broken clavicle...surgery or not?

[James Thomas]

I broke my clavicle June 21st (pretty painful but still was a fun ride prior to the fall). I have been presented the option of surgery or the old fashioned "let it heal as is". I have never broken a bone in my 33 year life span and am weighing the pros and cons of surgery. I would like input if you have experience. I already have back problems so I am leaning toward the surgery in order to alleviate potential future complications. Please let me know what your experience has been. Thanks!

 

[shming123]

i broke my collar bone in Feb. 2003. It was a complete break, with about an inch between each side of the collar bone, with a grape-sized fragment in the middle. For me too, it was the first bone i had ever broken, and i was sooooo painful. I sat AND slept in a recliner chair for 2.5 weeks, and wasnt able to take off that strap thing for 3 weeks becuase it was soo painful and had to let the 2 bones mend together a bit; it was that bad. I was not given the option of surgery, despite seeing 2 or 3 doctors. They said that there is a huge risk of infection of the collar bone, and this is quite common of the collar bone. I think mine would have healed so much faster if it was pinned together or something. I guess it is up to you, but ask your doctors. The nice thing about temporarily being unable to do a lot of things, is that you get a chance to put your feet up and have people wait on you a lot.

 

[James Thomas]

Originally posted by shming123
i broke my collar bone in Feb. 2003. It was a complete break, with about an inch between each side of the collar bone, with a grape-sized fragment in the middle. For me too, it was the first bone i had ever broken, and i was sooooo painful. I sat AND slept in a recliner chair for 2.5 weeks, and wasnt able to take off that strap thing for 3 weeks becuase it was soo painful and had to let the 2 bones mend together a bit; it was that bad. I was not given the option of surgery, despite seeing 2 or 3 doctors. They said that there is a huge risk of infection of the collar bone, and this is quite common of the collar bone. I think mine would have healed so much faster if it was pinned together or something. I guess it is up to you, but ask your doctors. The nice thing about temporarily being unable to do a lot of things, is that you get a chance to put your feet up and have people wait on you a lot.

Thanks for your reply. Unfortunately, I don't have the time to put my feet up. I am an electrical contractor and the sole employee of my company. I have already been back to work and have got a couple of friends doing the heavy stuff for me. I am leaning toward opting for surgery because of the increased recovery speed and because the original bone structure alignment is still maintained. Do you notice any back problems that you didn't have prior to the break? That seems to be a common complaint among those who just "let it heal".

 

[shming123]

nope, no back problems, i would even think that the strap thing would help improve your posture. But now that mine is completely healed, it is very noticeable because me collar bong is larger, and once in a while, there is a catch in it, not bad, but kind of like your knee or elbow moving and then it cracks(noise.) Its not painful, but annoying sometimes.

 

[DarrylZ]

. Please let me know what your experience has been.

Whilst racing motocross 2 years ago i snapped my clavicle off pretty bad, but mine was totally misaligned so had no choice but to have an operation to straighten and pin together.
I had what they call here in South Africa an exterior fixation, which means they dont actually cut the skin, but knock you out straighten the bones under x-ray and drill in the pins which hold and align the break. So even though you have plaster you still feel these pins which protrude out the skin +- 1 inch.

But the one good thing is you have very little pain thereafter.

If i can give some advice, do take care of it, i was a little eager to get back to racing then, and now still only have +- 80% movement .

Good luck

 

[shming123]

see...at least you guys had/have the option of surgery and having it pinned, i might have if i would have had the option, but mine was pretty misaligned as well. Now, just looking at both my collar bones, it is like comparing a pen vs. a marker. Not the actual size, but you get the point.

 

[DarrylZ]

[but you get the point.

My other collar bone has also been broken, and there i bent the plate they put in, so now i look like a bit of a spastic cause i have this huge lump(about half the size of a golf ball) that sticks out there.

p.s. They lied 'chicks' dont dig scars...

 

[James Thomas]

Originally posted by DarrylZ
[but you get the point.

