broken clavicle...surgery or not?

romey

i am on day 2 after a mt bike crash 7 mi into a 14 mi trail in moab, ut, porcupine rim. after the initial accident, i got up to ride out, crashed and landed on the same shoulder. 2 hours and many agonizing bumps later i was strapping on a sling and heading home, with my gf driving through a rocky mountain blizzard we made it home in 6 hours. question? i wad only provided with a sling, should i seek out a figure 8 brace, and why? is it for increased support and will it help in the long run? (1 post on here said it did and i was wondering if that is a universal truth)

FZ1AVN

Number 1, get an X-ray. Many times the bones do not line up, but surgery is not needed. On July 31 I landed on my head during a motorcycle accident. Full coverage helmet broke my collarbone. Read many stories about problems with alignment and healing. The figure 8 brace is not used if the bones are close. My left collarbone is not straight, but healed. Range of movement is not bad, but I do feel a difference from the right. I really mean that you must get an X-ray, the Ortho-Surgeon can then determine what to do. Along with the collarbone break, I had four broken ribs, a concussion and my lung collapsed and inflated. I'm 48 and my 120 miles a week probably saved my life. But you gotta get an X-ray and see a doctor, man.

ahinalu

Aloha,

Well I'm sitting here w/ a broken clavicle that happened about 4 hours ago.
I broke my left in August (both mtb biking). I had my left plated w/ a ti plate
from http://www.acumed.net (they explain it better than I). Anyway, the last
one I had I was lifting my arm over my head the next day. I took one tylox
in the morning after surgery and that was the last tylox I took until this afternoon. It's good to have extra when you need it ;-)

As far as after affects. I've been lucky. I was able to go back to work two wks after surgery. I have a very physicaly demanding job as a tour boat captain.
I steer w/ my left arm so I have nothing but good to say about the plate. From
what I hear, the type of plate and the ability of the surgeon has allot to do w/
how well it goes. My left arm was displaced over 1 1/2 " (compressed). My right
isn't as bad but I think I'm going to ask for the same thing.

I'm a believer in getting it plated for what it's worth.

ps great site/forum.

Aloha Chris

Sco++

I broke my right collarbone in June of 2003, at the age of 50... Mountain bike endo... I knew it snapped when I hit the ground. I could hear/feel the break in a strange sort of way. The xray showed a break seperation that measured a quarter of an inch. Spent the next 6-7 weeks in a simple sling. The knitted bone has a little lump in it, but is otherwise OK.
SEE A DOCTOR. GET THE XRAY.

swerwer

hi guys/ girls

good to be back after hurricane ivan here in the Cayman Islands..... Still kicking and riding...

Very interesting post you guys have here... I have broken three collar bones...lol and i only have two.... the last time in 97 i walked around for two weeks without it growing back on. Ok i didn't keep very still seeing that i did a 4000km drive in that time. When i got back the doctor gave me the option, and i opted for the pin and screws. healed a lot quicker and i still carry the pin. they said it should come out in a year's time(after the bike crash). I went back about a year and a half afterwards and the doc said: " if it aint bothering you leave it" so still have it. The femur pin has been removed though, but that is another story for another day.

ok see you guys/girls around a bit more..... chow....

Hanry

ps: i've hit two cars in the last month....not a happy camper.... blind @#$$%%#@!@ drivers.

__________________
RIDE HARD.... OR....GO HOME

Cwego

Hi all

I fell off my bike in the woods and hit a tree which was lying on the ground and broke my left clavical just over 3 weeks ago on Sunday 6th March. Went to casualty and got an X ray, the bone broke in the middle and the 2 pieces werre overlapping, making my left shoulder around 25mm shorter than the right . Was told to return the next day to see an Orthopedic surgeon, who said an operation was probably required, using a plate and screws, but due to the cuts and grazes on the outside of the skin there was too much risk of infection (good old MRSA in the NHS!). He told me to come back in 10 days for another X ray and consultation and hopefully the external wounding would be better.
In the mean time it was really painful and dropped down at the left side, so I was looking forward to the next meeting with the surgeon.
The new X ray was the same as the initial one, but the surgeon now said an option was to leave it for 8 weeks and see if it heals, if it did it would still be shorter than the other side, and he said it may not even heal and then an operation would be required, with 8 to 10 weeks wasted.
He asked how I felt and I explained i didn't want to wait as I am very active and compete in Motorcycle Enduros so was keen to get better ASAP! He booked me in for the operation the following Monday (now 10 days ago). He also said my age (27) and fitness helped me get the op, in older people they tend to leave them to heal??
My shoulder feels good now, he told me to wear the sling for 4 weeks but I feel ok without it. Can anyone else whos had the op tell me how long they wore the sling for?
Also, can anyone tell me roughly how long you should wait before lifting weights?
I realise every case is different but am just after a general idea.

Great site by the way, I found it by accident when surfing for info on Broken collar bones and read it all the time now!

