Clavicle Fracture

What is a broken collarbone?

The collarbone, also called the clavicle, is the bone over the top of your chest, between your breastbone (sternum) and shoulder blade (scapula). It is easy to feel the clavicle, because unlike other bones which are covered with muscle, only skin covers a large part of the bone.

Clavicle fractures are extremely common. Broken collarbones occur in babies (usually during birth), children and adolescents (because the clavicle does not completely ossify, or develop, until the late teens), athletes (because of the risks of being hit or falling), or during many types of accidents and falls.

How does a collarbone fracture occur?
Clavicle fractures are common injuries, and they can occur different ways. Some patients fall on an outstretched hand, others fall and hit the outside of their shoulder.

Broken collarbones can also occur from a direct hit to the clavicle. In babies, clavicle fractures occur at birth during passage through the birth canal.

What are the symptoms of a broken collarbone?
Most often, patients have shoulder pain, and difficulty moving their arm. Swelling and bruising around the broken bone are also quite common. After the swelling has subsided, the fracture is often easily felt through the skin.

At the doctor's office or in the emergency room, an x-ray will show the fracture. Your doctor will also perform an examination to ensure the nerves and blood vessels surrounding the clavicle are in tact. The nerves and vessels are rarely injured because of a broken collarbone.

What is the treatment for a clavicle fractures?
Treatment of clavicle fractures most commonly involves resting the affected extremity. There are several types of slings available; one commonly used is called a"figure-of-8" splint. This is a brace that wraps around the shoulders to keep them back--like a soldier standing at attention.

It is unusual for a clavicle fracture to require surgery, and most often an attempt at treatment in a sling is made. Surgery is required in some situations when either the skin is broken or if the fracture is severely displaced or shortened.

How long does it take to recover from a collarbone fracture?
Clavicle fractures should heal completely within 12 weeks, but the pain usually subsides within a few weeks. Often patients are back to full activities before 12 weeks has passed, especially with younger patients.

As a general guide to return to activities, nothing should cause worsening pain. If not wearing a sling causes pain, wear a sling. If driving hurts the fracture site, don't drive. If throwing a ball hurts, don't throw. Once an activity doesn't cause significant pain, a gradual return can be attempted.

Recovery is usually complete, with a full return expected. Patients may notice a persistent bump where the fracture was (often for months or longer), but this should not be bothersome.

Gestational diabetes

Gestational diabetes (or gestational diabetes mellitus, GDM) is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy. Gestational diabetes affects 3-10% of pregnancies, depending on the population studied.^[1] No specific cause has been identified, but it is believed that the hormones produced during pregnancy reduce a woman's sensitivity to insulin, resulting in high blood sugar levels.

Gestational diabetes generally has few symptoms and it is most commonly diagnosed by screening during pregnancy. Diagnostic tests detect high levels of glucose in blood samples.

Babies born to mothers with gestational diabetes are at increased risk of complications, primarily growth abnormalities and chemical imbalances such as low blood sugar. Gestational diabetes is a reversible condition and women who have adequate control of glucose levels can effectively decrease the associated risks and give birth to healthy babies.

Women with gestational diabetes are at high risk of developing type 2 diabetes mellitus after pregnancy, while their offspring are prone to developing childhood obesity, with type 2 diabetes later in life. Most patients are treated only with diet modification and moderate exercise but some take anti-diabetic drugs, including insulin therapy.