My other collar bone has also been broken, and there i bent the plate they put in, so now i look like a bit of a spastic cause i have this huge lump(about half the size of a golf ball) that sticks out there.

p.s. They lied 'chicks' dont dig scars...

based on your previous posting you said you have +- 80% movement. Have you fully recovered or is this a recent thing?
( I have almost that much movement now and I'm still busted!) I have read a great deal of info. lately and most of it recommends the procedure (pinning, that is). None of them have mentioned anything about minimized mobility after surgery though.

 

[DarrylZ]

anything about minimized mobility after surgery though. [/B

HI James
No my limited mobility is cause of my own impatience, you should have no problems after the operation with mobility, my problems arose from being over eager to get back into action and then doing some further damage, which regretably has never healed properly hence some limited range of movement. But not a major trainsmash, i can still do most things the only thing i can't do is chin ups on a bar or similar activities.

Good luck,

 

[Tromesa]

Hey everyone.. Hope you all healed ok.

I broke my clavicle 11 weeks ago in a high speed car crash. I also broke my ankle (tibia & fibia - requiring operation to get metal plate & screws - but that's another story all together).

I have gone back to the doctors to get x-rays at 6 weeks, and 10 weeks, and both xrays have shown that the clavicle hasn't 'joined' at all. They are now suggesting I may have to get surgery to get a metal plate to put it back together.

When I first broke it, I actually was keen on the idea of getting surgery, as I do martial arts and wanted my bones to be "back to how they were" if possible! Rather than having one collar bone shorter than the other. However all the doctors I've spoken to say that if it can heal by itself, they will almost always let it do so - which is 95% of cases. Apparently there are a lot of very important nerves etc in the shoulder, so they'd rather not do surgery if it's not necessary. Also studies have shown that there are more complications with internal fixations (plates/pins etc) than there are with natural healing.

I resigned to the fact that i'd probably rather a bump in my shoulder than the risk of some major nerve damage/infections etc. Now it looks like I don't have much choice! To the people that HAVe had surgery, were you happy with the final outcome? Full Range Of Movement etc?

Cheers guys. I'm not a cyclist, but this is a great forum, very well designed!

Tromesa.

PS. Purely out of interest - broken leg is much worse than broken clavicle!

 

[dvince]

I broke my collarbone when got hit by a car. It was a bad broke with fragments that caused pneumotorax on my lungs. They operated me after my lungs were clean and after that I have pins and plate for about 4 months. They said that without operation it could't heal. The operation and recovery wasn't difficult and after some days i was able to walk logn distances and even went in mountains, but couldn't ride my bike for about one month (I started on my stationary bike). 50 days after opreation I started my first road session. Now I am waiting to remove that plate and pins.
So I advice operation, because isn't complicate and you recover much faster that without it (and the pain of broken bone dissappear very fast). The only problem is that sign of a cut that you will wear for all life on your shoulder.

 

[Tromesa]

Just thought I should add after my last post, that I DID end up getting surgery, as my collar bone had shown no sign of new bone growth or healing after 3-4 months! As a part of the operation they took a bone graft from my hip, which they used as well as the metal plate to fix my collar bone.

The funny thing is, a hip bone graft is far more painful than the shoulder operation! (And the doctors informed me of this beforehand) The shoulder is a bit stiff etc for 2 or 3 weeks, but then its fine.. the hip causes a LOT of pain in your lower stomach muscles!!! nasty! But I'm now 3 weeks post op, and I am starting to feel the improvement. I would say 1-2 weeks and I'll be back on my feet

So in hindsight, I wish I'd got the operation in the first place! BUT... it's only early days at the moment, so i can't say if there are any long term complications etc... As dvince said, there is of course the scar, but that's no big deal to me. I have a metal plate & Screws in my ankle, but having them in your shoulder is a lot closer to your neck, major arteries/nerves etc, so it's not as simple a process!!

