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Health condition · Clinically reviewed

Broken collarbone, from sling care to fixation, and when it really matters.

Around one in twenty adult fractures is a clavicle fracture. Most heal in a sling; a smaller group need surgery, and a small number are true emergencies.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against BOAST, NICE and peer-reviewed orthopaedic sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK practice on displaced mid-shaft fixation, distal-third options and non-union management.

Key facts

A broken collarbone at a glance.

The essentials, in plain English. What it is, how it is classified, and how it is treated in the UK today.

  • What it is

    A fracture of the clavicle, the S-shaped strut linking the sternum and the shoulder. Up to 5% of all fractures in adults.

  • Who gets it

    Adolescents, young adults in contact and cycling sports, and older adults after low-energy falls.

  • Where it breaks

    Roughly 80% mid-shaft, 15% lateral or distal third, and 5% medial third close to the sternoclavicular joint.

  • How it happens

    A direct blow to the shoulder, a fall onto the point of the shoulder, or, less often, a fall onto an outstretched hand.

  • First-line treatment

    Most undisplaced fractures heal well in a broad-arm sling with early gentle range of movement and physiotherapy.

  • When surgery helps

    Open injuries, skin at risk, neurovascular threat, marked shortening, comminution, distal Neer II and displaced medial third.

Why this guide matters

One injury, three very different pathways.

Where the fracture sits on the clavicle, and how badly it has moved, shapes the entire treatment plan. The three points below drive everything else on this page.

  • Location, location, location

    Roughly 80% of clavicle fractures are mid-shaft, 15% distal and 5% medial. Each behaves differently in terms of healing and risk.

  • Most heal in a sling

    Undisplaced and minimally displaced mid-shaft fractures do well with a broad-arm sling, early movement and physiotherapy.

  • Some need a surgeon

    Open injuries, skin threat, marked shortening, Neer II distal fractures and displaced medial-third patterns benefit from operative fixation.

How the diagnosis is made

From A and E to a clear plan.

The steps a UK emergency department or shoulder clinic will normally follow, in order, so you know what to expect and why.

  1. 01

    Assessing

    History and mechanism

    Direct blow, fall onto the shoulder, fall onto an outstretched hand, or a higher-energy chest injury raise different concerns.

  2. 02

    Assessing

    Look and feel

    Swelling, deformity, tenting of the skin, a palpable step and inability to abduct the arm all point to a clavicle fracture.

  3. 03

    Assessing

    Neurovascular check

    Assessment of the brachial plexus and subclavian vessels, plus skin integrity, before any imaging.

  4. 04

    Confirming

    X-ray AP and cephalic tilt

    Standard AP plus a 45 degree cephalic tilt view of the clavicle to judge displacement, shortening and comminution.

  5. 05

    Confirming

    Chest X-ray

    To exclude pneumothorax, rib fractures and other chest injury in higher-energy mechanisms.

  6. 06

    Confirming

    CT for medial or complex

    CT is used for medial-third fractures, intra-articular injuries and any suspected mediastinal compromise.

  7. 07

    Planning

    Shoulder team review

    A shoulder and upper-limb surgeon reviews displaced, distal, medial and open fractures for a tailored plan.

Typical timeline: first assessment to a settled plan within the same day for most people.

Symptoms

What a broken collarbone actually feels like.

The classic mix of pain, deformity and lost shoulder movement, plus the features that mean it is time to escalate.

  • Pain and localised swelling

    Sharp pain over the collarbone that is worse on any movement of the arm or shoulder girdle.

  • Visible deformity

    A step or bump over the clavicle, often with the shoulder appearing to droop forwards and downwards.

  • Tenting of the skin

    The bone end pushes up against the skin. Marked tenting is a warning that the skin may break down.

  • Shortening of the shoulder

    The affected shoulder can look shorter or rotated forwards compared with the other side.

  • Supporting the arm

    Patients typically hold the injured arm against the body, cradling it with the opposite hand.

  • Loss of shoulder abduction

    The arm cannot be lifted away from the body without severe pain, and shoulder movement is limited.

  • Palpable step and crepitus

    A step in the bone, sometimes with grating on gentle movement, is a strong clinical sign of fracture.

  • Red flag, medial posterior displacement

    Difficulty swallowing, breathlessness or venous congestion after chest trauma is a surgical emergency.

Treatment

How a broken collarbone is treated in the UK.

Sling and physiotherapy for most, fixation for displaced and distal patterns, and specialist input for medial and non-union cases. See our clavicle fixation guide for the surgical detail.

  • Broad-arm sling

    Four to six weeks in a broad-arm sling with early gentle pendulum exercises is enough for most undisplaced mid-shaft fractures.

  • Analgesia and ice

    Regular paracetamol and, where appropriate, a short course of NSAIDs. Ice packs help in the first 48 to 72 hours.

  • Guided physiotherapy

    Structured range of movement and rotator-cuff strengthening from a shoulder physiotherapist restores function and prevents stiffness.

  • ORIF with plate and screws

    Open reduction and internal fixation for displaced mid-shaft, distal Neer II, skin threat and non-union. See our clavicle fixation guide.

  • Intramedullary elastic nail

    A less invasive option for selected simple mid-shaft patterns in slim patients or younger athletes, chosen by the operating surgeon.

