Midshaft Clavicle Fracture (under 12) Patient Information

You have a Midshaft Clavicle Fracture (Under 12). This is a break to the middle of your collar bone.

Pointing to collar bone to reference fracture placement

Healing

It normally takes 3-6 weeks to heal, but symptoms can continue for 3-6 months.

Pain and swelling

Your should may be swollen and you will have some pain. Taking pain medication and using ice or cold packs will help. More information is below.

Wearing your sling

Use your sling for 2-3 weeks. You can take it off to wash, dress and do your exercises. It does not need to be worn at night.

Person wearing a sling to support their arm

Exercise and activity

It is important to start gentle exercises straight away to prevent stiffness. You will find pictures and instructions for your exercises below.

You should not do any heavy lifting or overhead movement for the first 6 weeks.

Skin tenting

Occasionally, the skin over the fracture site can become very stretched and thin. If the skin around the bone starts to look very thin, or the bone seems very close to the skin, then you need to contact the Emergency Department immediately.

Follow up

A follow up appointment is not normally needed for this injury. Please contact the Emergency Department, your GP or NHS 111, if after 6 weeks your child still has significant pain or swelling. A lump (callus) may appear at the fracture site as it is healing; this is quite normal and should disappear over a few months after the fracture has healed.

Caring for your injury: Weeks 1-3

Remember to use your sling for the first 2-3 weeks. Take it off to wash, dress and do your exercises. You don’t have to wear your sling at night. You may find it more comfortable to sleep propped up on pillows.

Using a cold pack will help with your pain and swelling. You can use an ice pack or bag of frozen peas wrapped in a damp towel. Put this on your shoulder for 15 minutes every few hours. Make sure the ice isn’t in direct contact with your skin.

Try to rest your arm, especially in the first 24-72 hours.

Exercises

Start these exercises straight away. Hand, wrist and elbow exercises are only needed while you are wearing a sling. You can stop these once they become easy and you have full movement. Try to do these exercises 4-5 times a day. Repeat each exercise 10 times.

Hand, wrist and elbow exercises

  1. Open and close your hand. Next, move your wrist up and down. Repeat 10 times
  2. After a few days, hold a soft ball or rolled up socks. Squeeze the ball and hold for 5 seconds. Repeat 5 times.
    Four photos showing wrist exercise. Top left shows a tightly closed fist. Top right shows and out stretched hand. Bottom right shows a loose fist bent downwards from the wrist. Bottom right shows a loose fist bent upwards from wrist.
  3. Bend and straighten your elbow. Repeat 10 times.
  4. Bend your elbow to a right angle. Slowly turn your palm up to the ceiling and down to the ground. Repeat 10 times.
    Four photos depicting elbow exercise. Top left shows arm bent at elbow towards the body. Top right shows arm released down by the side of the body. Bottom left shows elbow bent at a right angle with palm face down. Bottom right show elbow bent at right angle with palm facing upwards.

Posture exercise

Bring your shoulders back and gently squeeze your shoulder blades together. Hold for 20-30 seconds. Repeat 5 times.

Two photos. Top photo depicts a relaxed back. Bottom photo shows a back where the shoulder blades are being pushed together into the centre.

Shoulder pendulum exercise

Stand next to a firm surface. Support yourself with your un-injured arm and lean forwards. Let your injured arm relax and hang down to the ground.

Gently swing your arm, making a small movement. Try to do this forward and backward, side to side and in small circles.

Aim to do this for 1-2 minutes in total. You do not need to push into pain. Remember to keep your arm relaxed.

Four photos depicting a shoulder pendulum exercise. Top left shows figure bent forward supporting themselves on a chair, with free arm being pushed backwards. Top left shows the arm swinging forwards. Bottom left shows arm swinging across the body. Bottom right shows arm swinging outwards away from the body.

Caring for your injury: Weeks 3-6

You can not stop using your sling.

You can return to light activities. Remember, you should not do any heavy lifting or overhead activity for 6 weeks.

Exercises

Start these exercises 3 weeks after your injury. Try to do them 4-5 times a day. Repeat each exercise 10 times.

Active assisted flexion

Use your other hand to lift your injured arm up in front of you, as shown in these pictures.

Two photos depicting active assisted flexion. Left photo shows arm close to the body bent at the elbow, with a supportive hand. Right photo shows arm elevated at a right angle, bent at the elbow and being supported by uninjured hand.

Active assisted external rotation

Keep the elbow of your injured arm tucked into your side and your elbow bent. Hold onto a stick, umbrella or something similar.

Use your good arm to push your injured hand outwards. Remember to keep your elbow tucked in.

If you don’t have a stick, hold your injured arm at the wrist, guide it outwards with your good hand.

Photo showing the elbow of injured arm tucked into the side and your elbow bent. Hold onto a stick, umbrella or something similar. Use your good arm to push your injured hand outwards. Remember to keep your elbow tucked in.

Caring for your injury: From week 6

Your injury should be healed.

You can return to normal activities. Do this gradually and be guided by any pain or discomfort you experience. Some heavier tasks may still be uncomfortable.

Exercises

Start these exercises 6 weeks after your injury. Try to do these exercises 4-5 times a day. Repeat each exercise 10 times.

Active flexion

Lift your arm forwards in front of you. Try to raise the arm as high as you can. You do not need to push into pain. If this is too difficult, try the same movement with a bent elbow.

Arm down by side Arm raised forward at right angle to body Arm raised straight up

Active abduction

With your palm facing forwards, move your arm out to the side in a big arc. Try to raise the arm as high as you can. You do not need to push into pain. If this is too difficult, try the same movement with a bent elbow.

Person with arm down by their side, palm facing forward Person with arm out to the side, palm facing forward Person with arm extended upwards, palm facing forwards

Active external rotation

Start with your elbow bent by your side. Move our forearm out to the side, keeping your elbow bent and near your waist.

Person with their arm bent at the elbow, hand pointing forward Person with their arm bent at elbow, hand pointing out to the side with palm facing forward

Frequently asked questions

I’m concerned about my child’s symptoms and/or they are struggling to regain movement.

Please contact the Emergency Department, your GP or NHS 111.

My child is struggling with the sling. What do I do?

Contact the Emergency Department.

Should my child go to school?

Your child can attend school as normal once their pain has settled.