broken clavicle...surgery or not?

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hi i wonder if some one can give me some advice.

i broke my collarbone about 5 weeks ago and have been back to the fracture clinic for three follow up appointments for xrays etc.

the first time i went the doctor told me that the bone was overlapping and to come back in 2 weeks to see how its doing..i was offered surgery (i think) by the doctor (he was mumbling.. alot) to which i replied that as long as it works fine and i am not too disfigured then i dont really mind.

i went back two weeks later and was told that the bone was still overlapping and to come back again in another 2 weeks to see how its getting on.

i went back again and was told that the bone still had a gap of about 1.5cm but was starting to close and the bone was starting to fuse. when i asked about surgery the doctor asked if i would do it...i said the same as before-as long as i have full mobility when its healed and as long as im not to deformed etc.

she went to her "boss" in the clinic to ask his opinion and he said to have me back again in around 3 weeks to see how it looks again.

i swim alot and have a physical job that requires full mobilty (which i need to get back to asap).

i have read up about this type of injury and there is alot of people who say that getting the surgery is the better option as the healing process is faster,you can return to light activities is around a week and your mobility will be alot better.

can request the surgery now? if so who do i ask?

the bone is protruding quite signifigantly and i am still very uncomfortable.

i dont want to be pushy with the doctors but i really dont want to go back in 3 weeks only to be told i need surgery and have to take more time off but at the same time i dont want to be stuck with a shoulder that doesnt give me the movement i need if i dont get the surgery.
any advice would be greatly appreciated.

thanks for your time in advance

rory http://www.cyclingforums.com/images/icons/icon10.gif

ps im 26 if that makes any difference

Hello Rory (and others considering surgery)

I am a 27 year old female and fractured the mid-shaft of my left clavicle 2 weeks ago. It was displaced and had an overlap of about 2 cm, so I was given the option of 'open reduction internal fixation' surgery by the NHS doctor. I was told the risks of not having the operation - non-union, malunion, longer time for healing etc. I read the research and decided to have the operation - 2 days ago now. So perhaps I can offer some advice on that side of things.

The operation apparently went well, and I now have a plate and 6 pins holding the clavicle in place. My posture feels normal again, the pain in the back of my shoulder blade from the dropping shoulder has gone and it feels pretty strong already. However, the experience of the operation was pretty horrible. It involves a general anaesthetic that 2 days later I still feel sick from, I have a large wound (about 4 inches), it's very sore and I have to wear a sling. I also had to spend a full day in the hospital ward (fortunately the doctors let me go home for the night).

Perhaps in a week or so I will notice the results more and feel more positive about the operation but I would advise you think carefully about whether to go through with it.

I found the following reading useful for making my decision:

http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijos/vol5n1/clavicle.xml

Robinson CM, Court-Brown CM, McQueen MM, et al (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15252081); Estimating the risk of nonunion following nonoperative treatment of a clavicular fracture. J Bone Joint Surg Am. 2004 Jul;86-A(7):1359-65. [abstract]

Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007 Jan;89(1):1-10. [abstract]

Rory - As you are unable to work without full mobility of the shoulder, it sounds like surgery may be the best option. You need to make it clear to the doctors what your priorities are. Have you spoken to a consultant surgeon? They would be able to offer the best advice and arrange the operation. At the end of the day, it's your decision and your future, so don't worry about being pushy!

Hope this helps.

Sophie

Hey Rory and other newbie’s, here is the video again.

Please take the time to watch it.

If you cannot not make up your mind, go to another doctor and get a second opinion. We all know that it's a hassle to go to other doctors, so find another one in your network, make the appointment, sit down in the office and fill out the insurance forms and pay your little co-pay.

Of course being new patient this new doctor might rush you out (typical) or, he might give you some excellent advice.

Try and find one that’s in with a bunch of other orthopedics specialists like I did. I was lucky, I am a cyclist, I race part time. In that group of Orthopedics that I stumble up on in was an Orthopedic surgeon that was a semi pro cyclist, and that’s all he did was repair other cyclist color bones and shoulders.

He used the best stuff on me. And he has seen and repaired ever kind of clavicle collar bone break.

My collar bone was broke in 3 pieces. There was no question about getting it plated.



But again look at the video link below. Good luck.


http://www.youtube.com/watch?v=ZIX9bGvA1OQ

hi i wonder if some one can give me some advice.

i broke my collarbone about 5 weeks ago and have been back to the fracture clinic for three follow up appointments for xrays etc.

the first time i went the doctor told me that the bone was overlapping and to come back in 2 weeks to see how its doing..i was offered surgery (i think) by the doctor (he was mumbling.. alot) to which i replied that as long as it works fine and i am not too disfigured then i dont really mind.

i went back two weeks later and was told that the bone was still overlapping and to come back again in another 2 weeks to see how its getting on.

i went back again and was told that the bone still had a gap of about 1.5cm but was starting to close and the bone was starting to fuse. when i asked about surgery the doctor asked if i would do it...i said the same as before-as long as i have full mobility when its healed and as long as im not to deformed etc.

she went to her "boss" in the clinic to ask his opinion and he said to have me back again in around 3 weeks to see how it looks again.

i swim alot and have a physical job that requires full mobilty (which i need to get back to asap).

i have read up about this type of injury and there is alot of people who say that getting the surgery is the better option as the healing process is faster,you can return to light activities is around a week and your mobility will be alot better.

can request the surgery now? if so who do i ask?

the bone is protruding quite signifigantly and i am still very uncomfortable.

i dont want to be pushy with the doctors but i really dont want to go back in 3 weeks only to be told i need surgery and have to take more time off but at the same time i dont want to be stuck with a shoulder that doesnt give me the movement i need if i dont get the surgery.
any advice would be greatly appreciated.

thanks for your time in advance

rory http://www.cyclingforums.com/images/icons/icon10.gif

ps im 26 if that makes any difference