Clavicle (Collarbone): Anatomy and Injuries
The clavicle, commonly known as the collarbone, is an S-shaped bone connecting the shoulder to the chest. It plays a key role in shoulder stability and arm mobility.
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The clavicle, commonly known as the collarbone, is an S-shaped bone connecting the shoulder to the chest. It plays a key role in shoulder stability and arm mobility.
What Is the Clavicle?
The clavicle, commonly called the collarbone, is a long, S-shaped bone located on each side of the upper chest. It connects the sternum (breastbone) to the scapula (shoulder blade) and forms an essential part of the shoulder girdle. The clavicle is one of the most frequently fractured bones in the human body.
Anatomy and Function
The clavicle articulates at two key joints:
- Sternoclavicular joint: The junction between the clavicle and the sternum – the only true joint connecting the upper limb to the axial skeleton.
- Acromioclavicular (AC) joint: The connection between the clavicle and the acromion of the scapula.
Key functions of the clavicle include:
- Stabilizing and positioning the shoulder
- Protecting underlying neurovascular structures, including the brachial plexus and subclavian artery
- Transmitting forces from the arm to the trunk
- Enabling a wide range of arm movements
Common Injuries and Conditions
Clavicle Fracture
A clavicle fracture is among the most common bone injuries, particularly in children, adolescents, and athletes. It typically results from a fall onto an outstretched hand or a direct impact to the shoulder. Symptoms include severe pain, swelling, visible deformity, and restricted shoulder movement. Treatment is often conservative using a sling or figure-of-eight bandage; however, significantly displaced fractures may require surgical fixation with plates and screws.
Acromioclavicular Joint Injury
AC joint injuries are commonly caused by falls directly onto the shoulder. Severity is graded using the Rockwood classification, and treatment ranges from conservative management to surgical reconstruction depending on the grade.
Sternoclavicular Dislocation
Dislocation of the clavicle at the sternum is relatively rare but can occur after high-energy trauma. Posterior dislocations in particular can be life-threatening due to proximity to major blood vessels and the airway, requiring prompt medical evaluation.
Inflammatory Conditions
Inflammatory diseases such as SAPHO syndrome or rheumatic conditions can affect the clavicle and its joints, leading to chronic pain and swelling.
Diagnosis
Diagnosis of clavicle injuries typically involves:
- Physical examination: Palpation, inspection, and range-of-motion assessment
- X-ray: The standard imaging technique for detecting fractures and joint abnormalities
- Ultrasound: Useful for evaluating soft tissue and joint structures
- MRI or CT scan: Indicated for complex injuries or inconclusive findings
Treatment
Treatment depends on the type and severity of the injury:
- Conservative: Immobilization with a sling or figure-of-eight bandage; pain management with ibuprofen or paracetamol; physiotherapy to restore shoulder function
- Surgical: Open reduction and internal fixation (ORIF) using titanium plates or intramedullary nails for displaced fractures
Uncomplicated clavicle fractures typically heal within 6 to 8 weeks, often faster in children.
References
- Longo UG et al. - Clavicle fractures: a systematic review of 2144 fractures. British Medical Bulletin, 2012.
- Rockwood CA, Matsen FA - The Shoulder. 4th edition. Saunders Elsevier, 2009.
- American Academy of Orthopaedic Surgeons (AAOS) - Clinical Practice Guideline: Clavicle Fractures, 2021.
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