Tony Romo and the cracked collarbone

Dallas Cowboys quarterback Tony Romo will not need surgery to repair a broken collarbone he sustained in Sunday’s game against the Giants. Romo was injured in the second quarter when he was hit by Giants linebacker Michael Boley during a blitz.  According to Romo: “I tried lifting my shoulder and it hurt like heck, but I was like, ‘OK, it will just keep getting better’ …The adrenaline of the game will allow me to [play], it’s my left shoulder, I don’t need to use it too much. I will figure out a way what I can handle when I’m out there, but that was before I knew it was broken.”

Coach Wade Phillips reported that, although a CT scan showed that surgery is unnecessary, that Romo will need to be out for six to eight weeks.

Left: Normal shoulder  Above: Left clavicle fracture

The collarbone, also called the clavicle, is considered part of the shoulder, connecting the arm to the body. 80% of clavicle fractures occur in the middle third of the collarbone.
Although several important blood vessels and nerves lie underneath the clavicle, they are rarely injured when the clavicle is fractured. Common causes of a fractured clavicle include falls onto a shoulder, sports injuries and trauma from traffic accidents.Newborns are also at risk of clavicle fracture while squeezing through the birth canal.

Symptoms of a clavicle fracture include:

  • Sagging shoulder (down and forward)
  • Inability to lift the arm because of pain
  • A grinding sensation if an attempt is made to raise the arm
  • A deformity or “bump” over the fracture site

Most broken collarbones heal well without surgery. A simple arm sling can usually be used to immobilize the arm. A child may have to wear the sling for 3 to 4 weeks; an adult may have to wear it for 6 to 8 weeks. Depending on the location of the break, a physician may apply a figure-of-eight strap to help maintain shoulder position.

Analgesics such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory medications, such as naproxen or ibuprofen (Alleve or Advil/Motrin), will help reduce pain.

For more information, click here to go to the Resounding Health Casebook on clavicle fractures.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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