|The collarbone can be broken by direct impact. However, it is most commonly fractured by indirect force moving up the arm following a fall on to an outstretched hand, and often happens after a fall from a bicycle or a horse. A broken shoulder often follows a heavy impact to the site of injury. It is therefore important to do a careful examination to rule out back or rib injury.
Along with potential swelling, bruising, and tenderness above the site of the injury, the victim is most likely to be supporting the injured arm, with the shoulder on the injured side slumped. Since the collarbone is close to the skin it is particularly important to look for an open fracture.
If you are confident that the shoulder itself is broken then the treatment is to work with the victim to find the best position. The application of an arm sling may provide some support, but more commonly the victim will want no bandages, settling instead for steady support from another person if available. The pain of the injury may make it necessary to call for an ambulance rather than transporting the victim to hospital in a car.
If the bone has pierced the skin, place a light dressing over the wound. Bleeding is likely minimal and your main concern is to prevent infection.
Work with the injured person to find the most
comfortable position for the arm and for the body as a whole. Generally this will be sitting up with the arm supported at the elbow. The victim may wish to go to hospital in this position, but should be offered the option of an elevation sling, which will help alleviate pressure on the collarbone and provide some comfort.
Do not give anything to eat or drink—the victim may need a general anesthetic in hospital.
A broken collarbone often happens following a fall from a bicycle or a horse rather than direct impact. Use an elevation sling to take the weight of the arm and relieve pressure on the collarbone. It is important to check for an open fracture as the collarbone is close to the skin and may easily puncture it.
APPLYING AN ELEVATION SLING
The elevation sling has a range of uses. As well as the treatment of a broken collarbone, it also provides comfort in the treatment of crushed or broken fingers and hands, relief in the treatment of burns to the arm, and is an aid in controlling bleeding through elevation.
Extra support can be gained by placing a triangular bandage folded into three (a broad fold) around the arm and body.
- Place the injured arm with the fingers by the collarbone on the uninjured side.
- Place the triangular bandage with the point resting at the elbow on the injured side.
- Tuck the bandage underneath the hand and down underneath the injured arm.
- Tie at the collarbone in a square knot (or a bow).
- Fasten the spare material at the elbow with a pin or twist it and tuck it away,