Introduction: The severity of symptoms, rate and completeness of recovery after closed treatment of the fractured clavicle has not been fully explored.

Materials and Methods: The severity and duration of pain, analgesic requirements, ability to perform acts of daily living, return to work, driving and sport were recorded along with appearance of the shoulder in 58 patients between one to two years after fracture was recorded. Radiographs were assessed by Robinson’s classification8 supplemented by fracture displacement.

Results: The majority of patients experienced severe pain that required codeine, paracetamol and ibuprofen. 13/58 patients (22%) ceased to experience pain by one month, 35/58 (60%) by three and 48/58 (83%) by six. There was no improvement in the remaining ten patients after six months.

21 patients described difficulty reaching and lifting (36%), 11/36 (31%) digging the garden, 13/58 (22%) were unable to reach between their shoulder blades. Over 90% had no difficulty with feeding (55/58), dressing (50/58), personal toilet (56/58), brushing hair (41/46), hanging up clothes (52/56) or ironing (37/41) but overall 23/58 patients (40%) had some functional restriction 1–2 years after injury. 18/48 patients (38%) returned to work within one month, 39 (81%) by three, and all by six. 28/30 (93%) clerical workers had returned within three months compared with 11/18 (61%) of manual (p < 0.05) 36/42 (86%) sportsmen returned. High impact sportsmen were less likely to resume than low impact or overhead. 38/46 (83%) of drivers returned by three months and all by six.

40/58 (69%) patients noted cosmetic deformity the severity of which was associated with worse functional outcome (p = 0.002). The degree of displacement of the fracture was associated with cosmetic deformity (p = 0.015) and functional outcome (p = 0.025), but the Robinson classification8 alone was not.

Conclusion: The majority of patients with a fractured clavicle perceive a cosmetic deformity and a substantial minority impaired function. There is potential to improve outcome and deformity by reduction and fixation in those with displacement of two or more cortical diameters.