Clavicle Fracture Management After Jujitsu Injury
You need immediate X-ray imaging to confirm a clavicle fracture and determine if surgical intervention is required. The pain and visible bump over your upper clavicle after jujitsu trauma strongly suggests a displaced midshaft clavicle fracture, which requires prompt radiographic evaluation to guide treatment 1.
Immediate Diagnostic Steps
Obtain standard clavicle radiographs immediately, which must include at least three views: anteroposterior (AP) views in internal and external rotation, and either an axillary lateral view or scapular Y view 2, 3. These plain films are mandatory as the first imaging step and will effectively demonstrate the fracture pattern, degree of displacement, and any shortening 2.
The visible bump you describe is highly concerning for significant displacement, which fundamentally changes your treatment pathway from conservative to potentially surgical 1.
Treatment Decision Algorithm
If X-rays Show Displaced Fracture (>2cm shortening or >100% displacement):
Surgical fixation is strongly recommended and will give you better outcomes. High-quality evidence demonstrates that surgical treatment of displaced midshaft clavicle fractures results in:
- Higher union rates (lower risk of nonunion) 1
- Better early patient-reported outcomes 1
- Faster return to work and sports 1
- Reduced rates of symptomatic malunion 1
You should pursue urgent orthopedic referral within 1-2 days if your fracture shows greater than 2cm of shortening, greater than 100% displacement, or significant comminution 4.
If X-rays Show Minimal or No Displacement:
Conservative management with a sling is appropriate. Most minimally displaced clavicle fractures heal successfully without surgery and have low nonunion rates 1, 5.
Immediate Pain Management
Start with acetaminophen up to 4 grams daily as first-line therapy, which provides pain relief comparable to NSAIDs without gastrointestinal toxicity 2.
Add topical agents such as methyl salicylate, capsaicin cream, or menthol for additional relief 2.
If acetaminophen fails, consider a short course of NSAIDs, but recognize the risk of gastrointestinal, platelet, and kidney effects, particularly if you're over 35 years old 2.
Critical Red Flags Requiring Emergency Evaluation
Seek immediate emergency care if you develop:
- Numbness or weakness in your arm or hand (suggests neurovascular injury) 2, 6
- Severe shortness of breath or chest pain (suggests associated thoracic injury)
- Skin tenting or open wound (requires emergent orthopedic consultation) 4
Immobilization Strategy
Use a simple arm sling for comfort and support rather than a figure-of-eight harness 7. The sling should support the weight of your arm and allow the fracture fragments to settle into acceptable alignment 5, 7.
Avoid overhead movements and heavy lifting completely until cleared by orthopedics 2, 3.
Common Pitfalls to Avoid
Do not assume this will heal fine without imaging. The visible bump indicates displacement, and displaced fractures have up to 15% nonunion rates with conservative treatment alone 1.
Do not delay imaging hoping it will improve. Clavicle fractures from contact sports like jujitsu frequently involve significant displacement requiring surgical consideration 5, 8.
Do not accept "wait and see" without proper X-rays first. Physical examination alone is insufficient—radiographic confirmation is mandatory to guide appropriate treatment 5, 9.
Expected Timeline
If treated surgically, expect faster functional recovery and earlier return to jujitsu (typically 3-4 months) compared to conservative treatment (4-6 months) 1. However, long-term outcomes at 1 year are similar between surgical and nonsurgical approaches for patient satisfaction 1.
The key decision point is the degree of displacement on your X-rays, which is why obtaining imaging within 24-48 hours is critical to your treatment pathway and ultimate outcome 1, 4.