Clavicle Fracture Rehabilitation: Key Insights and Advice

How to rehabilitate a clavicle fracture?

Hello Dr.
Chen, my father accidentally fractured his clavicle while riding his bicycle.
However, it has been several months without improvement.
He has been visiting the hospital for follow-ups, but ultimately it was discovered that the healing has failed.
Initially, surgery was suggested, but the doctor later stated that whether the clavicle heals or not is not important, and recommended that my father not undergo surgery, claiming that a broken clavicle would not cause any issues.
However, my father continues to experience pain in his clavicle and has difficulty raising his arm.
What could be the reason for this? Additionally, during the recovery period, he has been using a figure-eight sling.
Is it safe for my father to move his arm? Could movement cause further injury? Please provide a clear answer, as different hospitals have given varying opinions, leaving my family confused about the situation.
I kindly ask for your advice, Dr.
Chen! Thank you!

Xiao Qiu, 20~29 year old female. Ask Date: 2004/05/22

Dr. Chen Xingyuan reply Orthopedics

Dear Reader,
The treatment for clavicle fractures can be divided into conservative treatment and surgical treatment.
Surgical intervention is necessary in cases of open fractures, associated neurovascular injuries, mid-shaft clavicle fractures with significant displacement, fractures at the ends that are about to penetrate the skin and become open fractures, displaced distal clavicle fractures, and multiple fractures occurring simultaneously.
Additionally, the patient's pain tolerance and cooperation are important factors to consider.

Generally, the advantage of surgery is that it allows for immediate reduction and fixation of the fracture, reducing the duration of pain and enabling earlier initiation of shoulder rehabilitation activities.
However, this comes with various surgical risks.
If conservative treatment is chosen, an eight-shaped shoulder strap should be used for six weeks along with more frequent X-ray follow-ups, which can also achieve good results.
Typically, for mid-shaft clavicle fractures without significant displacement (as long as the fracture ends can make contact), and if the patient has good pain tolerance and cooperation, conservative treatment is often recommended.
Regardless of whether conservative or surgical treatment is chosen, shoulder rehabilitation exercises are crucial and should ideally begin as early as possible.
Initially, assistance from the uninjured hand or another person may be needed to help lift the arm, with the lifting angle based on the patient's pain tolerance and ensuring no sound is produced at the fracture site.
The goal is to achieve full arm elevation within four weeks.
Your father has been injured for several months, and currently, the range of motion in his shoulder joint does not seem ideal, with ongoing pain at the fracture site.
It is important to differentiate whether the pain is due to stiffness in the shoulder joint or poor healing of the fracture.
Clinically, many cases of poor clavicle healing have ultimately resulted in satisfactory outcomes, with minimal impact on daily activities.

At this time, I recommend that your father undergo active rehabilitation treatment to restore shoulder joint mobility as soon as possible.
Surgical treatment should only be considered if the pain at the fracture site does not improve.
Wishing you peace and success!
Sincerely,
Dr.
Chen

Reply Date: 2004/05/22

More Info

Hello, 小邱. I'm sorry to hear about your father's clavicle fracture and the challenges he has been facing during his recovery. Clavicle fractures are common injuries, especially among cyclists, and they can vary significantly in terms of healing and rehabilitation.

First, it's important to understand that clavicle fractures can heal in different ways. Some fractures heal well with conservative treatment, while others may require surgical intervention, especially if there is significant displacement or if the fracture is not healing properly. In your father's case, it seems that the initial assessment indicated a non-displaced fracture, which often does not require surgery. However, if there is persistent pain and functional limitation, it may warrant a reevaluation.

The fact that your father has been experiencing ongoing pain and difficulty lifting his arm suggests that there may be more to the injury than just the fracture itself. Sometimes, even after a fracture has healed, there can be residual issues such as muscle weakness, joint stiffness, or even nerve irritation that can contribute to pain and functional limitations. This is particularly true if the arm has been immobilized for an extended period.

