broken clavicle...surgery or not?

dpc61820

Another post-op detail...my doctor has me using an ultrasound bone stimulator. It's pretty simple to use, and, although I can't really see why weak ultrasound would make bones grow better, the research seems to show it's effective. Of course, that's research done by or sponsored by the company with a profit motive. The lit says use it once a day for 20 minutes, but the rep who came to my house to show me how to use it said to use it twice a day. I figure I'll use it twice, putting it on a different place in the morning and the evening. I think this is different than eletronic bone stimulators that are worn all the time.

More info (at least concerning the specific brand I'm using), for anyone interested, from the US FDA here:
http://www.fda.gov/cdrh/pdf/p900009s006.html

from the company here:
http://ortho.smith-nephew.com/us/node.asp?NodeId=2865

I won't know for some time what the outcome is, and will of course never really know how much this silly device has to do with whatever my outcome is, but if anyone has any questions about this thing let me know.

One more thing--this isn't only for post-op bone healing. The indications are actually to stimulate bone healing for any break, and according to the company's literature, it helps with non-union problems some time out.

jezzdog

I got bucked off a two year old horse and landed right on my shoulder. Anyway, if anyone has any uplifting comments about recovery and the op itself i would love to hear them.[/QUOTE] Well, I'm a female about twice your age. I got hit by a car while riding my bike on June 10th. I opted for the surgery and had it done on June 19th. ( plate and 8 screws) I gotta tell you that it hasn't been bad at all. I think the anaesthesia was worse than the actual procedure. Expect to have a couple of uncomfortable days after surgery (not bad pain, just achy, throbby stuff that the vicodin will take care of) I was off of pain killers by day 4 or 5 and just using tylenol after that. ( and it was a severe break, too....they had name for it...which i can't remember and the doctor said he doesn't see many of them) Anyway, it'll be 4 weeks tomorrow and I have close to 90% range of motion with my arm (and I'm and old fart...you're young and will probably be miles ahead of me) I'm a triathlete and I'm hoping to get the go-ahead to lightly run and bike by next week...that's how good I feel...I don't know if the doctor will agree to it or not. I guess the main point of my reply is to relieve your jangled nerves...don't worry, you will be fine. A couple of years ago I broke a bone in my foot. I opted against an operation and hoped for a non-operative union. A month later the bones were even farther apart and I ended up having to get the surgery anyway....that was also a piece of cake. Had I gone with the surgery first I wouldn't have wasted a precious month of summer on crutches. Let me know how you make out!

wolfman113

WELL HELLO AGAIN EVERYONE ITS ME THE WOLMAN HOPE EVERYONES DOIN FINE BECAUSE IM NOT..... JUST WHEN I THOUGHT I WAS ON THE ROAD TO RECOVERY,AFTER 2 SURGERYS,BAM I GET HURT AGAIN. THIS TIME IT WAS PRETTY INNOCENT OR SO I THOUGHT. WAS ON MY COMPUTER AND WENT TO GET UP AND FELL OVER MY DOG AND COMPLETLY DISLOCATED MY RIGHT SHOULDER. IT WAS IN MY ARMPIT LITERALLY. DR. SAID I FRACTURED IT PRETTY BAD. HE PUT IT BACK IN THE SOCKET BUT WHILE IT WAS OUT I DAMAGED SOME NERVES BAD. I AM SCHEDULED FOR ANOTHER SURGERY MON. MORNING,HE CALLED IT AN OPEN REDUCTION MAYBE MORE SCREWS, HES NOT SURE UNTIL HE OPENS ME UP MON. NERVE DAMAGE IS CERTAIN, BUT HOW BAD I WONT KNOW TIL AFTER THIS SURGERY...AM REALLY IN BAD SHAPE NOW MY WHOLE RIGHT SIDE IS A MESS.HOPE YOU ALL ARE DOIN BETTER THAN ME, WILL LET YOU KNOW HOW I MAKE OUT NEXT WEEK,WHAT ELSE CAN HAPPEN. BUT I TRUST IN GOD THAT IT WILL COME OUT O.K. TAKE CARE EVERYONE, BECAUSE GOD KNOWS I KNOW WHAT YOU ALL ARE GOING THROUGH..SEE YA WOLFMAN

jetnjeff

I was pretty bummed 9 weeks out. On a bone stimulator for half of of it. Wasn't united yet, but this last Wednesday was week 12 and I got the go ahead to ride. Even though I was riding as of about week 4. Couldn't stand the trainer in June. Was just easy rides to work and stuff. I did not take pain medication in order to get proper bio feedback and not hurt my self.

So at 6 weeks when the DR said I could stop wearing the Fig 8 brace but not ride yet (did not tell him I was) I split the difference and road with the brace.

I have been adding in a bit of Yoga as I became more able.

