A broken clavicle, or fractured collarbone, is a crack or complete break in the long, slightly curved bone that runs along the top of your chest from the base of your neck to your shoulder. It’s one of the most commonly broken bones in the body, and about 69% of these fractures happen in the middle third of the bone, where it’s thinnest and most exposed.
What the Clavicle Does
Each of your two clavicles is roughly 6 inches long and sits horizontally at the front of your shoulder. One end connects to your breastbone through ligaments; the other connects to your shoulder blade. Together, they act like structural struts that hold your shoulders in position and let you transfer force between your arms and the rest of your skeleton. Every time you push, pull, lift, or reach overhead, your clavicle is bearing and redirecting load.
Because the bone sits just beneath the skin with very little muscle or fat covering it, it’s vulnerable to direct hits. That same shallow position is also why a fracture is often visible from the outside.
How It Happens
Most clavicle fractures result from a direct blow to the shoulder or a fall onto an outstretched hand. Contact sports (football, hockey, rugby), cycling crashes, and motor vehicle collisions are the most common scenarios. In younger athletes, a hard tackle or a fall from a bike is the classic mechanism. In older adults, a simple fall from standing height onto the shoulder can be enough, especially if bone density is lower than normal.
Where the Bone Breaks
The location of the fracture matters because it influences treatment and healing. In a study of 1,000 consecutive clavicle fractures, 69% occurred in the middle third of the bone, 28% in the outer third (closer to the shoulder), and about 3% in the inner third (closer to the breastbone). The middle third breaks most often because it’s the narrowest segment and the point where the bone’s natural curve changes direction, creating a structural weak spot.
Fractures near the outer end tend to be more problematic. The ligaments in that area can become disrupted, making the fracture unstable. Displaced, unstable fractures of the outer clavicle have notably high rates of nonunion (the bone failing to heal), which is why they’re more likely to need surgery.
Symptoms You’ll Notice
A broken clavicle usually announces itself immediately. You’ll feel sharp pain at the fracture site, and it will hurt more if you try to lift your arm or move your shoulder. Many people instinctively cradle the injured arm against their body.
Beyond pain, there are several telltale signs:
- Visible deformity. Your shoulder may slump downward or forward compared to the other side, or the collarbone may look higher or lower than normal.
- Skin tenting. If the broken ends of bone are displaced, a sharp fragment can push up under the skin, creating an obvious bump or “tent” shape over the fracture.
- Grinding sensation. You may feel or hear a crackling or grinding when you attempt to move the shoulder. This is the broken bone ends shifting against each other.
- Swelling and bruising. The area around the break typically swells within the first hour and bruises over the following day or two.
How It’s Diagnosed
A standard X-ray of the clavicle is usually all that’s needed. Most fractures show up clearly on a front-to-back view, and a second angled view helps the doctor assess whether the bone ends have shifted apart. For fractures near either end of the bone, a CT scan is sometimes ordered to get a clearer picture of whether the break extends into the nearby joint. If there’s concern about a collapsed lung or rib injury from the same trauma, a chest X-ray will be added.
Treatment Without Surgery
The majority of clavicle fractures heal without an operation. The standard approach is immobilization with a simple arm sling, which keeps the weight of the arm from pulling on the fracture. A survey of U.S. surgeons found that 94% prefer a sling over the older figure-of-eight bandage (a strap that loops around both shoulders to pull them back). The figure-of-eight bandage is still common in parts of Europe, but evidence comparing the two is limited, and the sling is generally considered more comfortable.
You’ll typically wear the sling for several weeks, gradually weaning off it as pain decreases and you regain the ability to move your shoulder. Ice, over-the-counter pain relief, and sleeping in a semi-upright position (to avoid rolling onto the injury) help manage symptoms in the early days.
When Surgery Is Needed
Surgery becomes the better option when the fracture is significantly displaced (the bone ends have separated and lost contact with each other), when the break is open (bone has pierced the skin), or when there’s associated nerve or blood vessel damage. Unstable fractures of the outer clavicle are also strong candidates for surgical repair because of their poor track record with conservative treatment.
The operation typically involves realigning the bone and fixing it in place with a metal plate and screws. At nine months after injury, one large study found nonunion rates of 11% in patients treated without surgery, compared to less than 1% in those who had plate fixation. That’s a 93% reduction in the risk of the bone failing to heal. The tradeoff is the usual surgical risks (infection, hardware irritation, a scar) and the possibility that the plate may need to be removed later if it causes discomfort under the skin.
Recovery and Rehabilitation
Healing timelines vary depending on the severity of the fracture and whether surgery was performed. For nonsurgical fractures, most adults see solid bone healing by 6 to 12 weeks, though it can take longer. Surgical patients follow a structured rehabilitation protocol that generally unfolds in stages.
During the first four weeks after surgery, the focus is on gentle, assisted range-of-motion exercises: pendulum swings, table slides, and elbow and wrist movements. No weight is placed through the arm during this phase. From weeks five through eight, motion progresses to active-assisted exercises like wall slides, pulleys, and using a dowel to guide the arm through larger arcs. By weeks nine through twelve, the goal shifts to regaining full active movement and beginning gentle stretching of the shoulder, chest, and back muscles that have tightened during immobilization.
Strengthening starts around the three- to four-month mark with exercises like wall push-ups, resistance band work, and light shoulder raises. Return to sport typically falls in the four- to six-month window, with progressive loading that builds toward full contact or overhead activity. Data from NFL players who underwent surgical repair showed that 94% returned to professional play, with an average return time of about 211 days. Among those who made it back during the same season as their injury, the average was closer to 53 days, though these are elite athletes with intensive daily rehabilitation.
Potential Complications
The most significant complication is nonunion, where the bone simply fails to knit back together. Overall nonunion rates for clavicle fractures average around 5%, but the range in published studies is wide (3% to 29%), largely depending on the fracture type and how it was treated. Risk factors include smoking, older age, significant displacement of the bone fragments, and fractures of the outer third.
Malunion, where the bone heals in a shortened or angulated position, is more common than nonunion and can leave a visible bump or cause subtle changes in shoulder mechanics. Many people with mild malunion function normally and never notice a difference. In more severe cases, the shortened clavicle can cause the shoulder to feel weak or fatigued with overhead activities.
Numbness or tingling in the arm is possible if swelling or displaced bone irritates nearby nerves, but permanent nerve damage is rare. Hardware-related discomfort (feeling the plate or screws under the thin skin over the collarbone) is one of the more common complaints after surgery and the main reason some patients opt for plate removal once the bone has healed.