The collarbone, or clavicle, is a long, thin bone connecting the shoulder girdle to the trunk of the body. A forceful impact can displace this bone from its normal position, resulting in a dislocation. Because this injury is painful, people often seek the quickest route to recovery, leading to questions about whether a chiropractor can perform the necessary procedure. Understanding the precise nature of the displacement and the appropriate medical scope of practice is necessary before seeking treatment.
Anatomy and Types of Collarbone Dislocation
The term “dislocated collarbone” can refer to a separation at one of two distinct joints. The most common is an Acromioclavicular (AC) joint separation, which occurs at the outer end of the clavicle where it meets the shoulder blade. This injury is typically caused by a direct fall onto the shoulder or a hard impact.
Less common, but potentially more serious, is a Sternoclavicular (SC) joint dislocation at the inner end of the clavicle where it connects to the sternum, or breastbone. SC dislocations are usually the result of high-energy trauma, such as a motor vehicle accident or a significant sports injury. These dislocations are classified as either anterior (forward) or posterior (backward). A true dislocation, or luxation, means the joint surfaces are completely separated and no longer in contact.
Scope of Practice for Joint Reduction
A major distinction exists between the types of joint issues traditionally addressed by chiropractic care and a complete joint dislocation. Chiropractors are trained to treat joint dysfunctions and what they term “subluxations,” which are minor misalignments where the joint surfaces remain intact. A traumatic collarbone dislocation, however, is a true luxation, representing a complete disruption of the joint.
Restoring a completely dislocated joint requires a medical procedure known as joint reduction, which physically moves the bone back into its correct position. The high-velocity, low-amplitude adjustments typically used in chiropractic manipulation are not appropriate for a freshly unstable joint. Applying such force can be ineffective and potentially cause further soft tissue damage. The standard of care for a true, traumatic luxation requires specific training and resources found in a hospital setting for safe realignment.
Seeking Immediate Emergency Medical Care
Anyone suspecting a dislocated collarbone should seek immediate care at an Emergency Department (ED). The first step in management is obtaining diagnostic imaging, typically X-rays, to confirm the type of injury and rule out a fracture. In the case of an SC dislocation, a Computed Tomography (CT) scan is often necessary to accurately determine the direction of the displacement.
A licensed medical doctor, such as an ED physician or an orthopedic specialist, must perform the closed reduction. This procedure involves manually manipulating the clavicle back into place. It frequently requires conscious sedation or general anesthesia to relax the muscles and minimize pain. Following a successful reduction, the joint is immobilized, usually with a sling or specialized brace, to allow the torn ligaments and soft tissues to begin healing.
Consequences of Delayed or Improper Treatment
Failing to seek prompt and proper medical treatment for a collarbone dislocation can lead to significant long-term complications. If the joint is not accurately reduced, the patient may experience chronic joint instability, persistent pain, and a noticeable deformity. Over time, the abnormal motion within the joint can also lead to the premature onset of degenerative arthritis.
The most serious risk is associated with a posterior sternoclavicular dislocation, where the end of the clavicle is displaced backward toward the chest cavity. This displacement can compress vital structures located behind the joint, including the trachea, major blood vessels, and the esophagus. Delaying reduction can lead to life-threatening complications, such as difficulty breathing, choking, or compromised blood flow. Immediate intervention from an orthopedic or thoracic specialist is necessary in this scenario.