The surgical repair of a broken collarbone, or clavicle, most commonly involves Open Reduction and Internal Fixation (ORIF). This technique requires an orthopedic surgeon to realign the fractured bone fragments (open reduction) and secure them using specialized metal plates and screws (internal fixation). Understanding the complete timeline, from the operating room to the final return to full activity, is the primary concern for most patients. This process involves distinct phases, each with its own time commitment.
Operation Duration
The time spent inside the operating room for a clavicle ORIF procedure is typically between 60 to 120 minutes. This duration encompasses the entire sequence of events required to safely complete the surgery and wake the patient. The process begins with the administration of general anesthesia and often a regional nerve block to manage immediate post-operative pain.
Once the patient is anesthetized and the surgical site is prepared, the surgeon makes an incision to access the broken bone. The fractured pieces are maneuvered back into their correct anatomical position (the reduction phase). Finally, a contoured plate is secured along the bone with multiple screws to hold the fragments rigidly in place while they heal, followed by wound closure.
Variables That Influence Duration
The exact duration of the operation is highly dependent on the complexity of the specific injury. A simple, clean break of the clavicle’s mid-shaft often falls on the shorter end of the time range because the bone fragments are easier to realign and fix with standard hardware.
The procedure lengthens considerably if the fracture is comminuted, meaning the bone has shattered into three or more pieces. More fragments require greater precision and time for the surgeon to reconstruct the bone’s original shape before applying the fixation plate. Fractures located near a joint, such as the acromioclavicular joint, may also necessitate specialized surgical techniques or hardware, which can extend the operating time. Occasionally, poor bone quality or a large gap may require the use of bone graft material, adding extra steps to the fixation process.
Hospital Stay and Immediate Care
Following surgical fixation, the patient is transferred to the Post-Anesthesia Care Unit (PACU) for monitoring as they wake up from anesthesia. This initial recovery period usually lasts between one to three hours, allowing the medical team to ensure stability and effective pain control. The regional nerve block administered before surgery provides significant pain relief, often lasting up to 8 to 12 hours after the procedure.
Clavicle ORIF is frequently performed as an outpatient procedure, allowing many patients to be discharged on the same day. In other cases, a brief hospital stay of 23 hours for observation may be required, particularly if there are concerns about pain management or existing medical conditions. Discharge criteria prioritize the patient’s ability to manage pain with oral medication, demonstrate safe mobility, and understand immediate post-operative care instructions.
Long-Term Rehabilitation Timeline
The return to full strength and activity is the longest part of the process, guided by the body’s natural bone healing timeline.
Phase 1: Protection and Rest (Weeks 1-4)
This initial period focuses entirely on protection and rest. The arm is kept immobilized in a sling, and movement is restricted to passive range-of-motion exercises, such as gentle pendulum swings. This prevents joint stiffness without stressing the surgical repair.
Phase 2: Early Recovery (Weeks 2-6)
This phase marks the transition to early recovery and the gradual discontinuation of the sling, often around the four-week mark. The focus shifts to active-assisted and then active range-of-motion exercises to restore movement in the shoulder joint. Patients must strictly avoid lifting anything heavier than a small household object, like a coffee cup, to protect the healing bone.
Phase 3: Strength Building (Weeks 6-12)
This phase begins once the surgeon confirms early signs of bone union on X-ray. The physical therapy protocol becomes more aggressive, incorporating light weight training and resistance band exercises. The goal is to rebuild muscle strength in the shoulder and surrounding muscles, with many patients achieving nearly full range of motion by the eighth week.
Phase 4: Return to Activity (Months 3-6)
The final stage is the full return to strenuous activity, which generally occurs between three and six months post-surgery. Clearance for heavy lifting, contact sports, and high-impact activities depends on a final radiological confirmation that the fracture is completely healed and the bone is structurally sound. While the fracture is typically healed by three months, achieving full, pre-injury function can extend toward the six-month mark.