Three days of riding with out the brace was tough and my atrophied upper back muscles cramped a gave me a huge tension head ache tha oddly enough riding with the brace aleaviated (it gave me a head ache in the first week).

A few more weeks and I will add in Light MTBing and see how it goes. Follow up with DR in 6 weeks.

ocean123

Hi Everyone. I have a question, and welcome your advice. But first of all, thank you for this excellent forum. Reading what you have all shared over the past months, has helped me to know how to choose the best team of doctors, talk more intelligently with my own orthopedist, and make decisions about scheduling my own clavicle surgery.

Briefly, I can tell you that I was a passenger in an extremely serious automobile accident about a year ago. My clavicle was crunched into a bunch of jagged pieces (broken ribs, lucky to be alive, etc.) and we first tried the Wait-and-See protocol. Some pieces did indeed fuse, but two sections remained an inch apart. I finally had the ORIF (2 permanent plates and 16 screws) on 7/12/07 with my own hip graft (i.e. not from a bone bank.) I am a 52-year old active female, and my bone density is excellent. The surgery was pretty much a piece of cake, I'm surprised to report. Within days, I was walking pretty well, and was essentially off the Percocet, hardly sore at all.

There is a significant complication, though. The nerves got pretty stretched out during surgery traction, and I have temporarily lost the use of my arm. It would simply hang off me like a dead sack of potatoes, if it weren't in a sling. At its best, it feels prickly and painfully tingly and numb (doesn't sense pressure or temperature differences), like the feeling when your foot falls asleep if you've been sitting on it wrong. At its worst, I feel like my arm is on fire, and the pain is inconsolable, and the nerve meds don't seem to help. Apparently this pain is a good sign, that nerves are regenerating. The surgical team feels sure that nothing went wrong during surgery (the nerves are intact and were not knicked-- only stretched in traction, and also traumatized now, since all the muscles and nerves had contracted around my deformed skeleton during that long Wait-and-See period, and now it's all been surgically stretched to put everything back where it belongs.) They predict that this will reverse and my arm will be fine, but cannot predict the timetable: anywhere from 6 weeks to 6 months! Yikes!! Meanwhile, I'd love to not get fired from my job... We've already started the PT so that my joints don't freeze. Does anyone have any experience with this complication, or recommendations? Needless to say, I'd love to hear a success story. Thanks, and best of everything to all of you, too.

jetnjeff

That is a drag! I am not a Dr but it sounds like a pinched nerve to me,never heard of a stretced nerve. I developed a impingred nerve, a couple decades after I broke my first collar bone (left). The doctors said that it "No" when I asked if it could be related to to the break. My nerve was trapped in a knot. But except for the sack of potato thing, I had the wake you out of a deep sleep screaming pain and the arm on fire pain. The PT did specific things to break up the knot, that alleviated a large amount of the pain with in a few weeks. Electro stim, stretching, Deep mesage to break up the knot and finally the PT convinced the DR to give me a Cortisone shot to break up the scar tissue that was trapping the nerve. That was a few months in. I still stretch it from time to time.

They said it was from stuf like holdin the phone between the shoulder and head, all stuff I did not do except for sleeping on it some times. I think it was from scar tissue from the break, exacerbeted by a highly stresfull time in my work life.

santanaf

Well, I am just over 10 weeks post op and wanted to give a brief update. The last followup appt at 8 weeks I was told the bone had developed significant fuzziness at the site of the break and that I could begin lifting more weight. I'm not 100% clear to do whatever, but I can start doing curls and such back at low weight 10-20 lbs. I should still stay away from full pushups, bench, or military press, but I can at least get back into shape. I've also started stationary cycling again, able to put full weight on the bars in a sprint. The main thing I am doing now is running, 4-5 miles 4-5 times per week.

I am finished with PT at 10 weeks, given excercises to do from here on our. I have full ROM with 0 pain. I actually just went tubing on the Potomac yesterday with some friends. I did a lot of paddling and had no immediate or residual pain in my shoulder, only some slight muscle soreness today. I am also back to doing full home improvement projects, drilling above my head, installing drywall, etc. It is nice to be back.

I have some slight sensitivity only right on the spot where the break occured, mainly if I press a little hard on it. The site of the scar is still a little number on my shoulder, and the scar is healing very well, flat, and pink.

I am still very impressed with my doctor, as well as with my PT people. Overall, as unplesant as this experience has been, it could have been so much worse.

joewaroo

Hi guys and Gals,

My names Joe and i am in need of some really good advice about an operation i am supposed to be having on my left clavicle.

Basicly about 3 years ago i realised my left clavice wasnt the same as my right and my left shoulder just didnt have the same amount of easy movement as my right and also has a clicking noise / restriction when the abduction movement is performed. After going to the doctors and a shoulder speciasist and having x-rays and MIR scans etc. The conclusion was made that i had a twisted clavicle.