Cheers
Cwego

South Scotland

daymat

Hi Cwego ,

A few words of advice . I broke my clavicle 6 months ago, after 8 weeks clavicle hadnt healed due to inch and a half displacement . so decided to opt for an Internal fixation. I wore the sling for 6 weeks until the xray had shown that the bone graft had incorporated . Then i began my physio which took at least 3 weeks before i began any weights . So i suggest you continue wearing your sling for a minimum of 4 weeks, and make sure that any exercises you do dont cause any pain in your shoulder area . Please dont try to take any short cuts !!

Cheers, Matt

Cwego

Hi Matt

Thanks for the advice, I need to be more patient and leave it to mend!

Cheers
Craig

ahinalu

Cwego,

I was told no more than 5 lbs for the first 4 wks. I was told to keep the arm in a sling "as much as possible" and don't excert when it's not slinged. Keeping circulation in the arm and joint is a good thing, but don't lift anything, not even your arm!

I had surgery tuesday (it's thursday now), and I feel fine. I'm down to about one percocet every 6 hrs, although I'll take two before bed tonight. maybe none until lunch tomorrow.

Anyway, you'll heal fine. This is my second plate, the first one I could ride around the block in 1 1/2 wks (using ONLY my legs).

Anyway, healing vibes your way Cwego.

Aloha chris

Cwego

Hi Chris

Thanks for the advice mate.
Hope you are healing well too! So have you broken both sides now if this is your second plate? What a thought!

Cheers
Cwego

sethmyhre

Hi, who and where was your Dr.? I'm 3 weeks in and the jagged tip is still trying to escape my skin.

ahinalu

Cwego, yes I have a matching pair now. I'm sure to set off the metal detectors now (SS plate in leg, 2 Ti plates on collar bones).

sethmyhre, you kind of have to demand that a plate be put in.
Here's the deal.

1. Some doctors believe that if it ain't sticking out of your skin leave it. I'm told there's 97-97% chance of the bone healing fine. The problem with that thinking is that:
   • The shoulder joint isn't in the proper position anymore so shoulder problems in the future is for sure.
   • If you're in a semi physical job like mine (I drive a 65' tour boat at 20-22kts here on Kauai, kinda rough waters), then you'll have to wait the full 5-8wks till it heals before getting back to work.
2. Some other doctors beleive that if it's displaced more than 1.5 cm plate it. This is usually from more active sports type doctor. My arguments to my latest doctor (not so physically active), FOR the plate was this:
   • With the plate I will have a more normal shoulder joint structure/ alignment
   • Although you can't lift anything too heavy (no more than 5lbs for 4wks or so), the bone gets to heal faster since the Ti mimicks bone in how it flexes and such. So for me, as long as I don't stress the area, I can still function at work and make money.
   • The new plates from Acumed.net are fantastic. They are strong, but most importantly, they are pre-bent and erganomic.
3. The arguments against plating are good ones, and none to just brush off w/o understanding them.
   • Plating involves surgery. General anesthesia, while very common and they got it pretty down, there are problems that can happen like (very rare); brain damage, you might not wake up, etc. And of course when you get cut open, there's always a risk of infection. If you are a healthy individual w/ a good OR staff and surgeon, these risks are VERY SMALL.
   • The chance that the bone doesn't grow back are higher, than if it's left alone. I was told 94-95% chance that the bone won't grow together. So you have about a 4% chance greater of a problem w/ the plate.

I just told my doctor to imagine not being able to pay off your tuition/mortgage/bills. So for me it makes sense. If you work in an office, and you don't need to type or use the affected arm, then it doesn't make sense.

So if you're wondering why they haven't given you the option, they are looking after you (and their liability).

Good luck
Aloha Chris

sethmyhre

Thanks bro. I'm going to look for a third opinion tomorrow. Here are some interesting links to studies on pins vs plates vs slings. http://www.aaos.org/wordhtml/anmt2004/poster/p285.htm

http://www.aaos.org/wordhtml/anmt2005/sciprog/208.htm

http://www.aaos.org/wordhtml/anmt2004/poster/p299.htm

http://www.aaos.org/wordhtml/anmt2005/poster/p239.htm

These are some complications of pin fixations.

http://www.aaos.org/wordhtml/anmt2005/poster/p385.htm

and one against surgery

http://www.aaos.org/wordhtml/anmt2005/sciprog/034.htm

ahinalu

You'll see that the problems they had were with the rockwel pins (sp?). These as I understand them are inserted through your skin and the immobilization is done externally. That is why they tended to have more skin issue and infections. What I got comes from http://www.acumed.net/product-detail.php?productID=27 (and yes I asked for it by name). This stuff is great. I have no issues wearing a pack or other issues with my plate rubbing or anything like that. It's because they're thin and they form to the natural curves of your clavicle.

That was some great reading (for someone w/ nothing to do ).

Aloha Chris