broken clavicle...surgery or not?

ShanYang

I am 16 and it's been four months since i fracture my clavicle. I fractured my clavicle during gymnastic..i did a move and landed on the mattress on an outstretch arm, my right hand hit my right collarbone. I am wondering will surgery make it better? Will it feel much comfortable then natural healing? My clavicle is about 1.5cm overlap...i just hate raising my arm(affected side). I am a very active person and i love break dancing, i just wish i could be reborn! I'm just so unlucky these few weeks...sprain my ankle real badly, i hope nothing is broken. I'm just afraid that after surgery the bone would not fuse together and heal, a non-union. If i go surgery it will take total of 6 months to heal, my studies would definitely be affected. Please help me here! I'm desperate for answers! Not only do i have to worry about my clavicle, i have to worry about my sprain ankle and uneven chest...i got tons of questions to ask. Everytime i ask the doctor questions he never really answer them what i hope for. From what i read on the internet most althletic go for surgery...should i go for surgery end of this year?
If any of you under go the same experience as me please share it with me!

Curb

ShanYang, if your clavicle is broken in two pieces (in half) I would let it heal on it's own. Because you’re so young, your healing process in twice and fast as some of us older people. If you get it plated it will also heal fast and you can have the plate removed later on but you will get some scars.

But trust me, loosing six months of fitness to let your clavicle to heal at your age nothing. You got plenty of time to get back in shape and continue where you left off.

Just relax, keep it in the sling and follow your doctor's order and get yourself a good Physical Therapist and add a bunch of distractions in your life a few months and watch what happens. I guarantee you will be surprise how fast you will heal up.

Regards,

Craig B

Ok so it has now been about 3 years since I went through this process and I recieved a phone call from a guy in California that had the same complicated fracture that I had. So I will provide this info to all as I wish I had such information 3 years ago. My first recommendation is to get a good doctor, do your research and talk to people about that doctor. This was my first mistake. So after 6 months of waiting for the bone to heal on it's own and an MRI later it was necessary to install a plate. I had three surgery's on my clavicle and had broken 2 plates, the first after 4 months (did this playing golf but did get my doctors approval to play). This first plate was a titanium plate with seven screws (with a bone graft). Doctor told me the plate broke due to fatigue and that the bone was not healing. Second plate (stainless steel, why stainless steel, titanuim is stronger?) was put in and a bone stimulator was implanted in my chest. The idea behind the stimulator was to enhance the blood flow to the break. Oh yea, and another bone graft (and they hurt worse than the shoulder pain). 10 months go by and snap goes the second plate (I was super careful about lifting or anything, including golf, during those 10 months). However after 10 months I decide to hit a few golf balls, snap! broke again. But 10 months gone by, had to be healed by then! Throughout the process Xrays were never very clear. Now this doctor tells my geeze I don't know what to do for you I guess you will just have to live with the fracture. Wrong! I find another surgeon, this time a Trauma specialist from Henry Ford Hospital in Detroit. Guy was awesome! First thing he says is he believes that the reason the bone was not healing was because he felt the ends of the fracture were not allowing proper blood flow. Hmmm...never heard this from the other guy. He also did not want to use bone from my hip, he was giong to use a substance called rhBMP. So I had the 3rd surgery with rhBMP with another titanium plate and 9 screws. Today I am 100% healed (xrays show perfect bone growth), no pain, still riding motocross, snowmobiles, and working out. I still have the plate in and am thinking about removing it. It does not hurt but frankly it is a little annoying especially with the seat belt in my car as the plate is in my left shoulder. Still up in the air on this decision.
With my fracture, I wish I would have had surgery on day one. I am not saying this would be the case for everyone but I had 2 breaks (looked like a Z) and even my limited medical knowledge (I am an engineer though) had me questioning if this break could really heal on it's own. I think that the rhBMP (recombinant human bone morphogenetic protein) was a big factor in the healing process. You can google it and there is tons of info out there.
Good luck to those of you with this fracture and I cannot reiterate the importance of finding a GOOD doctor!.

Curb

Craig, with all due respect, are you telling us everything about your past clavicle ordeal?

