broken clavicle...surgery or not?

[eshlegs2]

hi,
about six weeks ago while biking with some friends i hit the rear wheel of one of my buddies. wound up with a pnemothorax(air pocket outside the lung), a broken rib, and of course, a broken clavicle. initial visit to ER only showed the clavicle. after three days of being bedridden, i began to walk around. there was this sudden shortness of breath; went back to ER. new xrays showed the broken rib and pnemothorax. percotcet and anti-inflammatories to begin.
six weeks after i've got serious arm movement problems; can't lift arm above shoulder; sleeping on that side is impossible. doctor says arm is ok, but it sure still hurts. any thoughts on when mobility and pain-free conditions appear?

Hi all,


Thanks for the thread!! Three weeks ago I broke my Clavicle and 8 ribs in a BMX accident. Clavicle bad enough for the ortho to recommend surgery. I had to wait for 3 weeks due to a hemothorax (blood on my lung). By the way, the fall was far less impressive than the injury. Anyway, I am a 40 yr old healthy male and have been put on 2 Tyenol and 400mg Advil for every 5 hours or so, and was told to take 2 mg hydromorphone if the pain got too bad. I have instead been taking the tylenol and advil as prescribed but taking it with 10 mg of long lasting morphine in the morning and evening. It is 2 days after surgery and I would say that the pain level is about a 5 or 6 given that the day of the accident it was about a 9. It may be a stupid question, but is this level of pain normal and how long has it taken others for the immediate pain to subside. Right now I describe the pain as more throbing with the occasional sharp pinching pain. Any opinion is greatly appreciated. Upon my healing I will provide a full synopsis of my injury and recovery to hopefully help others with concerns over this injury and the surgery.

 

[jetnjeff]

How well is the bone healing and how old are you?

Did you get surgery or a figure 8 brace?

hi,
about six weeks ago while biking with some friends i hit the rear wheel of one of my buddies. wound up with a pnemothorax(air pocket outside the lung), a broken rib, and of course, a broken clavicle. initial visit to ER only showed the clavicle. after three days of being bedridden, i began to walk around. there was this sudden shortness of breath; went back to ER. new xrays showed the broken rib and pnemothorax. percotcet and anti-inflammatories to begin.
six weeks after i've got serious arm movement problems; can't lift arm above shoulder; sleeping on that side is impossible. doctor says arm is ok, but it sure still hurts. any thoughts on when mobility and pain-free conditions appear?

 

[VetMXR]

I'm getting fairly familiar with broken clavicles now, as I've broken my right clavicle 3 times and my right once. First break was on right side, simple break in the center of the bone, no surgury required, but it took about 5 months for the bone to finally fuse together. It was a painfully long time, but the doctor just kept telling me to wait and that it would eventually heal. It did.

Second break was on the left side, pretty much the same, but healing was much quicker. Again, simple break, in the middle, just like the first but on the opposite side.

Third break was back on the right side, but this time it broke up close to the neck/chest area. This caused major concern on the doctor's part, due to arteries/lungs in the vacinity, but again they put it in a sling and monitored it closely. Again, no surgery.

Just as this latest break was beginning to heal, I high-sided in a left hand sweeper and not only re-broke this last break, but broke the opposite end on the same side as well up by the shoulder socket. The bone is not only broken on both ends, but it is disjointed. They said that it wouldn't heal now without surgery, and they were right. It's been a full year now since the last break, and the break up by the chest/neck area is still not attached.

Oddly enough, there is no pain. I can work okay, but it looks like hell. No telling what the long term effect will be, so am considering heading back to the doctor to review the surgery option. I've ridden my mountain bike with no major problems, even made a trip out to Moab this year, but have not gotten back on my motocross bike since this last incident.

VetMXR
45+ Vet Expert Motocrosser
Michigan

 

[feetorfish]

i had my road bike accident 10-20-2007. I'm a podiatrist, and was able to make some calls to the trauma hospital in my area. My clavicle fx was missed on x ray but I knew I had broken it. I pleaded for a ct scan at the hospital I'm on staff at. I broke my shoulder blade and it extended into the glenoid(joint) but not displaced. My clavicle is broken, as are ribs 1 2 an 3. All the brakes are in good position, so the orthopod says no surgery unless my shoulder droops later on, which they may do when you have 2 fractures on either side of a joint. My point is get a man or lady who is trained in shoulders. The Ortho I went to was recommended as a shoulder expert. As a matter of fact he was working at a motocross event when my friend called him. But any of you can go online and read about a physicians training and interests. You want one that does shoulders as a preference not hip and knee replacements. I know its harder when you don't live near a city. Most Ortho groups now have experts for most parts of the body.