  • Medial-third and joint work

    Displaced medial-third and sternoclavicular injuries are managed with cardiothoracic backup because of the vessels behind the sternum.

  • Non-union surgery

    Plate fixation with bone graft, sometimes iliac crest or a bone morphogenetic protein, for fractures that fail to heal at six months.

  • Malunion correction

    A corrective osteotomy is reserved for symptomatic malunion where shortening or angulation genuinely limits function.

What this guide is based on

The sources behind every claim on this page.

UK national guidance, orthopaedic society standards and landmark trials, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or shoulder specialist knows your history and imaging and can tell you which parts apply to you. If in doubt, get seen.

  • British Orthopaedic Association Standards for Trauma (BOAST). Clavicle fractures.

  • NICE. Fractures (non-complex): assessment and management (NG38).

  • Neer CS. Fractures of the distal third of the clavicle. Classification and management.

  • Allman FL. Fractures and ligamentous injuries of the clavicle and its articulation.

  • Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures.

Red flags

When a clavicle fracture needs urgent attention.

Most broken collarbones are safely managed in an emergency department and a shoulder clinic. These are the situations where the pathway changes.

  • Open fracture

    Any bone visible through the skin needs urgent transfer to a trauma unit for washout and fixation.

  • Skin at risk from tenting

    Marked tenting or blanching over a sharp fragment can progress to skin necrosis. This warrants urgent surgical review.

  • Neurovascular compromise

    Weakness, numbness, cold hand or an absent pulse points to brachial plexus or subclavian injury and needs emergency assessment.

  • Posterior medial displacement

    Difficulty breathing or swallowing, hoarseness or facial swelling after a chest injury is a mediastinal emergency.

  • Suspected pneumothorax

    Breathlessness or reduced air entry after high-energy trauma needs a chest X-ray and same-day emergency care.

  • Polytrauma or head injury

    A clavicle fracture with other injuries is managed within a full trauma pathway, not as an isolated fracture.

  • Non-union features

    Persistent pain, deformity or a click at three to six months, especially with shortening over two centimetres, needs surgical review.

  • Fragility fracture in an older adult

    A clavicle fracture from a low-energy fall in an older patient should trigger a fracture liaison service and bone health assessment.

  • Recurrent falls or blackouts

    The fall itself may be the story. Any loss of consciousness, dizziness or arrhythmia needs a full medical review.

Living with it

A well-defined recovery, from week one to full contact.

Four things make the biggest difference day to day. Use the sling, move early, plan a graded return and speak up if anything changes.

A quiet reminder

Bone heals to a timetable that is not yours.

Rushing back to contact sport before the fracture has united is one of the commonest reasons for a re-break. Trust the six to twelve week window.

  1. 01 Sling

    Wear the sling as advised

    Most undisplaced fractures need a broad-arm sling for four to six weeks. Take it off only for exercises and washing.

  2. 02 Movement

    Move early, but gently

    Early pendulum and elbow, wrist and hand movement prevent stiffness. Your physio will progress you week by week.

  3. 03 Recovery

    Return to work and sport

    Desk work often at two to four weeks, driving when in full control of the wheel, contact sport typically at three to six months.

  4. 04 Escalate

    Speak up if something changes

    Fever, worsening pain, a hand that goes cold or new breathlessness are not part of a healing collarbone. Get seen.

Frequently asked

Everything we get asked about a broken collarbone.

Quick answers on healing time, sling versus surgery, non-union and when a medial-third fracture is dangerous.

  • How common is a broken collarbone?

    Very common. Clavicle fractures make up around five per cent of all adult fractures. They peak in adolescents and young adults after sport and in older adults after low-energy falls, and are one of the most frequent injuries in cyclists, rugby players and horse riders.

  • Do I always need surgery for a broken collarbone?

    No. Most undisplaced and minimally displaced mid-shaft fractures heal well in a broad-arm sling with early gentle physiotherapy. Around eighty-five per cent do well without surgery. Fixation is recommended for open fractures, skin threat, neurovascular injury, marked shortening, comminution, distal Neer II patterns and displaced medial-third fractures.

  • How long does a broken collarbone take to heal?

    Bony healing typically takes six to twelve weeks. Comfortable range of movement usually returns within six weeks, desk-based work within two to four weeks, and a return to full contact sport at three to six months. Older adults and smokers often take longer.

  • What is a figure-of-eight bandage and do I need one?

    A figure-of-eight bandage wraps around both shoulders to try to hold the fracture reduced. Modern evidence shows it is no better than a broad-arm sling and it is often uncomfortable, so a simple sling is preferred in UK practice.

  • What is a non-union of the clavicle?

    A non-union is a fracture that has failed to heal, usually at around six months. The risk is higher with displacement, comminution, shortening of more than two centimetres, smoking, female sex and increasing age. Treatment is typically plate fixation with bone grafting.

  • When is a medial clavicle fracture dangerous?

    A displaced medial-third fracture, or a sternoclavicular joint injury with posterior displacement, can compress the great vessels, trachea and oesophagus behind the sternum. Difficulty breathing, swallowing or a hoarse voice after a chest injury needs emergency assessment with CT and cardiothoracic backup.

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