Broad arm sling (most patients) or plate fixation (selected patients)
Content reviewed by✓Mr Andrew Davies, PhD FRCS (Tr & Orth)· Reviewed June 2026Most broken collarbones heal perfectly well in a sling. Surgery is sometimes offered for specific fracture patterns, but a large UK research trial found that a sling gives results just as good as surgery for most people.
Step 1, Getting your sling and starting exercises
ℹ️ You will be given a broad arm sling to wear for comfort. This supports the weight of the arm and reduces pain, it does not hold the fracture in position (there is no cast for clavicle fractures). Gentle pendulum exercises begin from day one.
If surgery is recommended, usually for fractures with significant shortening (over 2cm), completely overlapping fragments, or an open wound, a metal plate and screws are fixed along the top of the clavicle. Surgery is day case (home the same day) under general anaesthetic and takes about 45–60 minutes.
Start pendulum exercises from day one
Let the arm hang by your side and swing it gently in small circles. This prevents the shoulder stiffening without putting any stress on the fracture. Do this 3–4 times a day.
Wear the sling for comfort, not to fix the fracture
The sling supports the weight of the arm and reduces pain. It does not hold the broken bone in place. Most patients need it for 2–4 weeks.
A firm lump will appear, this is normal
At 3–5 weeks a firm bump appears at the fracture site. This is the callus, new bone forming as part of healing. It is completely normal and does not mean anything has gone wrong. Most patients keep a small permanent lump.
No contact sport until X-ray confirms union
Return to rugby, football, cycling, horse riding or any sport with a risk of impact must wait until an X-ray shows the bone has fully healed, usually 6–12 weeks. Do not return to sport based on how it feels.
The day of surgery
ℹ️ You will be given a specific arrival time. Have no food from 2am on the day of surgery; you may drink clear water until 6am. Bring your medication list and any documents sent by the hospital.
Arrive at the time given
You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Consent and marking
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
Anaesthetic
You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.
Recovery room
After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.
In hospital
Most patients having arthroscopic or day-case procedures go home on the day of surgery. Those having joint replacement typically stay 1–2 nights. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.
Pain control
You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.
Wound check and dressing
A nurse will check the wound before you leave and explain how to keep it clean and dry.
Discharge letter and follow-up
You will receive a letter for your GP and details of your next outpatient appointment - usually at 2 weeks for a wound check.
You must not drive yourself home
Arrange for a family member or friend to collect you. You must not drive on the day of surgery if you have had a general anaesthetic or sedation.
Going home
⚠️ Important: Seek urgent attention if the skin over the fracture begins to look stretched or discoloured, this means the bone may be pushing against the skin. Also attend A&E if you have any numbness or weakness in the arm.
Keep the wound clean and dry
Avoid getting the wound wet until it is fully healed - usually 10–14 days. Use a waterproof cover or cling film when showering.
Take your pain relief as prescribed
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective.
Attend your wound check appointment
This is usually 2 weeks after surgery. Sutures or clips will be removed if used.
When to contact the hospital
Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, or a temperature above 38°C - these may indicate infection.
Recovery week by week
Sling and pendulum exercises
Broad arm sling. Pendulum exercises from day one. Ice for pain. No driving.
X-ray check
Follow-up X-ray to check position. Sling weaned as comfort allows. Active shoulder movement begins.
Increasing activity
Active shoulder movement increases. Return to desk work. Driving when safe, usually 4–6 weeks.
X-ray confirms healing
X-ray at 6–8 weeks usually shows good healing. Sling discontinued. Strengthening exercises.
Return to sport
Return to contact sport only after X-ray confirms union. Full strength returns over 3–6 months.
Why does my surgeon say I don't need surgery when the fracture looks so displaced?
A large UK randomised trial (Robinson and colleagues) compared plate fixation with sling treatment for broken collarbones. It found broadly similar function at 12 months for most patients. Surgery does fix the bone in a better position, but it also means a 20–30% chance of a second operation to remove the plate when it becomes prominent under the skin. Many patients choose the sling for this reason.
Will the lump go away?
The firm bump at the fracture site is permanent in most patients. It usually becomes less noticeable over time as the surrounding tissue settles, but it is unlikely to disappear completely. This is cosmetic only and does not affect function.
When can I go back to cycling / rugby / horse riding?
Only after an X-ray confirms the bone has fully healed, typically 6–12 weeks. Do not return to contact sport or high-impact activity based purely on how it feels, as the fracture may not yet be solid.
