both in clinic and with an X-ray. If the fracture hasn’t clearly healed yet, we might arrange another follow-up around twelve weeks.

 

Once the bone has healed, you can gradually return to normal activities. Most people can do light activities soon after healing is confirmed and return to sport or heavier lifting by ten to twelve weeks, depending on how symptoms improve.

 

Because this bone isn’t immobilised in a cast, healing can sometimes take longer than with other fractures. There’s a small chance the bone may not heal fully without surgery – but this is still uncommon.

 

It’s also normal to notice a lump at the fracture site once healing starts. This is caused by callus formation – the body’s natural way of bridging the break – and it often shrinks over the following 12 to 18 months.

In certain cases, surgery might still be considered. This is more likely if your skin is at risk, or if the fracture is badly displaced and you have high physical demands. But all surgery carries risk. The major blood vessels and nerves to your arm lie just beneath the collarbone, so surgery has a small but serious risk of damaging them.

 

Also, some patients find the metal plate used in surgery becomes prominent or uncomfortable. About one in ten people who have clavicle surgery end up asking for the metalwork to be removed later. If so, that procedure should only be done once the bone is fully healed – usually not before four to six months after surgery.

 

Now that your injury has been confirmed and supported in a sling, you’ll be seen again in fracture clinic in the next week or two. There, we’ll check the bone position, examine the skin, and decide on the best plan for you.

 

Most of the time, your fracture will continue to be treated without surgery. But if you smoke or have poorly controlled diabetes, that may increase the chance of slow healing – and we’ll factor that into your follow-up.

 

We’ll also get you started with physiotherapy early on, to keep the shoulder moving. As the pain settles and the bone heals, your activity level will increase step by step.

 

By around six to eight weeks, we’ll take another X-ray to check healing. If things are on track, you’ll start easing back into normal life. If there are concerns, we’ll review again at twelve weeks.

 

Once healing is confirmed, you can resume heavier use of the arm, including work or sport, between ten and twelve weeks – depending on your symptoms and progress.