So the end of my left clavice is rotated round about 90 degrees compared to my right clavice. This is limits my shoulder movement, not totally, but the pain sometimes is unbearable.

The specialist i saw recomended surgery simmillar to the surgery that you would get after breaking your clavicle, except mine has never been broken. (the doctors think that i have done this when i was a youngster and my bones were still soft and not fully developed) This surgery would involve what you guys talk of, having my clavicle broken and the a plate put in to set it in the right position.

I am 21, very active, and enjoy my sports. Especially wakeboarding and kitesurfing, unfortunatley these both take a toll on my shoulder.

I am really unsure of the surgery, a big part of me wants to get it done and on the days i have pain its all i want to have done. But another part of me dosent think its worth the risk and am i right in thinking i may never be able to use my shoulder to its full strength if something goes wrong.

So.... i really could do with some advice from people who have had this surgery, and weather or not it sworth going through with etc...

I have read alot of this thread and it has already give me some reasurance that getting the surgery would be ok and my shoulder would improve alot from having it. But theres this voice in my head thats a little unsure, also my mother and other family members dont think i should have it done.

Lately though and as im sat here typing its really hurting and i would love to get it sorted out.

I would really appreciate poeple thoughts on the whole situation as i am strugling to find other people wiht simmillar problems.

What i would really like to know is how strong my shoulder is going to be after having surgery and its healed???

Also i have meet two guys who have had this surgery after breaking there clavicle and both of them, the pins holding the plate on had slipped out of place. I dont know but would guess that they never really gave it time to heal properly and went back to normal life after having it done.

Thanks for reading, if you got this far, and i hope someone can help,

Joe

wolfman113

[JOE I WOULD SAY TO THINK TWICE BEFORE MAKING ANY DECISIONS ABOUT SURGERY... YOU DONT WANT TO GO THRU WHAT I DID, A LIVING HELL QUOTE=joewaroo]Hi guys and Gals,

My names Joe and i am in need of some really good advice about an operation i am supposed to be having on my left clavicle.

Basicly about 3 years ago i realised my left clavice wasnt the same as my right and my left shoulder just didnt have the same amount of easy movement as my right and also has a clicking noise / restriction when the abduction movement is performed. After going to the doctors and a shoulder speciasist and having x-rays and MIR scans etc. The conclusion was made that i had a twisted clavicle.

So the end of my left clavice is rotated round about 90 degrees compared to my right clavice. This is limits my shoulder movement, not totally, but the pain sometimes is unbearable.

The specialist i saw recomended surgery simmillar to the surgery that you would get after breaking your clavicle, except mine has never been broken. (the doctors think that i have done this when i was a youngster and my bones were still soft and not fully developed) This surgery would involve what you guys talk of, having my clavicle broken and the a plate put in to set it in the right position.

I am 21, very active, and enjoy my sports. Especially wakeboarding and kitesurfing, unfortunatley these both take a toll on my shoulder.

I am really unsure of the surgery, a big part of me wants to get it done and on the days i have pain its all i want to have done. But another part of me dosent think its worth the risk and am i right in thinking i may never be able to use my shoulder to its full strength if something goes wrong.

So.... i really could do with some advice from people who have had this surgery, and weather or not it sworth going through with etc...

I have read alot of this thread and it has already give me some reasurance that getting the surgery would be ok and my shoulder would improve alot from having it. But theres this voice in my head thats a little unsure, also my mother and other family members dont think i should have it done.

Lately though and as im sat here typing its really hurting and i would love to get it sorted out.

I would really appreciate poeple thoughts on the whole situation as i am strugling to find other people wiht simmillar problems.

What i would really like to know is how strong my shoulder is going to be after having surgery and its healed???

Also i have meet two guys who have had this surgery after breaking there clavicle and both of them, the pins holding the plate on had slipped out of place. I dont know but would guess that they never really gave it time to heal properly and went back to normal life after having it done.

Thanks for reading, if you got this far, and i hope someone can help,

Joe[/QUOTE]

saff

Hi all,

I broke my left clavicle (and six ribs) in a t-bone mva 7 weeks ago while on hols in South Africa. The Orthopaed who treated me there would have operated when the friction burn from the seatbelt healed. I was very keen to have the surgery due to the reduced healing time - I find it unbearably frustrating sitting around waiting to heal and having to depend on my partner to complete the smallest of tasks for me. Unfortunately, by the time the burn healed, the Orth was on holiday and my partner was keen to return to the UK so he could get back to earning - in hindsight a mistake as I would be justabout good as new by now had I stayed for the op...

As suspected, treatment on the NHS is a very drawn out process and my first two appointments were with a doc who apparently was not authorised to make the decision about surgery, due to his locum status! I was v angry when I learned this as I felt 3 weeks had been wasted - I am however comforted somewhat after reading all your posts, and realising that this does drag on and I'm not necessarily being jerked around by the NHS.