My Clavicle fracture is in good position so I'll probably not need surgery.

 

[Curb]

Has anyone recently broken or had surgery on their clavicle? I broke mine this sept 5 2007 and looking for someone who has gone through Physical Therapy to get their opinion.

 

[buggerit34]

First up, this forum is on the money. If your out there trawling for info on broken clavicle's as I was a month ago, this forum is a great resource to help you work out your own course of action.



Broke my right clavicle up high, approx 35-40 mm in from shoulder 22-Sep-07 flipped high-side off mountain bike after reaching for drink bottle on a straight stretch of dirt road, (hit a pot hole) damm. Would rather say I did it attempting a wild jump but no, got complacent. Anyway we learn!



I don't live in the city and while not putting any regional Dr's down, I tracked down and travelled to see a specialist shoulder surgeon. I think it's only common sense to see someone (be they in the country or city) who works more frequently with shoulders to really get detailed advice. My bone was sticking up approx 20 mm from its normal home and while it did not penetrate the skin, it wasn't far from it.



First local Dr said "leave it to heal naturally" and I'm a "let nature take its course" kind of guy, never had surgery during my last 34yrs and not keen to start now but.........after hearing stories from many friends and associates about their collar bone experiences, (good/bad and every one has a different story) and reading from others within this forum, I noted that those with a similar break to me (close to the shoulder) appear to have greater ongoing problems. I play lots of sports and have a good feel for when I may get a little out of whack after play which is rare, but I might over-stretch during a tennis serve and feeling it while swimming the next day or do something to my lower/upper back while surfing and feel it when playing golf. It can usually be fixed with just a little click during a stretch, or some yoga moves, perhaps get a massage/manipulation and I'm back in line.

I certainly didn't want to have unnecessary surgery OR an on-going ****ling issue that couldn't simply be put back in line, so I travelled to seek a second opinion. The difference with the second specialist is that he didn't advise either way, he wasn't keen to put me under the knife or brush me with a "wait and see how it goes". He simply gave me more information on the pro's and con's of both surgery and leaving as is. I had informed options and the Dr actually asked me which road I wanted to take. It was 11 days after the accident and calcification had just started, I felt the surgery option was best for me.


I got very lucky due to another patient cancellation and I had plates and screws inserted the next day. Needed some type of bone stimulant inserted in the gap between the break as I had lost some bone fragments. It’s now 3 weeks after surgery and I was advised to keep in sling for 4-6 weeks and so far I've been a good boy with just a little time out of the sling to keep the elbow loose. I don't move my shoulder much and I can feel that is still a little ginger, sometimes sore more towards outer shoulder muscle rather than at the break. I can only keep you posted.



All I can say is arm yourself with info, go with whatever option you feel comfortable with and if that’s surgery, then go with "who" you feel comfortable with. Do your own homework to see who has done theirs!

Has anyone recently broken or had surgery on their clavicle? I broke mine this sept 5 2007 and looking for someone who has gone through Physical Therapy to get their opinion.

 

[cptaylor]

Has anyone recently broken or had surgery on their clavicle? I broke mine this sept 5 2007 and looking for someone who has gone through Physical Therapy to get their opinion.

I broke mine more than a year and a half ago. It fused together all crooked and one bone laying on top of the other and I had a lump there that I was not satisfied living with the rest of my life. So I had surgery on Sept 5. The Dr re-broke it and pinned it together. I'm supposed to have the pin in for around 3 months then I should be free and clear.

No rehab or physical therapy at all. I have not even used a sling since I left the hospital 6 hours after surgery. Although I did take it real easy the first month. After about 1.5 months I have 100% full range of motion although I still am not picking up anything heavy or working out.

If you do choose surgery I think pinning it is 100x better than plate and screws.

First: The incision is a lot smaller so the scar will be less visible (mine is a little over an inch) and should heal up fine since I'm soaking it in Mederma 4x/day.
Second: Only about 3 months or so is all thats needed to keep the hardware in. In some cases it could be in for up to six months but that's rare. I think most people that go the plate & screw route have to keep it in for 18 to 21 months.

I hope I answered some of your questions. I too prowled the message boards looking for answers because I was not satisfied with my first Dr's "Let it heal naturally" train of thought so I know what you're going through.