In this forum, we don’t want to spook anyone now.



The clavicle plate installation is simple and only takes about 3 hour, out patient.

I went in at 1:30 pm and was home at 6:30 that night.



Now, if you get an orthopedic that very in experience and install it incorrectly than yes it may come apart.

Clavicle operations these days are routine and if you go to a real Orthopedic Specialist, one should not have a problem getting it installed correctly, get it done at a hospital of course, not in his office!

If you live in the backwoods and you let someone operate on you with no experience then it’s your fault.



Craig, as far as you breaking your plate 2 or 3 times and having multiple operations, well I don’t know about that.



All I know is those Acumed Locking Titanium Clavicle Plates are rock hard strong and I got one in me now and I am doing bunch of stuff, not crazy stuff like dead lifting or anything like that.

Craig B

Curb, I am not trying to spook anyone but frankly surgery of any kind is not routine, and if it was so simple then I imagine it would be recommended more but I was informed that there are many risks with such operations (ie. infection, nerve damage, and appearently there is also a major artery in this area that could be ruptured during such a procedure). Secondly I don't live in the backwoods nor did I let some backwoods Doctor perform this surgery. I live in the Detroit area and had my first 2 operations at Crittendon Hospital in Rochester Michigan. With the first operation I was in and out of the hospital in about 7 hours, they required me to stay overnight for the second operation. As I stated above, the first titanium plate that broke was an Acumed Locking device and I have this broken plate in my possesion as I asked the doctor for it. The one currently in my shoulder is also an Acumed Locking plate as well. I am a mechanical Engineer and know very well how strong Titanium is but I also know that it broke and was very painful when it broke. I wasted close to 2 1/2 years of my life screwing around with this injury because in my opinion it was not handled in an appropriate manner hence my message to people to research and find the right Doctor! The Doctor that performed my first 2 surgery's was a shoulder specialist but I did not know anyone that actually went to him (but in the event I ever need surgery of any kind again I will for sure do much better homework). I also saw 4 different orthopedic surgeons after the injury. Besides do you really think insurance companies would pay a backwoods doctor $33 thousand dollars for this type of operation?!

For 6 months after the original break I did zero physical activity as I was in pain whenever I did the most mundain task. For the first 4 months after the first operation I did nothing for 4 months, and after the second operation I did nothing for 10 months. After my third surgery the bone was fully healed after 6 months. Hmmmmm......quite interesting, makes one think that something was different but for sure the patient was the same.

I am trying to provide people with a real life situation (with facts) so that they may have further info to discuss with their doctor. As far as I am concerned as a patient I would like to have as much information as possible to make a well informed decision. I don't know who you are and really do not appriciate your implications that I am being less than honest. What would my motive be??

Bottom line is if I had known then what I know now I would have had a much faster recovery and not been cut open 3 times! And if one person can benefit from this information then it was worth my time sharing.

alienator

You are spot on. It is not uncommon at all for collarbone hardware to break. Likewise, it's not uncommon for other orthopedic hardware to break. The list of motorcycle roadracers who've had to have plates and screws replaced in their collarbones--because theirs broke--is long. I was warned that I could easily break the titanium rod in my tibia.

As for the risk vs. benefits of such surgery, you're again, spot on. Installing hardware in bones can result in disruption of blood flow in the periosteum and cause slow healing. There is always the risk of infection, and an infection of the bone can lead to all sorts of nasty things that may be prolonged for a very long time.

When the rod was installed in my tibia, it was a relatively simple and short procedure, all of about 45 minutes. Was it routine? Far from it. Less than a week later I developed a DVT in the broken leg. Boy, did the swelling from all that backed up venous blood feel nice! One week after the dx of DVT, I developed a transient nerve disorder, as a result of the trauma, surgery, and DVT that was more painful than when I originally broke the leg.

I saw a pic once of someone's new Moots. The head tube and been snapped off when the rider got hit by a car. If you can break a Ti frame, you can sure as hell break orthopedic fixtures, be they Ti or stainless steel.

Curb

Hi Craig no problem. Did not mean to offend you. Sorry about that!

