So I just discovered this forum while doing a search about clavicle surgery.
I just couldn't resist the temptation to post since I probably have had more experience with clavicle surgery related to cycling injury than anyone here. I have had surgery for my clavicle THREE TIMES. If you are contemplating this procedure, you owe it to yourself to read this. Here’s my story…
On November 15, 2002, I ate **** over the bars while doing a series of jumps in the Santa Monica Mountains known as the Kenter Whoops, or Kenter Whoop De Doos. I was better than that mistake, but mistakes do happen and I hesitated off the lip of a fairly large jump. Came up short and went over the bars. I new something was wrong instantly. I drove myself home after some other guys helped me load my Enduro onto the top of my car. Once at home, I sat around the house in an extraordinary amount of pain for about an hour before I realized that I may actually have a significant injury that required medical attention.
X-rays at Cedars Sinai Hospital revealed a displaced fracture of the clavicle – I actually broke it in 2 places so it was in three pieces! Surgery was “necessary” - Vicodin was prescribed.
Two weeks later – the day before Thanksgiving, at UCLA Medical, I had the surgery which involved the implantation of a steel plate across the top of the bone to hold the primary fracture together. Secondarily, a rubber band was put in to hold the bone down and in place because the second break was on the bottom of the bone. This would ensure the bone would all fuse back together again.
I was told to wear a sling for 8 or more weeks, and follow up appointments were scheduled. About ten weeks later I started riding again – without the permission of my doctor.
On my fifth ride out, I was riding in Griffith Park, Los Angeles. I live near there and although it's illegal to ride a bike on the dirt there, I do it frequently.
So I am up at the top of the hill and I see this Japanese tourist. Then I see this flight of stairs made out of rail road ties right next to the Japanese guy. I had launched these stairs, and cleanly stuck the landing, SEVERAL times. Right next to the stairs is a little path that allows me to just ride around them.
I looked at the stairs...
I looked at the path...
I looked at the unassuming Japanese tourist and just couldn't resist the temptation to have a little fun and show off.
I did a point and shoot off the top of the steps and came up just a little short – which had happened before and I’d recovered. This time I must have feathered the front brake a little because the rear wheel kicked up off the bottom step and over I went. Low speed over the bars crash.
Now, this was not a very severe crash. I stood right up and wasn't cut or scraped or anything. I started to brush myself off when I noticed a sharp pain coming from my right shoulder. F@ck! I thought. I think I just re-broke the damn collarbone!
SO I got on the bike and rode angrily home.
In an unbelievable twist of sick irony, when I got home I had a message on my machine from my surgeon. His office had called to remind me of my follow up visit -THE VERY NEXT DAY!!! What are the odds of that!?
That night I realized that when I pushed on the inside of my collarbone I could now feel something inside grind and pop and shift. I was convinced I had re-fractured the bone.
So I went in the following morning to see the doctor and was forced, naturally, to tell him what happened. He was fairly displeased to say the least. We did some x-rays and they showed no sign of fracture... that was odd, I thought, because I could FEEL the damn bone moving around in there.
But you can't argue with the x-rays, I thought.
I told him I had some pain and was granted a virtually unlimited supply of Vicodin - to which I became completely dependant on over the following months. The doctor decided that, since there was no visible fracture in the x-rays, it must be the implant itself that was moving around and causing me pain. A second surgery would be necessary in order to remove the hardware and end my suffering. But we had to wait a few more months because the bone needed a little more time to heal up – according to him. I now suspect that he just wanted to see if it would stop bothering me on its own.
Three months later - now DEEP into a steady pattern of Vicodin abuse - I went under the knife again.
When I woke up the doctor was called in to see me.
He explained that although we couldn't see the fracture in the x-rays, I had been walking around with a broken clavicle for three months. Apparently, the bone had broken in a different position. What this doctor had failed to tell me was the following:
Steel implants used to mend broken bone can actually CAUSE fractures. You see, the collarbone has some natural flexibility. When you screw a rigid piece of steel to it, it no longer does and the normal capability of the bone to absorb shock by flexion is eliminated. SO what happens? The bone actually snaps at the end of the steel plate! I was, needless to say, extremely ******!
He had just done a second fairly extensive implantation of yet another piece of hardware. YIPPEEE!! That meant that not only had I been misdiagnosed and walked around with a fracture for 3 freaking' months! I also now had another implant on my collarbone which could cause another fracture in the future!!! PLUS, I was being told I still couldn't ride a damn mountain bike for at least another 3 months, and I should maybe even resign myself to giving up the only sport I have ever truly loved!!! I wanted to kill a couple of radiologists just to watch ‘em die!!!!
So, what have we learned from this?
First off, surgical implants for displaced clavicle fractures will mend the bone, but they also provide you with a permanent weak link because of the steel plate. The collarbone is ALREADY a weak link in the human body. A shank of metal bolted to it just makes it that much weaker. The steel, and I know I am repeating myself here, can actually CAUSE FRACTURES during falls that would normally not be significant enough to break bone.
Additionally, if and when you do break the bone again due to the implant, it will DEFINITELY require surgery. This is because the bone will be broken and in there with it will be all that metal junk moving around and preventing it from EVER healing. As I experienced first hand.
SO…
I told you earlier that I had had 3 surgeries on the collarbone.
Well, I just had all the steel **** taken out four days ago. This was a completely voluntary procedure. I did this because of what I know about those implants. My new doctor tells me that once healed – it will take about 6 weeks for the screw holes in the bone to fill back in – I will be as good as I was before I ever injured the collarbone in the first place.
Yes, I could still break the bone. But it would be just like any other collarbone fracture. 90% of which do NOT require surgery.
My best advice? If your doctor thinks you may heal without surgery… let it heal naturally.
Having that metal in there forced me to hold back in my riding, snowboarding, and dirt biking for the last 3 years out of fear of hitting the ground on my right side. I knew that on any ride, all it would take was a minor crash on my right arm, an outstretched hand, or my right shoulder and I would be in hell all over again. If I had it to do again, I probably would have lived with the displaced fracture. I have since met a few guys – mostly dirt bikers – who have had bad collarbone breaks and never bothered with the surgery. They definitely have some mild deformation of the shoulder, but they move around okay.
If you do have a surgery done, just realize that you will have a weak link until you have the hardware removed. This second surgery can also be an insurance obstacle. I basically claimed the implant was causing me a lot of pain in order to get the thing covered by my insurance. They wouldn’t do the procedure just because of my lifestyle and the risk associated with leaving the implant in.
I know this was a long post, but I have never before told this whole story anywhere and figured what the hell. If it helps just one of you guys in you decision making about shoulder surgery I will be pleased.
And remember the golden rule:
“If it ain’t broke, fix it till it is!”
, the skin under my incision is numb and I am having some discomfort because I can feel the screws rubbing on the inside my skin. It kind of feels like ants crawling inside my skin.