Regarding the use of a figure-eight brace (八字背帶), this is a common method for supporting a clavicle fracture. While it helps stabilize the fracture and promotes healing, prolonged immobilization can lead to stiffness and weakness in the shoulder and arm. Gentle range-of-motion exercises are usually encouraged as soon as tolerated to prevent stiffness and maintain mobility. However, these exercises should be performed under the guidance of a healthcare professional, such as a physical therapist, to ensure they are done safely and effectively.

If your father is experiencing significant pain with movement, it may be beneficial to consult with an orthopedic specialist who can reassess his condition. They may recommend imaging studies, such as X-rays or an MRI, to evaluate the healing of the fracture and check for any other underlying issues that could be causing pain. If the fracture is indeed not healing properly, or if there are other complications, surgical options may need to be reconsidered.

In terms of rehabilitation, once the fracture has stabilized, a structured physical therapy program can be very beneficial. This program typically includes:
1. Pain Management: Addressing pain through modalities such as ice, heat, or electrical stimulation.

2. Range of Motion Exercises: Gradually increasing the range of motion in the shoulder joint to prevent stiffness.

3. Strengthening Exercises: Once the pain is manageable and range of motion improves, strengthening exercises for the shoulder and upper arm can help restore function.

4. Functional Activities: Gradually incorporating activities that mimic daily tasks to improve overall function.

It's crucial to have a clear communication line with your father's healthcare providers. If there are conflicting opinions, seeking a second opinion from another orthopedic specialist may provide clarity and help establish a more definitive treatment plan.

In summary, while clavicle fractures can often heal without surgery, persistent pain and functional limitations should not be ignored. A thorough evaluation and a tailored rehabilitation program can significantly improve your father's quality of life and functional abilities. I hope this information helps you and your family navigate this challenging situation. Please encourage your father to stay proactive in seeking the care he needs. Thank you for reaching out, and I wish your father a smooth recovery.

Similar Q&A

Recovering from Clavicle Fracture: Tips for Balanced Push-Ups

After a clavicle fracture, if you find it difficult to perform push-ups and your weight shifts to your right hand, it may be due to a lack of strength in your left arm, which was affected by the injury. This imbalance can occur if the left side has not regained full strength or m...

Dr. Shi Guozheng reply Orthopedics
After a fracture, a period of inactivity can lead to a decrease in muscle strength around the shoulder joint. Therefore, it is essential to gradually practice strengthening exercises. You can perform lifting movements (pulling actions) and also incorporate pushing movements. Prog...

Rehabilitation After Clavicle Fracture Surgery: Safety and Guidelines

Hello Dr. Lee, I underwent a clavicle fracture fixation surgery on August 28, where a titanium alloy plate was implanted at my own expense, and a 1 cm segment of pelvic bone was used for fusion due to poor healing. After returning home, since I hadn't used my arm normally fo...

Dr. Li Yongheng reply Orthopedics
Hello, you underwent surgery for a clavicle fracture revision on August 28, which involved the insertion of a titanium alloy plate and an autologous bone graft from your pelvis. Currently, you are using the strength of your normal left hand to support your dangling right hand. In...

Do You Need Rehab for a Clavicle Fracture? Understanding Recovery and Risks

Hello, Director Su! I accidentally fell and fractured my clavicle because my palm hit the ground first. I am currently wearing a brace. Do I need rehabilitation? Will there be any long-term effects? Thank you!

Dr. Su Hongci reply Rehabilitation
Clavicle fractures are one of the most common types of fractures. They typically heal well without the need for surgical intervention. Most cases can be managed by using a figure-of-eight shoulder strap to immobilize the shoulder in an upward and backward position. A triangular b...

Understanding Clavicle Fractures: Recovery, Surgery, and Rehabilitation

Hello, Doctor! I have a mid-shaft fracture of the left clavicle with some comminution. The orthopedic surgeon at Li Hsin Hospital suggested surgery to fix it with a titanium alloy plate. I would like to ask the following questions: 1. After recovery, will I be able to return to...

Dr. Shi Guozheng reply Orthopedics
After recovery, there may be a slight decrease in muscle strength, but most patients can return to their pre-injury state. No physician can guarantee a full 100% recovery. Removing the plate has its benefits, as it reduces local irritation; however, if it is not removed, there is...