What is a Clavicle Fracture?

Clavicle Fracture Description:

A clavicle fracture, also known as a collarbone fracture, is a common injury involving the clavicle bone, which connects the shoulder to the chest. These fractures often occur due to falls, sports injuries, or direct trauma to the shoulder. A comprehensive understanding of clavicle fractures, including their causes, symptoms, and management, is essential for effective treatment and recovery.

Causes and Mechanisms of a Clavicle Fracture:

Clavicle fractures typically result from:

• Direct Impact: A fall onto the shoulder or a direct blow to the collarbone can cause a fracture.

• Sports Injuries: High-impact sports or activities that involve a risk of falls may lead to clavicle fractures.

Clavicle Fracture Risk Factors:

Certain factors may increase the risk of sustaining a clavicle fracture, including:

• Age: Clavicle fractures are more common in children and young adults.

• Participation in Sports: Engaging in contact sports or activities with a risk of falls elevates the risk.

• Osteoporosis: Weakened bones due to osteoporosis can make individuals more susceptible to fractures.

Signs and Symptoms of a Clavicle Fracture:

Common signs and symptoms of a clavicle fracture include:

• Pain: Immediate pain at the site of the fracture, aggravated by movement.

• Swelling: Swelling and tenderness around the fractured area.

• Deformity: In some cases, a visible deformity or a "bump" may be apparent.

• Limited Range of Motion: Difficulty moving the arm and shoulder due to pain.

Clavicle Fracture Treatment:

1. Early Assessment:

• A thorough assessment by a physiotherapist is crucial to evaluate the extent of the clavicle fracture, assess surrounding structures, and identify individualized treatment needs.

2. Immobilization Support:

• Physiotherapists work with patients to adapt to slings or braces, ensuring they provide optimal support without hindering other aspects of daily life.

3. Pain Management:

• Modalities such as heat or cold therapy, gentle massage, and specific exercises help manage pain and discomfort associated with the fracture.

4. Range of Motion Exercises:

• Gradual introduction of passive and active range of motion exercises helps restore flexibility in the shoulder joint. This is initiated as early as possible, considering the stage of healing.

5. Strengthening Exercises:

• Specific exercises targeting the muscles around the shoulder and upper arm are introduced to rebuild strength gradually. Progressive resistance exercises ensure a safe and effective recovery.

6. Posture Training:

• Physiotherapists focus on correcting and maintaining proper posture during daily activities to prevent undue stress on the healing clavicle.

7. Functional Activities:

• Physiotherapists guide patients through functional activities that mimic daily tasks to enhance coordination and promote the integration of the shoulder into regular movements.

8. Joint Mobilization Techniques:

• Manual therapy techniques, including joint mobilizations, may be applied to improve joint mobility and reduce stiffness.

Clavicle Fracture Exercises:

• Physiotherapists design personalized home exercise programs, emphasizing the importance of consistency to optimize recovery.

• Patients are educated on self-management techniques and advised on when to seek professional guidance.

Gradual Return to Activities after a Clavicle Fracture:

• Physiotherapists work with patients to ensure a safe and gradual return to daily activities, including work and recreational pursuits.

Preventing Recurrence of Clavicle Fractures:

• Education on injury prevention strategies, ergonomic principles, and proper warm-up techniques is integral to preventing future injuries.

Clavicle Fracture ORIF (Open Reduction Internal Fixation)

A clavicle fracture ORIF (Open Reduction Internal Fixation) is a surgical procedure performed to repair a broken collarbone using metal plates, screws, or rods to hold the bone fragments in place while they heal. The clavicle, or collarbone, is a long, bone that connects the shoulder blade to the sternum (breastbone). Clavicle fractures are common injuries, often resulting from falls, sports injuries, or motor vehicle accidents.

Indications for clavicle fracture ORIF include displaced fractures, open fractures (where the bone breaks through the skin), fractures with associated nerve or blood vessel damage, and fractures that fail to heal with conservative treatment such as immobilisation in a sling.

During the ORIF procedure, the surgeon makes an incision over the fracture site and realigns the broken bone fragments into their correct position. The fragments are then held together using metal plates, screws, or rods, which are placed either on the surface of the bone (external fixation) or inside the bone (internal fixation). The incision is then closed, and the patient is typically placed in a sling to support the arm and shoulder during the initial stages of healing.

Physiotherapy Rehab after a Clavicle Fracture ORIF

Physiotherapy plays a crucial role in the recovery process following clavicle fracture ORIF. The goals of physiotherapy are to promote healing, restore range of motion, regain strength and function, and prevent complications such as stiffness and weakness.

In the early stages of rehabilitation, the physiotherapist focuses on pain management and gentle mobilisation exercises to prevent stiffness and promote circulation to the injured area. Passive range of motion exercises may be initiated to gently move the shoulder joint through its available range without causing further damage to the healing bone.

As healing progresses, the physiotherapy program is advanced to include active range of motion exercises, strengthening exercises targeting the muscles surrounding the shoulder joint, and functional exercises to improve shoulder stability and mobility. These exercises are tailored to the individual patient's needs and may be performed in both supervised physiotherapy sessions and as part of a home exercise program.

Physiotherapists also provide guidance on proper posture and body mechanics to prevent strain on the healing clavicle and surrounding structures. Additionally, we may use manual therapy techniques such as soft tissue massage and joint mobilisations to address any residual stiffness or muscle tightness.

Conclusion

Overall, physiotherapy plays a vital role in the rehabilitation of patients undergoing clavicle fracture ORIF, helping to regain function and return to their normal activities safely and effectively. Through a combination of hands-on therapy, guided exercises, and education, physiotherapists support patients throughout the healing process, promoting optimal recovery and outcomes.