The collarbone (clavicle) connects the shoulder to the upper sternum (breastbone). It is the most common fracture (broken bone) of childhood. It usually breaks in the middle and cause pain and swelling.
The fracture follows a fall on the shoulder or an outstretched hand. Sometimes, it is caused by a direct blow to the collarbone.
Within one week, most collarbone fractures form a lump of new bone (called callus). By 2 to 3 weeks, the pain usually is gone. By 8 weeks, the bone usually is strong enough for sports and other activities. By 6 months, the lump at the fracture site usually has disappeared and the collarbone has returned to normal.
Figure of eight bandage. Some children are put in a figure of eight bandage (brace) that pulls the shoulders back and keeps the fracture in the correct position for healing. Check the buckles or Velcro in back to be sure they are snug. The advantage of this brace is that the hands and arms can still be used. This is very important for the school age child with a fracture on the side of the writing hand. A tight bandage can interfere with circulation. If tingling, numbness, pain, or color change (blue or pale) of the fingers occurs, take off the figure of eight until the fingers feel normal. When you put the bandage back on, make sure it is a little looser.
Sling and elastic bandage. Some children are placed in an arm sling held against the chest by a wide elastic bandage. It has the disadvantage of disabling the hand on the side with the fracture. For writing assignments, however, the arm can temporarily be removed from the sling if it's not too painful. An advantage of the sling is it's more comfortable than the figure of eight. Either method works equally well for healing the fracture. The sling or figure of eight is continued until the fracture is no longer painful, which is usually 2 to 3 weeks.
Pain Relief. Give acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) for pain. Continue this for at least the first 48 hours. Applying a cold pack or ice pack to the collarbone for 20 minutes a few times may also help.
Bathing. The figure of eight bandage or the sling can be removed for bathing.
School. Your child can return to school after 1 day of treatment at home.
Activities. After the pain is gone (2 to 3 weeks), your child should begin moving the shoulder and regaining full range of motion. A helpful exercise is leaning forward and swinging the arm in a circle (like a pendulum). Your child should avoid bike riding, sports, or any rough play until the collarbone is completely healed (8 weeks).
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