Clavicle Overlap and Stabilization After Fracture

Clavicular overlap and fixation?

Hello Doctor: In mid-October, I suffered a clavicle fracture due to a car accident.
Recently, when I touched the fracture site, I noticed that the clavicle seems to be overlapping.
Even when I use a figure-eight shoulder brace and try to hold my shoulders back, the clavicle remains in an overlapping position and has not united.
I would like to ask the doctor: 1.
"Is it normal for the clavicle to be in an overlapping state? Will using force later affect my ability to raise my arm high?" 2.
"Why is the figure-eight shoulder brace and my attempts to hold my shoulders back not able to bring the clavicle together?" Thank you, Doctor.

Xiansheng, 20~29 year old female. Ask Date: 2016/11/10

Dr. Shi Guozheng reply Orthopedics

Overlapping of the clavicle fracture will not affect future function as long as the bone has healed.
If the bone heals properly, the arm will not have limited range of motion.
The figure-eight shoulder strap is tied around both sides of the shoulders.
Insufficient force will not pull the fractured ends apart, and they will not realign on their own.
Therefore, there will definitely be a phenomenon of overlapping fracture ends.

Reply Date: 2016/11/10

More Info

Hello! Thank you for your questions regarding your clavicle fracture and the concerns you have about the healing process. Let's address your queries one by one.

1. Is clavicle overlap normal? Will it affect my ability to lift my arm?
Clavicle fractures often result in some degree of overlap, especially if the fracture is not completely displaced. This overlap can be a normal part of the healing process, as the body attempts to stabilize the fracture site. However, significant overlap or malalignment can lead to complications, such as improper healing or limited range of motion. In many cases, if the fracture is stable and there is no significant displacement, patients can regain full function over time. However, if you experience pain, limited range of motion, or difficulty lifting your arm, it may indicate that the fracture is not healing properly or that there are other underlying issues. It’s essential to follow up with your orthopedic surgeon to assess the healing process through physical examination and possibly imaging studies like X-rays.

2. Why can’t the figure-eight strap and self-posturing help the clavicle to unite?
The figure-eight strap is designed to help stabilize the shoulder girdle and promote proper alignment of the clavicle during the healing process. However, if the fracture is significantly displaced or if there is a gap between the fractured ends, the strap alone may not be sufficient to bring the bones into proper alignment. Additionally, the healing process can take time, and the body needs to form a callus around the fracture site before the bones can unite completely. If the strap is not providing the necessary stabilization or if the fracture is not healing as expected, it may be necessary to consider other treatment options, such as surgical intervention.

Additional Information:
Clavicle fractures are common injuries, particularly in high-impact sports or accidents. The healing process typically involves immobilization for several weeks, during which time the body forms a callus around the fracture. This callus is a temporary structure that eventually hardens into bone. The timeline for healing can vary based on factors such as age, overall health, and the specific nature of the fracture.

In most cases, non-surgical treatment is effective, and patients can expect to regain full function within a few months. However, if there is significant displacement or if the fracture does not heal properly, surgical options such as internal fixation may be necessary. This involves the use of plates, screws, or rods to stabilize the fracture and promote proper alignment.

It’s also important to engage in physical therapy after the initial healing phase to restore strength and range of motion. Exercises will focus on gradually increasing mobility and strength in the shoulder and arm, which can help prevent stiffness and improve function.

In summary, while some overlap in clavicle fractures can be normal, it’s crucial to monitor your symptoms and follow up with your healthcare provider to ensure proper healing. If you have concerns about your ability to lift your arm or if the figure-eight strap is not providing the expected results, don’t hesitate to reach out to your orthopedic specialist for further evaluation and guidance. Your recovery is important, and addressing these concerns early can help ensure the best possible outcome.

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