Fractures of the Upper BodyThe collarbone can be broken by direct impact. However, it is most commonly fractured by indirect force moving up the arm following a fall on to an outstretched hand, and often happens after a fall from a bicycle or a horse. A broken shoulder often follows a heavy impact to the site of injury. It is therefore important to do a careful examination to rule out back or rib injury.
Broken collarboneAlongside potential swelling, bruising and tenderness above the site of the injury, the casualty is most likely to be supporting the injured arm, with the shoulder on the injured side slumped. As the collarbone is close to the skin it is particularly important to look for an open fracture.
Broken shoulderIf you are confident that the shoulder itself is broken then the treatment is to work with the casualty to find the best position. The application of an arm sling may provide some support, but more commonly the casualty will want no bandages, settling instead for steady support from another person if available. The pain of the injury may make it necessary to call for an ambulance rather than transporting the casualty to hospital in a car.
First Aid Treatment
If the bone has pierced the skin, place a light dressing over the wound. Bleeding is likely to be minimal and your main concern is to prevent infection.
Work with the injured person to find the most comfortable position for the arm and for the body as a whole. Generally this will be sitting up with the arm supported at the elbow. The casualty may wish to go to hospital in this position, but she should be offered the option of an elevation sling, which will help alleviate pressure on the collarbone and provide some comfort.
Applying an elevation sling
The elevation sling has a range of uses. As well as the treatment of a broken collarbone it also provides comfort in the treatment of crushed or broken fingers and hands, relief in the treatment of burns to the arm and is an aid in controlling bleeding through elevation.
Do not give anything to eat or drink the casualty may need a general anaesthetic in hospital.
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