But I must reiterate,
Clavicle operations these days are very routine and if you go to a real Orthopedic Specialist, a person should not have a problem getting it installed correctly.
Routine meaning that they are done all the time because people are always breaking their clavicles. Not routine that there are no risks.

I did not say that there were not idiot doctors out there.
Can the plate break, yes if you fall on them and you do stuff before the bone heals and heals to the plate. (Did you not have post Dr visits xrays?)

I've only had my plate 4.5 months.

My othropedic installs these plates all the time. He’s in with 4 others orthopedics that do the same thing and other orthopedic stuff. He told me that if something will go wrong or if you do something that stresses the plate, you will definitely know.(PAIN!)

And when I was going through PT, my PT was putting pressure on my plate and shoulder left and right. If was going to break, it would have broken then.

Anyway I appreciate you sitting me straight concerning your condition. Looks like you had a healing problem doing that time.

And thanks for the heads up, I better make sure I don’t swing any golf clubs!

Craig B

Clavical surgery's are performed on less than 2% of all patients that break this bone. Ask your Doctor

Curb

Thanks for the information.

matagi

Firstly, clavicle surgery is not routine - it is still quite uncommon as a percentage of the total number of fractured clavicles. First line treatment is still to allow the bone to heal without surgical intervention if it is a simple fracture. Comminuted and compound fractures are a different kettle of fish entirely and the level of intervention will depend on the severity of the fracture.

Secondly, you can break the plate without falling on it - all it requires is a movement which stresses the plate in an inappropriate plane. And it can be something as simple as an involuntary flinch that does it.

Curb

Gosh, please go back and read the past post in this forum and see how many people have had surgery plates installed. And re-read what I said below in my original post! That’s all I am going to say from this point on!

Oh, let me ask, what do you call a heart by pass? It’s a serious operation but it’s still a routine operation because it’s done hundreds of time a day.

Originally Posted by Curb

But I must reiterate,
Clavicle operations these days are very routine and if you go to a real Orthopedic Specialist, a person should not have a problem getting it installed correctly.
Routine meaning that they are done all the time because people are always breaking their clavicles. Not routine that there are no risks.

matagi

You sir, have a problem with the definition of routine surgery. Routine does not refer to the number of a particular type of procedure performed, routine surgery is simple surgery which has a low complication rate - things like having a vasectomy, getting your gall bladder out, having your appendix removed, etc. etc. (and even these procedures can, on occasion, have nasty complications)

A heart bypass is far from routine surgery despite the fact that bypasses are performed frequently and regularly.

Also, the number of people in this thread who have had clavicle surgery represents a skewed sample - so you cannot use that as a basis for the claim that clavicular surgery is common (or routine to use your rather loose definition). It is certainly common amongst the contributors to this thread but represents a drop in the ocean of the total number of clavicle fractures.

Curb

I had promise I was not going to respond and I really should not let certain individual engage me but I can't resist.


So, a routine surgery is what you call a low complication right?


So, it must make one wonder why most clavicle operations are treated as out patient, (no over night stay).

Example: I was in at 1:30 pm and home at 6:30pm same day. Would you classify this as a low complication surgery? What would you call it? We can’t wait to hear!

And hell, the doctors made me wait a whole week before he did the operation and the bone was poking up in my skin like a little tent! Now that’s serious! More serious that the damn operation!


Of course this same day surgery is dependent on the severity of the break that is.

And another thing, as you stated breaking the plate, YOU SAID; all it requires is a movement which stresses the plate in an inappropriate plane. And it can be something as simple as an involuntary flinch that does it.
Hell for 3.5 months that my PT and Orthopedic Surgeon were moving my arm in ways that I would never do it if it was not broken. If my plate was going to break it would have broken by those two guys and they were man handling something serious and to top it off, the bone was not even healed!

Elsiehandle

Hello Hummer - final update for you. James is now fully functional in his arm. He reports absolutely no pain - either from the recent op or the pain he was getting thoughout the past year. He has more movement in his shoulder than when he had the plate in, and is getting back into sport again. So, from James' experience - the plate is better out than in!

I hope everybody on this forum get over their breaks soon whichever method of repair they choose!

Leigh