Hand, Wrist & Upper Limb
Clavicle Fracture
Non-Operative & Operative management
About Your Injury
A clavicle (collarbone) fracture is a break in the bone connecting the breastbone to the shoulder blade. It is a common injury after a fall onto the shoulder or outstretched arm, or direct impact to the collarbone, such as in sport or a cycling accident.
Non-Operative Management
Clavicle fractures can often be safely and effectively managed without surgery. The decision is individualised to each patient, based on patient factors (age, comorbidities, occupation) and specific characteristics of the fracture (location, displacement, skin integrity). Despite sometimes alarming looking X-rays, sling immobilisation and early gentle range of motion usually result in healing and good long-term function.
Recovery Timeline
Weeks 0–2
Sling for comfort, pendulum and gentle elbow/wrist movement, pain control.
Weeks 2–6
Progressive weaning from the sling as pain allows; gentle shoulder movement introduced.
Weeks 6–8
X-ray to confirm healing; return to light activities.
3 months
Return to full shoulder movement and most activities.
4–6 months
Return to contact sport or heavy overhead work, once healing is confirmed.
Follow-Up Schedule
2 weeks
Clinical review of pain and early movement.
6 weeks
X-ray to confirm healing progress.
3 months
X-ray to assess for nonunion, and final review prior to return to sport or heavy activity.
Nonunion
Nonunion means the fracture fails to heal. It is a frustrating but relatively rare complication of clavicle fractures. We monitor for it with X-rays through your follow-up appointments, and a decision about whether the bone is healing as expected is usually made around the 3-month mark. To reduce the risk: follow the physiotherapy protocol as guided, maintain a healthy, balanced diet to support bone healing, and avoid all nicotine intake — including cigarettes, vaping, and nicotine replacement products — the single biggest modifiable risk factor for nonunion.
Operative Management
Significantly displaced or shortened fractures are treated with surgery to restore length and alignment.
A plate and screws are placed along the top (superior surface) of the clavicle to hold the fracture in the correct position while it heals. This procedure is performed under general anaesthetic, with local anaesthetic infiltration at the time of surgery for good pain control in the first 12–24 hours afterward. It is usually done as day surgery or with a single overnight stay.
Recovery Timeline
Weeks 0–2
Sling, with pendulum and gentle elbow/wrist movement.
2 weeks onward
Weaning from the sling as pain allows, with gentle shoulder movement introduced.
3–5 months
A gradual, protocol-based return to sport and full activity, guided by a good physiotherapist, once union is confirmed.
Follow-Up Schedule
2 weeks
Wound check and review of pain and early movement.
6 weeks
X-ray to confirm healing progress.
3 months
X-ray to assess union, ahead of a gradual return to sport and heavy activity.
Delayed Union & Nonunion
Delayed union means healing is taking longer than expected; nonunion means the fracture fails to heal altogether. Despite surgical fixation, both remain a recognised risk with clavicle fractures, particularly in smokers — nicotine is the single biggest modifiable risk factor, and avoiding it altogether gives your fracture the best chance of healing on time.
Hardware Removal
The plate and screws are not routinely removed, but removal is frequently required — the clavicle sits directly under the skin, so hardware irritation is more common here than at many other sites (for example, from clothing or bag straps). If needed, this is a day surgery procedure usually performed 6–12 months after your original operation.