Returning to Activity After a Clavicle Fracture

A common question I hear when evaluating a patient with a clavicle fracture is: when can I return to full activity?

In recent years, there has been an increasing trend toward plate fixation of displaced mid-shaft clavicle fractures. Whereas in years past it was felt that most clavicle fractures heal without an operation, several studies have now demonstrated that healing rates and outcome are more predictable with operative treatment of displaced clavicle fractures. Another benefit of plate fixation is a quicker healing time, as demonstrated in the Canadian Orthopedic Trauma Study.

What the research shows

An article in the November 2013 issue of the American Journal of Sports Medicine provides more insight into the recovery time for clavicle fractures in the athletic population. The study by Meisterling and colleagues reviewed 29 clavicle fractures that occurred during athletic activity and were treated with plate fixation. All patients, or 100%, returned to sporting activity and 100% were satisfied with treatment, which shows that the vast majority of clavicle fractures treated with a plate will be able to return to sports.

My post-operative plan

In my practice, I recommend surgical treatment for clavicle fractures that are completely displaced. The post-op plan typically looks like this:

• After surgery, patients are in a sling for 2 weeks to allow the break to heal. Stationary bike and walking are allowed immediately.
• After 2 weeks, the sling is removed and motion exercises begin.
• At that point return to noncontact sports is allowed, such as biking and swimming.
• At 8 weeks after surgery, strengthening is started and participation in overhead sports (e.g. golf, tennis, basketball) is allowed.
• Return to contact sports (e.g. football) is allowed at 12 weeks after the operation.

The average healing time for a displaced clavicle fracture that is treated without an operation is 6 months, whereas the above times with plate fixation are much quicker than non-operative treatment. As in the above study, I find that the vast majority of individuals are satisfied with their treatment and return to activity.