About your shoulder

The Shoulder Joint is made up of 4 joints.

  • The Glenohumeral joint, (the ball meets the socket)
  • Sternoclavicular (SC) joint (the collar bone meets the chest bone),
  • Acromioclavicular (AC) joint (the collar bone meets the acromion of the scapula- the ‘tip’ of the shoulder)
  • Scapulothoracic joint (the shoulder blade meets with the ribs at the back of the chest) and the.

The Acromioclavicular joint (ACJ) is situated on top of the shoulder and only connected by ligaments. ACJ joint dislocation is a common injury. The mechanism of this injury is usually a heavy fall onto the tip of the shoulder. You may notice a more prominent ‘bump’ at the shoulder tip when compared to the other shoulder. The injury is seen most commonly in sports such as football, rugby, bicycle, horse riding and skiing.

What are the treatment options?

Your pain, range of movement and function can improve with Physiotherapy. Some patients may have ongoing functional problems as they cannot return fully to their sport of job. Depending on your ongoing symptoms and damage to the joint, your doctor may offer you surgery to repair the joint.

What is the procedure and what does it involve?

The operation is done by an incision at the top of your shoulder. Most people are given a full general anaesthetic and normally discharged from hospital next day. The joint is made secure by synthetic material or tendon graft which stabilises the joint.

Clavicle fracture

Q: I sustained a fracture of the collarbone – do I need surgery?

A: Not all collar bone fractures need surgery – in fact very few do. Vast majority of fractures will heal by themselves without any functional deficit in the future. However, it is important to recognise some indications where surgery is proven to improve healing and outcomes. For example, if there is wide displacement, skin compromise or ligament injury.

Q: Does an operation makes it heal quicker?

A: An operation only helps the bone to heal in proper alignment – actual bone healing time does not change substantially. An operation however, stabilises the bone and allows you to move the arm immediately after the operation, thereby preventing longer term stiffness and expedite recovery.

Q: How long does it take for a collarbone to heal?

A: There are various factors like age and nutritional status that affect healing time, but on an average it should heal by 6 weeks.

Q: I am left with a bump after the collarbone fracture healed!

A: It is not uncommon to have a permanent bump where the fracture heals. Usually it is only of cosmetic significance and does not interfere with the function or strength. See a specialist if it causes pain or other symptoms, which may be a result of significant shortening of the bone ends.

Q: What factors should be considered when deciding whether an operation is needed?

A: Age of patient, bone ends tenting the skin, significant displacement of bone ends (typically more than 2 cm), multiple displaced fragments, ligament damage along with the fracture, or a floating shoulder (meaning fracture of the collarbone and shoulder of the same side) are some of the indications when operation is recommended.

Q: Is it a complex operation?

A: All the important nerves and blood vessels pass under the collar bone, and are carefully protected during surgery. Nonetheless, there is some risk of damage which can cause variable degrees of neurological deficit. Other risks are the same as any other operation, like infection, non union, delayed healing etc. occasionally the plate may feel prominent under the skin and need removal after the fracture has healed. Taken together, these risks are less than 10%.

If you have a clavicle fracture, please contact Dr Sarda on 7742089371 or email drsarda.in@gmail.com.