Broken Collarbone (Child)
Your child has a broken collarbone (fractured clavicle). The collarbone connects the breast bone (sternum) to the shoulder. This injury may cause pain, swelling, bruising, and a bump (deformity) around the break. A more serious collarbone break may harm nerves and blood vessels in the area, as well as the lungs.
Children can break their collarbone by falling on a shoulder. Infants can break their collarbone during delivery. This may happen because of greater than normal birth weight.
A broken collarbone is usually diagnosed by an X-ray. But the break may not show up on the first X-rays done, especially in children. Your child may need follow-up X-rays if the break can’t be seen. These are usually done in 10 to 14 days. At that time, they may show that the break is healing.
A broken collarbone is usually treated with a shoulder immobilizer or sling. Younger children often need to keep the shoulder in the immobilizer for 2 to 4 weeks. Adolescents typically need to keep the shoulder immobilized for 4 to 8 weeks. Your child will need to start range-of-motion exercises when the pain from the injury eases. Only rarely is surgery needed for a broken collarbone.
Even after the break heals, your child may have a bump at the site of the fracture. This may get smaller over the next 6 to 9 months. But sometimes the bump never goes away.
Your child’s healthcare provider will tell you when your child can go back to playing contact sports. At that point, your child should no longer have any pain when moving the shoulder. He or she should also have regained shoulder strength. This usually takes 6 to 8 weeks.
Your child’s healthcare provider may prescribe medicines for pain. Follow the provider’s instructions for giving these medicines to your child. Don’t give your child aspirin unless the provider tells you to.
Put an ice pack on the injured area. Do this for 20 minutes every 1 to 2 hours the first day for pain relief. You can make an ice pack by wrapping a plastic bag of ice cubes in a thin towel. Don’t put the ice directly on the skin, because this can cause damage. Continue using the ice pack 3 to 4 times a day for the next 2 days. Then use the ice pack as needed to ease pain and swelling. You can put the cold pack directly on the shoulder immobilizer or sling.
If your child has a sling, he or she can take it off for bathing and sleeping.
Your child should avoid raising the injured arm overhead until he or she can do this without pain.
Encourage your child to wiggle or exercise the fingers of the hand on the injured side often.
Follow up with your child’s healthcare provider, or as advised. Your child may need follow-up X-rays to see how the bone is healing. If you were referred to a specialist, make that appointment as soon as you can.
Special note to parents
Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done for protection of the child. Please try to be patient and not take offense.
Call 911 if any of these occur:
When to seek medical advice
Call your child's healthcare provider right away if any of these occur:
Area of bruising over the collarbone gets larger
Hand or fingers of the affected arm on the injured side become swollen, numb, cold, burning, or blue
Pain or swelling gets worse. Babies too young to talk may show pain with crying that can't be soothed.
Your child can’t move the fingers of the hand of the injured collarbone
Tingling in the fingers of the hand of the injured collarbone that is new or getting worse
Fever (see Fever and children, below)
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.
Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.
Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.
Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.
Fever readings for a baby under 3 months old:
Fever readings for a child age 3 months to 36 months (3 years):
Rectal, forehead, or ear: 102°F (38.9°C) or higher
Armpit: 101°F (38.3°C) or higher
Call the healthcare provider in these cases:
Repeated temperature of 104°F (40°C) or higher in a child of any age
Fever of 100.4 or higher in baby younger than 3 months
Fever that lasts more than 24 hours in a child under age 2
Fever that lasts for 3 days in a child age 2 or older