 

[Curb]

Hi, just to be clear, I broke mine in 3 pieces and had the surgery with the plate and screws. The dr took out the small broken piece but put the tow bones close to gether with the plate and screw and told me that new bone will fill in the gap. it's a small gap about 3/4 of inch. not sure if this will fill in. and what about therapy, how was it doing therapy. was it painful?

I broke mine more than a year and a half ago. It fused together all crooked and one bone laying on top of the other and I had a lump there that I was not satisfied living with the rest of my life. So I had surgery on Sept 5. The Dr re-broke it and pinned it together. I'm supposed to have the pin in for around 3 months then I should be free and clear.

No rehab or physical therapy at all. I have not even used a sling since I left the hospital 6 hours after surgery. Although I did take it real easy the first month. After about 1.5 months I have 100% full range of motion although I still am not picking up anything heavy or working out.

If you do choose surgery I think pinning it is 100x better than plate and screws.

First: The incision is a lot smaller so the scar will be less visible (mine is a little over an inch) and should heal up fine since I'm soaking it in Mederma 4x/day.
Second: Only about 3 months or so is all thats needed to keep the hardware in. In some cases it could be in for up to six months but that's rare. I think most people that go the plate & screw route have to keep it in for 18 to 21 months.

I hope I answered some of your questions. I too prowled the message boards looking for answers because I was not satisfied with my first Dr's "Let it heal naturally" train of thought so I know what you're going through.

 

[Curb]

Boy, you like breaking that bone. Wait until they put that metal plate and screws in you. I got one and i dont like it..but it works. that may make you stop breakin them.

I'm getting fairly familiar with broken clavicles now, as I've broken my right clavicle 3 times and my right once. First break was on right side, simple break in the center of the bone, no surgury required, but it took about 5 months for the bone to finally fuse together. It was a painfully long time, but the doctor just kept telling me to wait and that it would eventually heal. It did.

Second break was on the left side, pretty much the same, but healing was much quicker. Again, simple break, in the middle, just like the first but on the opposite side.

Third break was back on the right side, but this time it broke up close to the neck/chest area. This caused major concern on the doctor's part, due to arteries/lungs in the vacinity, but again they put it in a sling and monitored it closely. Again, no surgery.

Just as this latest break was beginning to heal, I high-sided in a left hand sweeper and not only re-broke this last break, but broke the opposite end on the same side as well up by the shoulder socket. The bone is not only broken on both ends, but it is disjointed. They said that it wouldn't heal now without surgery, and they were right. It's been a full year now since the last break, and the break up by the chest/neck area is still not attached.

Oddly enough, there is no pain. I can work okay, but it looks like hell. No telling what the long term effect will be, so am considering heading back to the doctor to review the surgery option. I've ridden my mountain bike with no major problems, even made a trip out to Moab this year, but have not gotten back on my motocross bike since this last incident.

VetMXR
45+ Vet Expert Motocrosser
Michigan

 

[logicdevice]

Hi,

I broke my right clavical in a bike accidant near from shoulder joint and the broken bone lifted up ( over laped ) . It was really painfull for first week slightly using my hand and its working good but i cant lift any kind a weight or cant move frequently my hand . Shown 3 surgeons and they all said let it heal in its own. its about 3rd week my shoulder lifted up bit and it looks bit smaller thn the left shoulder , i wish to have it into its original position as i loves to swimm and i m fast right arm bowler too. If i let it on its natural proccess , i m sure i cant bowl or swim ever . i m 29 yrs old. any suggussions.

 

[Curb]

Hello Logic, broke mine this sept 5 2007 in 3 pieces.

Now in my 6 weeks of recovery with aggressive PT.

I'm a cyclist and a dept manager so it's imperative for me to get back ASAP.



I got the surgery. Plate and 6 screws. I was back to work in 4 days after the surgery wearing the sling. Dr told me to loose the sling this past wed 10-24-07.



Heres my advice, if it broken in half as most of them are, if you can bear with it let it heal itself.

If it broken in multiple pieces, get the pin and screws.

Forget all that nonse you hear where people who have multiple beaks of the bone said they let heal on it's own.



I got the surgery 9/11/07 at 1:30 in the afternoon and was home at 6pm that same day. The surgery scar is extremely thin.



i am now lifting light weight and doing stand up pushups and is riding my bike trainer with the injured lightly holding the handlebar. But I am going to take it easy and go at my own pace. I got all winter to recover properly.