I finally saw a consultant last week who is keen to operate as the displaced bone fragment is lying adjacent to the clav resulting in about a 2.5cm drop in the left shoulder and while the break is not causing any pain now (I've been off all meds for 3 weeks) and movement in my arm is improving, I do suffer an intense, burning muscle pain in my shoulder at times when I don't wear the sling, from what I can only presume to be the lack of support from the clavicle itself. It feels like there is a huge weight pulling down on my arm/shoulder. Will this improve or will I continue to suffer pain? I have already suffered from back pain for 17 of my 31 yrs and dont want to make it any worse.

The happy, but v unfortunately timed news is that I am 8 weeks pregnant!! I am already extremely concerned about all the xrays and meds administered while in hospital and up until the time I discovered the pregnancy and due to a backlog at my GP, I have been informed not to expect a call from the midwife or refferal to an Obs Gyn until at least 14-16 weeks (another 6 weeks until those concerns are addressed!) I have been assured that the risk of miscarriage / deformity from general anaesthetic during surgery are 'minimal' during the first trimester, and even less thereafter. There is, nevertheless, still a risk.

I have been left to make the decision and I really don't know what to do. If I decide not to have the surgery, I am most concerned about resultant (im)mobility of the shoulder and possible continuing muscle pain. There is a slight cosmetic concern as I am quite bony and the difference in shoulder height and shape is obvious, some clothes now even sag slightly on that shoulder. The bump where it heals on its own will also be obvious and I've been told it will take another 5 weeks until its healed (argh!). If I do have the surgery however, much quicker healing time (yay) but there is of course the cosmetic concern of scarring - so either way, I'll just have to grin and bear whichever I am left with. The pregnancy issue just complicates the situation, especially considering I don't know if any damage has already been done. Lastly my sick pay at work runs out shortly, and with a baby on the way, I'm keen to maintain an income and get back to a 'normal' life, before its all turned on its head in 7 months time. (Am I being selfish in the way I'm looking at this?) We have not yet told anyone about the pregnancy, hence my unburdening this rather lengthy explanation on you all - I really need to hear your thoughts, comments, experiences please... thanks

ocean123

Wow, your pain sounds intense. I would recommend getting a second opinion and MAKE SURE that any orthopaedist who touches you has a "Fellowship in Shoulder". If they did their specialization in foot bones or spine bones, that doesn't help you at all. Whoever holds a scapel to you, must be performing YOUR specific surgery several times weekly or daily. You don't want to be their first! Interview as many surgeons as you need to (it's your dime, after all) and get third, fourth opinions, as many as it takes, until you find the person/team that feels right. Don't let anyone cut you, until you know it's the right person. I don't know how easy this is, maybe you live in a small town or something, if so, do your homework for a big city surgeon and fly out there for your surgery. If this sounds extreme, just remember what's at stake. This surgery is great when it works, and crippling when it doesn't, so stack everything in your favor that you can. Good luck to you.

joewaroo

Yeh it certainly can be. Thanks for the advice, but living in a small town i saw my local doctors who recomended me to an otherpedic surgeon, who then recomended me to a shoulder specialist in a big city, he seemed confident about what he could do etc. but hes a doctor after all. (confidence is what they do well). He has also performed the surgery before on people who have broke the clavicle etc. and he thinks that surgery is the correct procedure and because of my age etc i will recover well from it.

After reading this forum post it has swayed my desicion to serioulsy considering getting the surgery, as before i was thinking "no way". Well originally i wanted to get it done, but then thinking about it and talkin to my family and freinds i decided no. But lately it has been aching like crazy.

Its just that 60% of the time it dosent bother me, but when it hurts its really hurts and makes things awkward to do. You can push through the pain etc if you really wanna do something, but i dont know if thats the answer anymore. And not getting it sorted, could things lead to arthrietes. I also get alot of neck pain, that seems to stem from my shoulder not being supported enough. Sometimes i wonder if alot of it is physcological, from finding out what is wrong, as i have always know something was different about my shoulders, just that in the last few yearas i have really discovered the problem.

Sorry about the legnth of my posts, i just have a lot to say, with little people in the same situation to say it to.

Thanks again,
Joe

MtnLvnSweetpea

jetnjeff

From what I understand if the skin is not broken they are hesitant to operate due to the risk of infection. But with broken skin and your bone in more than one piece, it wouls seem to me that they should have operated right away. But now this far i your skin has probably healed and they would go back to it is now more risky to operate. There are different proceedures mentioned on this thread that make a smaller scar and are less invasive. But you will have to read them all like me to find them as I can not recall the details.

3 weeks before you got a Figure 8 brace? That should be the first course of action.

Bone stimulator seemed to help my 42 year old bone heal abit faster.

Good luck!