Recovery calendar
A week-by-week guide to recovery. Individual timelines vary, always follow your surgical team.
Consent information
Purpose and intended benefits
The aim of surgical fixation is to restore clavicle length and alignment, potentially improving cosmesis and allowing earlier return to activity compared with sling treatment. Evidence from randomised trials suggests no significant difference in long-term function compared with non-operative management for most mid-shaft fractures.
What the procedure involves
Under general anaesthetic, through an incision over the clavicle, the fracture is exposed, reduced, and secured with a pre-contoured plate and screws applied to the superior or anterior surface of the clavicle. For unstable lateral third fractures, a different implant (hook plate, cortical button, or suture technique) is used to restore the coracoclavicular distance. Takes approximately 45-75 minutes. The plate is usually left in permanently unless it causes symptoms.
Alternative treatments
Broad arm sling
The standard non-operative treatment for most mid-shaft clavicle fractures. Union expected within 6-12 weeks in most cases. Randomised trials show broadly equivalent functional outcomes at 12 months for most displaced fractures.
Figure-of-eight bandage
An alternative to sling; no evidence of superiority. Generally less comfortable and not recommended.
No immobilisation
For minimally displaced or stable fractures in patients who are comfortable with early activity, no immobilisation may be acceptable under specialist guidance.
Risks of the procedure
If the plate is removed before full biological consolidation, the fracture may fail to heal. Plates are generally left in place indefinitely unless symptomatic.
If the plate breaks before the fracture heals, revision fixation and bone grafting may be required.
Wound or deep bone infection. May require plate removal and antibiotics.
The subclavian vessels and brachial plexus lie beneath the clavicle. Injury during surgery is rare but serious.
The clavicle is a subcutaneous bone and the plate lies directly under the skin. The scar may be prominent, and the plate may be palpable or visible.
Plate prominence causing discomfort over the clavicle is common and is the most frequent reason for a second procedure to remove the plate.
Expected and managed with regular analgesia.
The clavicular scar may be tender for several months.
The plate may be visible or palpable under the skin, particularly in slim patients.
A sling is worn for comfort for 1-2 weeks after surgery. Restriction is minimal.
If you choose not to have surgery
Most clavicle fractures heal without surgery within 6-12 weeks. Randomised trials demonstrate no significant functional advantage to surgery over non-operative management at 12 months for most displaced mid-shaft fractures. Non-union occurs in approximately 1-5% of mid-shaft fractures without surgery. A cosmetic deformity (bump at the fracture site) is common with non-operative treatment.
Your questions, answered
Plain-English answers to the things people most often ask, drawn from real patient questions and grounded in published guidance. Tap a question to open it.
About thisWhat is a broken collarbone?
A clavicle (collarbone) fracture is a break in the bone running from the breastbone to the shoulder, usually after a fall onto the shoulder or outstretched arm. Most breaks are in the middle third of the bone.
Your choiceDo I need surgery?
Most collarbone fractures heal well without surgery, supported in a sling. Surgery, using a plate or pin, is considered for badly displaced or shortened breaks, breaks threatening the skin, or certain high-demand situations. Your surgeon weighs healing, function and your activities together with you.
Getting backHow long does it take to heal?
Bone healing usually takes around 6 to 12 weeks, with movement and strength returning over the following weeks to a few months. Return to contact sport is generally later, once the bone has healed and strength is back.
Pain & sleepHow do I manage pain and sleeping?
A sling, simple pain relief and sleeping propped up help in the early weeks. Keep the elbow, wrist and hand moving from the start to prevent stiffness; shoulder movement is introduced as your team advises.
The lumpWill there be a lump where it healed?
A lump of new healing bone is common as the fracture knits, and it often becomes less noticeable over time. Occasionally a break is slow to heal or does not unite, which may need review, so keep your fracture-clinic appointments.
UrgentWhen should I seek urgent help?
Seek urgent review if the skin over the bone looks about to break, if the hand becomes cold, pale or numb, if you are very short of breath, or if a surgical wound becomes hot, red or starts discharging.
WellbeingIt is frustrating being in a sling, is that normal?
Very normal. Early hand and elbow exercises, a clear timeline, and knowing the bone is healing all help. Contact your team if pain or progress is worrying you.
- NHS: Broken collarbone
- British Elbow & Shoulder Society: early exercises and sling care
- British Elbow & Shoulder Society: patient information
These links are to UK clinical guidance and patient information from recognised organisations. This page is for general information and does not replace personalised advice from your own clinical team.