Currently, my shoulder in tender to the touch a little but bearable.



I am only giving you high level information. if you need more detail ask the questions and I will try and answer.
Hopes this helps.
Regards.


I broke my right clavical in a bike accidant near from shoulder joint and the broken bone lifted up ( over laped ) . It was really painfull for first week slightly using my hand and its working good but i cant lift any kind a weight or cant move frequently my hand . Shown 3 surgeons and they all said let it heal in its own. its about 3rd week my shoulder lifted up bit and it looks bit smaller thn the left shoulder , i wish to have it into its original position as i loves to swimm and i m fast right arm bowler too. If i let it on its natural proccess , i m sure i cant bowl or swim ever . i m 29 yrs old. any suggussions.[/QUOTE]

 

[Curb]

Same here. it's normal. dont worry.

Hi all,

Day 8 after surgery and the pain seems to be increasing. I have been working, though mostly with my arm in a sling to prevent being bumped. Has anyone had the pain increase over time? I saw my surgeon today and he said everything looks ok though he didn't seem to care much or show an interest to my concerns or give any real advice. The sight of the incision is very tender to the touch and every once in a while a get a very sharp shooting pain in my shoulder.

ANYONE!?!?!?!?!

thanks

Simon

 

[logicdevice]

Thnx for the opnion CRUB i m using my hand very frequently with lil bit pain after second week , i m just willing to get back my clavical as it was . I do not wants my shape out. Rest of the surgeon I have shown my clavical , they all said let it heal its own way. If it heal its own , my shape would be out. I m just worried about the shape.

 

[alienator]

Thnx for the opnion CRUB i m using my hand very frequently with lil bit pain after second week , i m just willing to get back my clavical as it was . I do not wants my shape out. Rest of the surgeon I have shown my clavical , they all said let it heal its own way. If it heal its own , my shape would be out. I m just worried about the shape.

It's pointless to ask for advice here. Your doctor(s) are the ones that know. Just because one guy had success with surgical repair, does not mean the next guy will. Your shape is actually a secondary concern. What should be foremost in your mind is the proper healing of your collarbone, because the one thing that is just about guaranteed is that if it heals wrong, getting it repaired later is more difficult and painful.

In the grand scheme of things, a few weeks matter so very little.

 

[feetorfish]

its very helpful to ask for advice here, although as in any important decision your due diligence is the the most important thing. I am a physician, and I have no problem with patients asking others advice. You must consider the source and take advice from as many places as you can. I think some of the most important questions to ask are how much faster will I heal? With what option will my function be better and how much better. I don't want surgery to improve my non dominant wing by 5%. All of you know their are not many surgeries out there that don't have the possibility to make things worse. Hearing real life experiances here is very helpful to people as a part of making their own decisions. If there was one right decision all would have the same procedure to fix it. Some people will choose to have surgery just because of the bump. Again its a personal decision, just like surgeries that are completly cosmetic in nature.

I am 8 days post clavicle.scapula and ribs fracture,(road bike) and don't need surgery. I have a small bump, but can live with it and will choose to.

 

[Curb]

Hi feet or fish, it's great you as a doctor is in this forum offering advice to us. We appreciate it.

The reason we are here is because our doctors, during our appointments, rush us in and out of their office. They don want to hear anything. They just come and say, it looks ok come see me in 2 months. When you ask an important question, they only give you small bits of information and sometimes it's wrong. So what do we have to do, we have go around asking other doctors their opinion. It really sucks.

There are great doctors out there, you just have to shop around but the insurance companies hold you back.



When I broke my clavicle in 3 pieces, the surgeon remove the small broken piece. He said it was to jagged to put back. He was able to plate and pin the clavicle bones close together where the tips is touching each other. The doctor said that the space in between will fill in with bone…WHEN!!!! I ask him. It will he said.

Don’t know if he is correct or not. Now I have to wonder should I go on a diet of calcium and vitamin D. Not knowing is not a good thing. I only wish my doctor was more talkative

its very helpful to ask for advice here, although as in any important decision your due diligence is the the most important thing. I am a physician, and I have no problem with patients asking others advice. You must consider the source and take advice from as many places as you can. I think some of the most important questions to ask are how much faster will I heal? With what option will my function be better and how much better. I don't want surgery to improve my non dominant wing by 5%. All of you know their are not many surgeries out there that don't have the possibility to make things worse. Hearing real life experiances here is very helpful to people as a part of making their own decisions. If there was one right decision all would have the same procedure to fix it. Some people will choose to have surgery just because of the bump. Again its a personal decision, just like surgeries that are completly cosmetic in nature.