Regs,
Tromesa

 

[RyanG3]

Just thought I should add after my last post, that I DID end up getting surgery, as my collar bone had shown no sign of new bone growth or healing after 3-4 months! As a part of the operation they took a bone graft from my hip, which they used as well as the metal plate to fix my collar bone.

The funny thing is, a hip bone graft is far more painful than the shoulder operation! (And the doctors informed me of this beforehand) The shoulder is a bit stiff etc for 2 or 3 weeks, but then its fine.. the hip causes a LOT of pain in your lower stomach muscles!!! nasty! But I'm now 3 weeks post op, and I am starting to feel the improvement. I would say 1-2 weeks and I'll be back on my feet

So in hindsight, I wish I'd got the operation in the first place! BUT... it's only early days at the moment, so i can't say if there are any long term complications etc... As dvince said, there is of course the scar, but that's no big deal to me. I have a metal plate & Screws in my ankle, but having them in your shoulder is a lot closer to your neck, major arteries/nerves etc, so it's not as simple a process!!

Regs,
Tromesa

Hi,
Where on your collar bone was the break? I broke mine back in January and the main bone part is still loose. It gets painfull by the end of the day every day. I am going to see the orthopedic doctor soon to see if they can do anything for it. Did they say that some doctors won't fix them? I'm just curious becuase I really hope I can get the bones to actually stick together. I just have one break but the space between the bones can be stretched to about 1" depending on how I move my shoulder. It broke sort of near the end of the shoulder. My first doctor said just to leave it because 98% of these heal on their own. I am about to get a 2nd opinion because its been 8 months and it doesnt seem right. I am not a cyclist either, but I do agree this is a great forum. I did this on a snowboarding superpipe. I was able to do a swim marathon with the broken bone, but its tough to do the normal day to day things now.

Ryan

 

[Jhikers]

Broke my right clavicle in two places back in March this year. Went into surgery two days later - was on the ergo two weeks after that.

Recovery was sensational - so much quicker and less painful than friends I've seen recover from the same break. They let it 'heal as is' and varied from 2-6 months for their recoveries.

Get it pinned!

100%

 

[Craig B]

Hello to all of you that have been as unfortunate as I,


I broke my collar bone about 6 weeks ago on a motocross bike. I am 42 years old and a very active individual. I was as well told to let it heel on it's own. However, It is broke in two places and is shaped like a Z with a 15mm piece that is vertical. I, as well as many of my friends, think it is wrong to let it heal in this manner. I have a very large bump (edge of the bone) where the bone from the neck area is sticking up in the skin. The doctor keeps telling me to let it heal like this that an operation is risky due to infection. I have had four doctor's opinions and 2 were against the operation and 2 stated it was an option. Since my normal Doctor has convinced me not to have the operation and the bone is healing I am concerned about such a late operation.

My wife is also not carzy about the operation. It is still very discomforting after 6 weeks and the bone under the skin continues to cause pain but it appears that the bones have begun to fuse back together. I would really like the operation. Any suggestions from those of you that have had a similiar break? I am really struggling with how bad this looks (bone protrudes approx 20mm more than the good collarbone.

Thanks
Craig
Michigan, USA

 

[Tromesa]

Hi,
Where on your collar bone was the break? I broke mine back in January and the main bone part is still loose. It gets painfull by the end of the day every day. I am going to see the orthopedic doctor soon to see if they can do anything for it. Did they say that some doctors won't fix them? I'm just curious becuase I really hope I can get the bones to actually stick together. I just have one break but the space between the bones can be stretched to about 1" depending on how I move my shoulder. It broke sort of near the end of the shoulder. My first doctor said just to leave it because 98% of these heal on their own. I am about to get a 2nd opinion because its been 8 months and it doesnt seem right. I am not a cyclist either, but I do agree this is a great forum. I did this on a snowboarding superpipe. I was able to do a swim marathon with the broken bone, but its tough to do the normal day to day things now.

