[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Clavicle fracture [Conditions](https://durgical.com/en/conditions/) · [Upper limb](https://durgical.com/en/anatomy/region/upper-limb/) # Clavicle fracture A clavicle fracture is a break of the collarbone, usually in its middle third; it is one of the most common fractures and most heal without surgery. Updated 2026-10-29 ## Structures involved Tap one to see what it is and open it in 3D. - [Clavicle](https://durgical.com/en/anatomy/clavicle/) - [Subclavian artery](https://durgical.com/en/anatomy/right-subclavian-artery/) - [Subclavian vein](https://durgical.com/en/anatomy/subclavian-veins/) - [Plexus trunks](https://durgical.com/en/anatomy/brachial-plexus-trunks/) - [Conoid ligament](https://durgical.com/en/anatomy/conoid-ligament/) - [Trapezoid ligament](https://durgical.com/en/anatomy/trapezoid-ligament/) - [AC ligament](https://durgical.com/en/anatomy/acromioclavicular-ligament/) ## What it is Break of the collarbone, one of the most common fractures at all ages, usually in its middle third. Most heal without surgery, but the nearby subclavian vessels, [brachial plexus](https://durgical.com/en/anatomy/roots-of-brachial-plexus/) and lung must be checked. ## Who gets it Common in children, adolescents and young adults, especially men, from falls, contact sports, cycling and motorcycle accidents; also seen in newborns as a birth injury and in older adults after simple falls. ## Causes - Fall onto the side of the shoulder (most common) - Fall on an outstretched hand - Direct blow to the clavicle - Birth trauma in newborns (for example shoulder dystocia) ## Risk factors - Contact sports and cycling - Motorcycle and road traffic accidents - Young male sex - Osteoporosis and falls in older adults - Large birth weight or difficult delivery in newborns ## Pathophysiology The middle third is the thinnest part and lacks ligament and muscle support, so it breaks most often. After a midshaft fracture the medial fragment is pulled up by the [sternocleidomastoid](https://durgical.com/en/anatomy/sternocleidomastoid-muscle/) and the lateral fragment falls with the weight of the arm and is pulled medially, causing shortening. The subclavian vessels and brachial plexus lie just beneath. ## Classification - By location (Allman): middle third (most common), lateral (distal) third, medial third (rare) - Lateral third fractures further divided by the integrity of the coracoclavicular (conoid and [trapezoid](https://durgical.com/en/anatomy/trapezoid/)) ligaments - Non-displaced, displaced, shortened or comminuted ## Symptoms and signs - Pain over the clavicle after a fall or blow - Visible or palpable deformity or bump - Swelling and bruising - Arm held against the body, supported by the other hand - Painful or limited shoulder movement; crepitus ## Red flags - Skin tenting or an open wound over the fracture - Cold, pale or pulseless arm, or an expanding haematoma: subclavian vessel injury - Numbness or weakness of the arm: brachial plexus injury - Shortness of breath or reduced breath sounds: pneumothorax - Associated [scapula](https://durgical.com/en/anatomy/scapula/) fracture (floating shoulder) or high-energy polytrauma ## Diagnosis **Clinical** Local tenderness and deformity, with a full check of the [skin](https://durgical.com/en/anatomy/skin/), distal pulses, arm sensation and strength, and breath sounds. **Tests** Usually none; tests are added only for associated injuries in polytrauma. **Imaging** AP and cephalic-tilt X-rays of the [clavicle](https://durgical.com/en/anatomy/clavicle/) confirm and measure displacement and shortening; CT for medial fractures or sternoclavicular involvement; [chest](https://durgical.com/en/anatomy/region/chest/) X-ray if pneumothorax is suspected. ## Differential diagnosis - Acromioclavicular joint separation - Sternoclavicular joint dislocation - Proximal [humerus](https://durgical.com/en/anatomy/humerus/) fracture - Shoulder dislocation - Scapula fracture ## Goal of treatment Achieve painless union with acceptable alignment and full shoulder function, and detect early any injury to skin, vessels, nerves or lung. ## Treatment **Conservative** Most fractures: a sling or figure-of-eight bandage for comfort, analgesia, and early gentle movement as pain allows. **Surgical** Open reduction and fixation with a plate or intramedullary device for open fractures, skin at risk, neurovascular injury or floating shoulder; often considered for marked shortening or displacement and some lateral fractures (criteria vary). **Rehabilitation** Progressive range-of-motion and strengthening exercises once pain settles, with gradual return to sport. ## Complications - Malunion with a visible bump or shortening - Nonunion, more likely with displaced, shortened or lateral fractures - Subclavian vessel or brachial plexus injury - Pneumothorax - Hardware irritation or infection after surgery ## Prognosis Most midshaft fractures heal well without surgery, especially in children, who remodel strongly. Displaced and shortened fractures in adults have higher rates of nonunion and symptomatic malunion. ## Prevention - Protective equipment in contact sports and cycling - Road safety measures for motorcycle riders - Fall prevention in older adults ## Test yourself Think of the answer, then tap the question to see it. ## Which part of the clavicle is fractured most often? The middle third (midshaft). ## How are most clavicle fractures treated? Non-operatively, with a sling for comfort, analgesia and early movement. ## Which structures must be examined after a clavicle fracture because they lie just beneath it? The subclavian artery and vein, the brachial plexus and the apex of the lung. ## Why does the medial fragment of a midshaft clavicle fracture displace upward? The sternocleidomastoid pulls it up, while the arm's weight pulls the lateral fragment down. ## What is an absolute indication for surgery in a clavicle fracture? An open fracture, skin at risk from tenting, or associated neurovascular injury. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/conditions/clavicle-fracture/) ## Related conditions - [Acromioclavicular joint separation](https://durgical.com/en/conditions/acromioclavicular-joint-separation/) - [Proximal humerus fracture](https://durgical.com/en/conditions/proximal-humerus-fracture/) - [Shoulder dislocation](https://durgical.com/en/conditions/shoulder-dislocation/) - [Brachial plexus injury](https://durgical.com/en/conditions/brachial-plexus-injury/) - [Radial head subluxation (pulled elbow)](https://durgical.com/en/conditions/radial-head-subluxation/) Educational information, not medical advice. For any symptom, see a health professional. Sources: [Clavicle Fracture](https://www.ncbi.nlm.nih.gov/books/NBK507892/) (StatPearls (NCBI Bookshelf), 2026). [← All conditions](https://durgical.com/en/conditions/) ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/conditions/clavicle-fracture/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/clavicle-fracture/