I am 8 days post clavicle.scapula and ribs fracture,(road bike) and don't need surgery. I have a small bump, but can live with it and will choose to.

 

[Garden Girl]

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

Hi I was wondering how things are going with the bone stimulator. My break occurred back in March and I'm functioning just fine despite the fact the bone has not healed yet. Since it hasn't joined yet but my body is still trying to repair it the doc has suggested a bone simulator. Even though initionally he had recommended surgery and I decided against it. He now agrees that surgery is not necessary due to my ability to have complete range of motion, strength and nearly no pain, even though it has not joined. I'd appriciate any comments on the stimulator.

 

[alienator]

Hi I was wondering how things are going with the bone stimulator. My break occurred back in March and I'm functioning just fine despite the fact the bone has not healed yet. Since it hasn't joined yet but my body is still trying to repair it the doc has suggested a bone simulator. Even though initionally he had recommended surgery and I decided against it. He now agrees that surgery is not necessary due to my ability to have complete range of motion, strength and nearly no pain, even though it has not joined. I'd appriciate any comments on the stimulator.

I'd like to hear more about external ultrasound bone stim. When I needed bone stim, ultrasound was new on the scene. My PT called the Left Coast, Right Coast, and everywhere in between and couldn't get any definite data or parameters for tx.

I did use:

1. Fosamax--effect unknown or very little
2. External magnetic bone growth stim--effect unknown or very little
3. Surgically implanted electric bone growth stim--worked pretty well

 

[feetorfish]

Curb good luck with your injury. All the folks on this board are active and are anxious to get back to their activities. The doctors are more rushed these days. HMOs have reduced reimbursments and the docs are naturally trying to see more patients.Its best to have your questions prepared in your head and ask them in order of importance. He or she may be 1.5 hours behind, you never know how many questions you are going to get in. The good thing about clavicles is if he got them straight and close there is a very good chance it will heal. Clavicles just have a lower rate of non unions then other bones. Calcium and a little Vit D can't hurt. Its cheap insurance. Just don't overdo the D(fat soluble). I'm a big believer in 2nd opinions, but they are harder to get with insurance companies now. Your best bet is to go online. Find out where the ortho did a fellowship(ie the foot and ankle institute or the shoulder institute of Emory) Make friends with the lady in your primary care group who handles referals and get good referals. Again good luck.

Hi feet or fish, it's great you as a doctor is in this forum offering advice to us. We appreciate it.

The reason we are here is because our doctors, during our appointments, rush us in and out of their office. They don want to hear anything. They just come and say, it looks ok come see me in 2 months. When you ask an important question, they only give you small bits of information and sometimes it's wrong. So what do we have to do, we have go around asking other doctors their opinion. It really sucks.

There are great doctors out there, you just have to shop around but the insurance companies hold you back.



When I broke my clavicle in 3 pieces, the surgeon remove the small broken piece. He said it was to jagged to put back. He was able to plate and pin the clavicle bones close together where the tips is touching each other. The doctor said that the space in between will fill in with bone…WHEN!!!! I ask him. It will he said.

Don’t know if he is correct or not. Now I have to wonder should I go on a diet of calcium and vitamin D. Not knowing is not a good thing. I only wish my doctor was more talkative

 

[feetorfish]

I don't know what the rules are for bone growth stimulators are for clavicles. In the foot or ankle we generally use them when there is no visible signs of healing after 6-8 weeks depending on the insurance company. I think some may even require 12 weeks. In the foot it has to be a long bone(ie not the heel), so I guess the clavicle would be a fine candidate. Its proven therapy all the way back when we had to implant the wire under the skin. Now its just wrap the machine around the injured part. Insurance is always the tricky part. They are pricey.

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

Hi I was wondering how things are going with the bone stimulator. My break occurred back in March and I'm functioning just fine despite the fact the bone has not healed yet. Since it hasn't joined yet but my body is still trying to repair it the doc has suggested a bone simulator. Even though initionally he had recommended surgery and I decided against it. He now agrees that surgery is not necessary due to my ability to have complete range of motion, strength and nearly no pain, even though it has not joined. I'd appriciate any comments on the stimulator.