A broken collarbone (clavicle fracture) requires immobilization for proper healing. The clavicle connects the shoulder blade to the breastbone and supports the shoulder. A sling immobilizes the broken fragments, reduces pain, and prevents movements that disrupt the initial formation of soft callus, which bridges the fracture gap. The specific duration of sling use is highly individualized and must be determined by a physician through clinical and radiographic assessment.
Determining the Duration of Immobilization
The duration of sling wear aligns with the period required for “clinical union,” when the fracture site is stable enough for gentle movement. For adults, this period is typically three to six weeks, though full healing takes longer. Children often heal faster, sometimes reaching this milestone in four to six weeks, due to better bone regeneration potential.
The severity and type of fracture significantly influence this duration. Non-displaced fractures, where fragments remain well-aligned, may require strict immobilization for only two to three weeks of continuous wear. Displaced or comminuted fractures, where bone pieces are separated or shattered, need longer immobilization because the bone must bridge a larger gap.
Physicians monitor healing progress using follow-up X-rays, which show the formation of a bony callus across the fracture site. Pain level also guides treatment; subsiding pain often indicates improved stability, allowing for gradual reduction in sling use. For fractures requiring surgery (Open Reduction and Internal Fixation or ORIF), the sling may be worn only for comfort for one to three weeks, but strict movement restrictions protect the surgical repair.
Practical Guidance for Sling Wear
Properly wearing the sling maximizes effectiveness and minimizes discomfort. The sling should support the elbow comfortably, with the hand resting slightly higher than the elbow to promote circulation and prevent swelling. Ensure the neck strap does not dig into the skin, which could cause nerve irritation or pain.
Sleeping with a broken collarbone is challenging, but patients often find relief sleeping in a semi-upright position, such as in a recliner or propped up with pillows. This prevents rolling onto the injured side and maintains the arm’s position. For daily hygiene, the sling can be removed for careful showering, keeping the arm close to the body and using the uninjured hand to wash the affected area.
To prevent re-injury or displacement, strictly avoid certain activities while wearing the sling. This includes lifting, pushing, or pulling anything with the injured arm, or reaching the arm overhead or across the body. Patients must watch for signs requiring immediate medical attention, such as increased swelling, severe pain, new numbness or tingling in the hand, or a sudden change in hand color.
Transitioning Away from the Sling
The decision to stop wearing the sling is a gradual process guided by the physician, based on objective evidence of healing from X-rays. When the bone is deemed clinically stable, constant sling use is discontinued, typically three to six weeks post-injury. The initial phase following immobilization often reveals expected stiffness and muscle weakness in the shoulder and arm due to inactivity.
Rehabilitation begins almost immediately after discontinuing the sling, focusing on restoring basic joint mobility without stressing the newly forming bone. This involves starting passive and active range-of-motion exercises under the guidance of a physical therapist. Initial exercises are gentle, such as pendulum swings, which use gravity to move the arm without engaging the shoulder muscles.
The goal of these early exercises is to prevent shoulder stiffness and begin regaining movement. Although the sling is no longer worn continuously, many patients use it intermittently for comfort or protection. It may be used in crowded public spaces or at night during the first few weeks after clearance, serving as a reminder to avoid sudden, unguarded movements.
Achieving Full Recovery and Return to Activity
Removing the sling marks the start of the recovery phase, but the bone lacks full pre-injury strength. The overall timeline for the bone to achieve full strength and remodeling (where the tissue is fully consolidated) is typically 12 weeks or more. Adherence to a full physical therapy regimen during this period prevents long-term stiffness, weakness, and mobility issues.
Physical therapy progresses from gentle range-of-motion exercises to strengthening activities targeting the shoulder and surrounding muscles. The final stage involves returning to demanding activities, such as contact sports or heavy manual labor. Clearance criteria usually require the patient to have a full, pain-free range of motion and strength equal or near equal to the uninjured side.
Returning to high-impact or contact activities prematurely, before the bone is structurally sound, risks re-fracture or failure of surgical hardware. Physicians advise avoiding contact sports or heavy impact activities for a minimum of 10 to 12 weeks, depending on the individual’s healing rate and fracture nature. Continued adherence to the therapist’s program ensures a safe and complete return to full function.