Hey Ryan,
My break was actually im the middle of my collar bone. I was told, similar to you, that approximately 95% of collar bone breaks heal by themselves, and that it's better to let them heal without surgery if possible. The difference with my break was they called it a "high energy" fracture. Which I am told refers to the impact - mine was 70km/hr head on car crash into a telegraph pole. Telegraph pole's don't move much!

HOWEVER, all the reading I have done seems to imply that clavicle breaks that AREN'T in the 'middle' of the bone DO more often require surgery. Apparently the majority of breaks are in the middle of the bone, and heal correctly, but that breaks closer to either end do require surgery. I read somewhere that if one of the following applies, it's more likely you may require surgery:
- High energy fracture
- the break is towards either end of the bone
- the bone pierces the skin during the break
- more than 1.5cm (15mm) gap between the bones

Also, my specialist STRONGLY believed that smoking cigarettes slows the healing of bone. I was further proof of his claim, and I have now quit

I know how you all feel, I was very unsure of what to do. But all I can tell you is that my first 2 doctors told me that it would probably be UNNECESSARY to have surgery, and it wasn't until 10 weeks that they sent me to a specialist in clavicles/shoulders... even THEN, the specialist recommended waiting to see how it goes, so it was literally 4 months after the accident, that the specialist finally said 'ok, you'll definitely need surgery'.

I was also told by the doctors that there are "two schools of thought" when it comes to the decision, and that some doctors don't recommend it, and some do. All I can say is that in my situation it seems to be working very well, and I'm glad I can finally move/lift things etc without worrying about damaging my shoudler.

I'm now 5 weeks post-shoudler op (with bone graft), and have almost 100% range of movement in my shoulder, however I'm not bearing full weight on it yet. I think actualy building up the muscle will probably take a few weeks.

I hope this helps people. I would recommend getting a few opinions, and try and track down a specialist in the field if possible. I'm in Sydney, Australia and am happy to recommend mine if it will help anyone!

Good luck

PS. Here's a link that I found quite informative:
http://www.jpy.com/john/clavicle/

Hope this helps!

 

[RyanG3]

Hey Ryan,
My break was actually im the middle of my collar bone. I was told, similar to you, that approximately 95% of collar bone breaks heal by themselves, and that it's better to let them heal without surgery if possible. The difference with my break was they called it a "high energy" fracture. Which I am told refers to the impact - mine was 70km/hr head on car crash into a telegraph pole. Telegraph pole's don't move much!

HOWEVER, all the reading I have done seems to imply that clavicle breaks that AREN'T in the 'middle' of the bone DO more often require surgery. Apparently the majority of breaks are in the middle of the bone, and heal correctly, but that breaks closer to either end do require surgery. I read somewhere that if one of the following applies, it's more likely you may require surgery:
- High energy fracture
- the break is towards either end of the bone
- the bone pierces the skin during the break
- more than 1.5cm (15mm) gap between the bones

Also, my specialist STRONGLY believed that smoking cigarettes slows the healing of bone. I was further proof of his claim, and I have now quit

I know how you all feel, I was very unsure of what to do. But all I can tell you is that my first 2 doctors told me that it would probably be UNNECESSARY to have surgery, and it wasn't until 10 weeks that they sent me to a specialist in clavicles/shoulders... even THEN, the specialist recommended waiting to see how it goes, so it was literally 4 months after the accident, that the specialist finally said 'ok, you'll definitely need surgery'.

I was also told by the doctors that there are "two schools of thought" when it comes to the decision, and that some doctors don't recommend it, and some do. All I can say is that in my situation it seems to be working very well, and I'm glad I can finally move/lift things etc without worrying about damaging my shoudler.

I'm now 5 weeks post-shoudler op (with bone graft), and have almost 100% range of movement in my shoulder, however I'm not bearing full weight on it yet. I think actualy building up the muscle will probably take a few weeks.

I hope this helps people. I would recommend getting a few opinions, and try and track down a specialist in the field if possible. I'm in Sydney, Australia and am happy to recommend mine if it will help anyone!

