From the Research
A sling for a mid-shaft clavicle fracture can typically be discontinued after 4-6 weeks, once the patient has minimal pain and clinical evidence of healing has begun, as supported by the most recent study 1. The exact timing varies based on fracture severity, patient age, and healing progress. Initially, the sling should be worn continuously except during bathing and gentle range of motion exercises. After 2-3 weeks, if pain is decreasing, patients can gradually reduce sling use, first removing it for short periods at home while maintaining protection during higher-risk activities. Some key points to consider when deciding to discontinue the sling include:
- Fracture severity: more severe fractures may require longer immobilization
- Patient age: older patients may require longer immobilization due to decreased bone density and healing capacity
- Healing progress: clinical and radiographic evidence of callus formation and fracture union should be assessed before discontinuing the sling Complete discontinuation should occur only when the patient can perform arm movements with minimal discomfort and after clinical assessment confirms adequate healing. Radiographic evidence of callus formation, usually visible around 4-6 weeks post-injury, helps confirm healing progress, as noted in a study published in 2020 1. The sling serves to immobilize the fracture site, reduce pain, and prevent displacement of bone fragments during the early healing phase. Premature discontinuation risks delayed union or non-union of the fracture, while prolonged immobilization can lead to shoulder stiffness and muscle atrophy, highlighting the importance of following an appropriate timeline for sling use, as discussed in a review of current concepts in midshaft clavicle fractures 2. It's also important to consider the overall treatment strategy, which should be tailored to the patient's specific needs and expectations, utilizing a shared decision-making model, as recommended in a 2018 review 2.