A distal clavicle fracture is a fracture (break) in the distal third of the clavicle (collarbone). This occurs after a specific injury and can be initially be mistaken for an acromioclavicular sprain (“separated shoulder”) on a physical examination.
Most displaced distal clavicle fractures do not heal on their own without surgical intervention. They are associated with injury to the coracoclavicular ligaments, thus allowing significant displacement and non-healing of the fracture. Significantly displaced and open (when the bone breaks through the skin) fractures require surgery to prevent infection, restore the proper bony alignment of the clavicle, and promote healing. Patient lifestyle factors, such as smoking, can also prevent normal healing.
X-ray of distal clavicle fracture
CT scan of distal clavicle fracture
Frequent Signs and Symptoms
- Deformity or bump if the fracture is complete and the bone fragments separate enough to distort the normal appearance of the top of the shoulder
- Pain, tenderness, and swelling at the fracture site
- Bruising at the site of injury
- Loss of strength or pain when attempting to use the affected arm
- Numbness or coldness in the shoulder and arm on the affected side if the blood supply is impaired or nerves are injured (rare)
- Uncommonly, shortness of breath or difficulty breathing
Etiology (Causes)
- Usually, impact or falling on the tip of the shoulder
- A direct blow to the clavicle
- Less commonly, an indirect stress, such as falling on an outstretched hand or on the tip of the elbow