Good luck

PS. Here's a link that I found quite informative:
http://www.jpy.com/john/clavicle/

Hope this helps!

Hi, Thanks for the information. I did see 2 more specialists (1 referred me on to another). They did say I have a non-union and the can help me out by plating and bone graft. So, its been nine months now since it was broken. The specialist that I saw last mentioned that he would have plated it in the beginning because the break was near the shoulder end. So, I will be doing the surgery in a few weeks and am very excited to get my shoulder back to normal. It makes me realize how different doctor opinions can be in this area. I was glad to give the natural healing a go, but after learning that this type of break normally becomes a non union, I would have pushed more earlier on. I could tell it wasn't healing, but the general practice doctor kept telling me to wait longer.

I'm just glad that it can be fixed now. Thanks for the information. How was the surgery after? Long healing time or pain?

Thanks,
Ryan

 

[artmichalek]

Two years ago I broke off the outer end of my right clavicle, about two inches in. The fracture was completely displaced, and both of my doctors recomended against surgery. New bone had to grow into a gap of about an inch, and it did eventually heal. It was eight weeks before I was given clearance to ride a stationary trainer, and four more before I was allowed on the road. As a result of the break, my shoulder shifted about downward 3/4", and my shoulder blade sticks out a bit on that side. Since the accident, I find that if I'm standing up for any length of time, the muscles on that side of my neck and back get extremely sore.

 

[jon l]

I broke my calvicle in about the middle: the 2 ends were overlapping, and there were lots of fragments floating around as well. That shoulder was ~ 5cm shorter than the other, but the skin didn't break . The doctor didn't really give me the option of leaving it, just said it would be best to plate'n'screw it, so I did. I had surgery the next day, and was back on the bike, going slowly, in 3 weeks time. It does sometimes get a little sore if I lay with that arm in the air, but it's fine, and I'm glad it was done.

Don't know about you guy's, but from my experience, I'd get it done again.

Jon L

 

[Tromesa]

Hi, Thanks for the information. I did see 2 more specialists (1 referred me on to another). They did say I have a non-union and the can help me out by plating and bone graft. So, its been nine months now since it was broken. The specialist that I saw last mentioned that he would have plated it in the beginning because the break was near the shoulder end. So, I will be doing the surgery in a few weeks and am very excited to get my shoulder back to normal. It makes me realize how different doctor opinions can be in this area. I was glad to give the natural healing a go, but after learning that this type of break normally becomes a non union, I would have pushed more earlier on. I could tell it wasn't healing, but the general practice doctor kept telling me to wait longer.

I'm just glad that it can be fixed now. Thanks for the information. How was the surgery after? Long healing time or pain?

Thanks,
Ryan

Hey Ryan,

Glad to hear that you have a 'plan of action', and are moving forward. I for one am very glad I got the surgery done, and I'm sure you will be too. It's a little surprising that the GP you saw didn't recommend surgery in the first place (seeing as your break was closer to the end of the bone)... I totally agree with you - it makes you realise how different doctors opinions are. And it can be very frustrating, if this information about collar bones breaks is available on the internet, why the hell didnt he know!?!? But in my situation, I was also happy to give the natural healing a go, but didn't hesitate about the decision for surgery.

I'm now about 7-8 weeks post-op, and i have full range of movement in my shoulder, and no pain at all. I'm not bearing full weight yet (ie not lifting anything heavier than around 2.5 kg with the shoulder), but am starting to build up the muscle now. Im very happy with the results..

I have to warn you though, the hip graft is PAINFUL Don't be scared or anything, but just be aware that the hip graft will hurt more than the shoulder, so be prepared to sit/lay down for a few weeks after the operation, or if you walk, it will be very slowly! You'll probably want to avoid sneezing & coughing or even laughing too hard as well hehe... That lasted for about 5 weeks for me. But having been through it, I would definitely do it again, as the result is almost 100% recovery for the shoulder

Good luck!

Adam