Brief Answer: It is unlikely to be due to "wear and tear". Detailed Answer: Hi, thanks for writing to XXXXXXX Pain occuring in any operated bone by internal fixation (plates & screws) always indicates Infection (whether mild or moderate in intensity), unless proved otherwise. Spontaneous fracture of a bone (without any known injury) always indicates that the involved bone is very Osteoporotic (weak) and are termed as Stress fractures. Wear and tear is very very unusual at your age. A detailed clinical examination and appropriate investigations are needed to know the exact cause of your symptoms. Bone mineral density (BMD) test, Vitamin D blood estimation, Serum calcium levels are to be done to know the status of your bones. The other possibility or cause for the pain through the clavicles that is occuring during cough might be due to the irritation of the apical pleura of the lung by the tip of the screw (if it is protruding far beyond the clavicle margin downwards). So, a thorough evaluation is needed to establish a proper diagnosis. Hope I have addressed your query. Happy to help further Regards

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Brief Answer: It could be a REFERRED PAIN. Detailed Answer: Hi, Nice to hear from you. As per your description, I suspect that the cause of intense pain around the collar bone area during coughing could be due to a referred pain. The term referred pain implies pain occuring at a remote area, the exact underlying problem being in a different area. This is due to the same nerve supply that both areas share. In your case, I feel either you have some issues beneath the DIAPHRAGM or in the Apex of the lung, that are causing you to feel pain around the collar bone area. So, I suggest you to consult a General physician for a Clinical examination and diagnosis of your problem. Hope I have justified your query. Good day

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