Diagnosis and preliminary examinations
Once the collarbone fracture has been diagnosed, doctors weigh up the pros and cons of surgery and conservative therapy. In order to be able to make a decision, various preliminary examinations are carried out. First and foremost, X-rays of the clavicle provide information, possibly supplemented by CT or MRI.
This also facilitates the planning of the operation. Before the operation, motor or sensory deficits and possible circulatory problems are also recorded in order to assess vascular or nerve damage. In addition, blood samples are examined to be able to provide blood reserves in case of complications during the operation and to record the coagulation status of the patient, which is important for the performance of an operation. An ECG is also standard. Once the extent of the collarbone fracture has been determined and the preliminary examinations have been carried out, the operation can begin once the indication has been clearly established.
Causes for a collarbone fracture
With a fracture rate of 10-15% in adults, the collarbone is the second most frequently affected by bony injuries after the radius fracture near the wrist (distal radius fracture). The cause can be an indirect force (more frequent), such as a fall on the extended, intercepting arm (e.g. fall from a bicycle) with transmission of the force to the clavicle, or a direct trauma (less frequent) by a blow or fall on the front shoulder. Traffic accidents (approx.
50%, here especially motorcyclists who break their collarbone through the lower edge of the motorcycle helmet) and sports injuries (approx. 35%, most common fracture of the cyclist) are the most common causes of collarbone fractures. In about 80% of cases, the clavicle breaks in the middle part of the shaft, because that is where the diameter of the clavicle is smallest. In about 15% of cases, the lateral (lateral, near the shoulder) and in about 5% the medial (near the breast bone) end of the clavicle is affected. The bone in these areas has a larger diameter, is therefore more stable and is additionally stabilized by numerous ligaments.