Anatomy
The clavicle (clavicle) forms a joint with the sternum and the upper bony prominence of the shoulder blade (acromion). Among other things, the clavicle serves as the attachment for many shoulder and chest muscles. 
Skeleton
A. Clavicula
(Collar bone)
Cause
A direct fall on the shoulder or outstretched arm or direct trauma can cause a fracture of the collarbone, which is one of the most common fractures (5-10% of all fractures). The fracture usually occurs in the centre of the collarbone. The ligaments that hold the clavicle in place can also break during the fracture.
Symptoms
Pain similar to the collarbone with aggravation with movement in the shoulder joint. In fractures with displacement of the bone, a bulge can often be seen on the collarbone.
Examination
Sudden onset of severe shoulder pain with pain-induced restriction of movement after a trauma should always lead to an examination by a professional. An ultrasound scan will usually confirm or rule out a suspected fracture ( Moritz JD. 2023).
However, X-ray is still used.
Treatment
Depending on the type of fracture, you may choose to relieve the pain and possibly use a short-term arm sling until the pain subsides after a few weeks at most. The arm can be used freely within the pain limit. Heavy lifting should be avoided for the first 6 weeks.
For more complicated fractures with displacement, surgery may be chosen in some cases, but the scientific evidence on the benefit of surgery is limited (Markes AR, et al. 2022) Children are usually treated with weight bearing and rehabilitation alone (Vargas-Vila MA, Mehlman CT, Pennock AT. 2019).
Rehabilitation, specific:
Once the pain has subsided (often after a few weeks), you can start cardio training in the form of running and rehabilitation according to the guidelines under general rehabilitation for children. After 4-6 weeks, you can start gentle muscle training of the shoulder muscles.
After a few months, children will often be able to participate in contact sports.
Complications
In the vast majority of cases, the fracture heals without complications. However, some people experience long-term discomfort after a clavicle fracture even if the fracture heals. Some fractures form a false joint (pseudoarthrosis) that requires (re-) surgery.
The collarbone protects major blood vessels, lung and nerve centre. In rare cases, a clavicle fracture can cause damage to these structures, requiring emergency hospitalisation.
