Collarbone surgery involves repairing a broken clavicle bone. Surgeons will try to realign the displaced bone and fix it in place to help it heal. People can usually return to their usual activities within 3 months.

The clavicle, or collarbone, sits on top of the rib cage in front of the chest. It provides support for shoulder movement.

A collarbone fracture often occurs due to a fall onto the shoulder or an outstretched arm. This type of fracture is common. About 5% of all adult fractures involve the collarbone. About 35%-45% of breaks in the shoulder area involve the collarbone.

After a collarbone fracture, doctors may recommend surgery. This article explores collarbone surgery, including what happens during the procedure, risks, and recovery.

A person with a scar on their collarbone from clavicle surgery.Share on Pinterest
Jessica Christian/The San Francisco Chronicle via Getty Images

Doctors may treat a collarbone fracture with or without surgery. In some cases, conservative treatment without surgery is an option. But in other instances, doctors recommend surgery.

The break can occur in the following places:

  • In the middle of the collarbone, where the bone attaches to the shoulder blade or ribcage. This is the most common type of clavicle fracture.
  • Near the acromioclavicular (AC) joint, where the clavicle meets the shoulder. This is the second most common type of fracture.
  • Close to the sternum (breastbone). This is the least common type of break.

The need for collarbone surgery depends on the severity of the fracture. Sometimes, the bone may only crack. However, more serious fractures can result in the collarbone breaking into several pieces.

Collarbone surgery involves putting the bone back into the correct alignment, which promotes proper healing.

Doctors may recommend collarbone surgery in the following situations:

  • A displaced fracture: This involves a break that moves the bone so much that it becomes misaligned. This fracture has an increased chance of complications, such as not healing well.
  • An open fracture: This refers to a broken bone that breaks through the skin. An open fracture causes an increased risk of problems, such as infection.
  • A non-healing fracture: Collarbone fractures may also involve nonsurgical treatments. However, about 30% of collarbone fractures treated without surgery do not heal properly. When a nonsurgical approach fails, surgery may become an option.

Learn more about the causes of collarbone pain.

Collarbone surgery aims to stabilize the broken bone, allowing it to heal in the correct position.

Surgery usually involves open reduction and internal fixation (ORIF) surgery. This is where surgeons realign the misplaced bones and then fix them in place with screws, pins, plates, or rods.

Typically, doctors perform the surgery under general anesthesia, which means a person is unconscious throughout the procedure.

ORIF surgery involves the surgeon:

  1. applying antiseptic to the skin area, which helps prevent infection
  2. making an incision in the skin and muscle near the collarbone
  3. aligning and repositioning the pieces of bone
  4. inserting plates, screws, or pins to hold the bones in place and improve shoulder strength

Learn more about bone fracture repair.

Anyone having surgery on their clavicle will receive specific instructions before the operation. This may include stopping certain medications for a time before surgery. However, a person should not stop taking medications until a healthcare professional has instructed them to do so.

Preparation may also include getting an X-ray of the collarbone to determine the severity of the bone misalignment.

Usually, before surgery, doctors order blood tests and an EKG to check for any abnormalities that may prevent the surgeon from operating safely.

Healing time after collarbone surgery can vary depending on someone’s overall health and lifestyle. For example, smoking tobacco may slow the healing process. Most people can resume regular activities about 3 months after the surgery.

During initial recovery, a person will wear a sling to keep the shoulder from moving. Pain levels may vary. But some pain is a natural part of the healing process. The doctor will advise how to manage pain during recovery.

A small patch of skin below the cut may feel numb. This may become less noticeable over time. Some people report feeling the plate that holds the bones in place.

A healthcare professional may also recommend physical therapy after an initial period of healing. Physical therapists can aid recovery by teaching people exercises to improve their range of motion and strengthen the shoulder.

Regular follow-up appointments with a healthcare professional are necessary to ensure the bone heals well.

Learn more about how broken bones heal.

The outcome of collarbone surgery is typically good. But it is not clear whether surgery leads to better overall healing.

This 2018 research involved a small study of 138 people with closed midshaft collarbone fractures. Of the participants, 69 had collarbone surgery, and 69 received nonoperative treatment.

The study found no differences in poor outcomes or complications between the group treated with surgery and the nonsurgical treatment group.

But other research has found that surgery provides a more favorable recovery than nonsurgical treatment. A 2022 systematic review and meta-analysis involved 3,094 people with a closed midshaft collarbone fracture. The study indicated that surgical treatment led to fewer complications and better long-term function than nonsurgical treatment.

Doctors might recommend nonsurgical treatment for a collarbone fracture if the bones are not significantly misaligned.

Treatment may include:

  • wearing a sling to prevent the bone from moving while healing
  • icing the area to reduce inflammation
  • taking pain medication, such as acetaminophen (Tylenol), to relieve pain as the bone heals
  • doing physical therapy to improve strength and range of motion

Learn more about how fractures heal here.

All surgery carries risks, including the risk of infection and excessive bleeding. Sometimes, the bone does not heal properly after collarbone surgery, which is known as non-union. However, the overall infection and non-union rate for collarbone surgery affect fewer than 4.5% of people.

A large number of nerves surround the collarbone. Nerve injury due to the surgery can occur but is uncommon.

Another possible risk involves discomfort from the pins, screws, or plates used to hold the bone in place.

Collarbone surgery involves the repair of a clavicle fracture. Not all collarbone fractures require surgery. But for an open or displaced fracture, healthcare professionals often recommend surgery.

Surgery involves putting the bone into the proper position and fixing it using pins, rods, screws, or plates to keep it in place.

Healing times vary, but people typically resume their usual activities within 3 months.