broken clavicle...surgery or not?

[seattlecyclist]

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

There's no easy correct answer for everyone. The treatment is tailored to the individual. Risks of surgery are infection and non union, but also injury to the lovely things that are near your clavicle (subclavian artery and vein - those really do bleed like stink) and lungs (specifically collapsing one). There are actually reports of death due to migration of pins (at some time after surgery I might add) to the aorta. Strange but true.

For athletes, paratroopers, and a variety of others whose livelihood depends on getting back to the activities that caused the break, surgery, by someone skilled in it, is my recommendation. I would have it myself. Just realize the risks can be substantial, even in teh best of hands.

Ask your surgeon about an "intermedullary screw"

My 2 cents.

 

[byfred]

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!

I broke mine May 29th, 2003. My doctor told me "that as long as both ends are in the same room, they will eventually get back together" He put that "figure #8" strap on me, sent me home, with instructions to return in 3 weeks to begin therapy. I put in 2 or 3 really painful nights in bed, and it was all uphill from there. When I returned for "therapy", I already had full movement, and he sent me home again, with instructions "not to move any pianos". I was back on my bicycle that day, three weeks from my fall and did a 3000 mile Bike Tour that summer. I haven't had a bit of trouble with it at all, and I'm 66 years old.
During that first 3 weeks, I found that it was VERY painful to use a fly-swatter........something to do with "quick movements", I would imagine.
Just take things a little easy and I'm sure you will be just fine.

 

[RyanG3]

Hi Adam,
Did have the surgery and I am still pretty sore. It has been about 2 weeks. I can definitely feel the support for my shoulder already though. The doctor said he almost did a hip graft but was able to save enough bone from the collar bone cleanup to re-use He did have to cut a lot of muscle away and re-sew under the bone that I grew over the collar bone. Did you have considerable pain during the recovery? I still can't do a whole lot without sharp pains in my shoulder. I'm told not to lift more than 2.5kg for the next 4 more weeks and see how it is then. So far, just the support in my arm seems to be worth the effort. It doesn't feel like it is "hanging" there anymore.

Yes, it would be good to give doctors internet training (for those who have none) to keep up with the latest. It has greatly helped my awareness.

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

 

[vickieflores]

I'm not really a cyclist, but broke my collar bone in July 2003 falling off a horse and think that whilst surgery may be the answer you do need to be aware of the risks/complications involved.
Initially I went along the route of wait and see and when things hadn't improved and there was no sign of union after 2 months I had surgery to pin/plate my clavicle.
Initially this seemed successful - the pain vanished overnight and I was back at work within a week. A couple of weeks after that I experienced a numbness in my middle and ring fingers and over the next 2 weeks this numbness spread up my arm towards my elbow to the point where i'd lost all feeling in 2 fingers and half my arm. To cut a long story short, the plate and pins were removed 4 weeks later and x-rays showed that there had been some union. The feeling returned to my fingers and arm and MRI scans have shown there to be no permanent nerve damage.
Unfortunately over the next few months I began experiencing increased pain in my neck and the original fracture site which revealed that there is no union. After many scans I had my clavicle pinned/plated and bone grafted again a week ago. ...so far so good!
Whilst I definitely agree that in some cases surgery is the best option, please be aware that there are risks and that I was lucky that the nerve damage wasn't permanent - even so I'm still here with a broken collar bone almost a year and a half after the original accident, so it isn't always the quickest way either!
From what I've read though, it seems to be doctors who favour the "wait and see" approach, whilst patients generally report that they are very glad that they went ahead with the surgery (i.e. I was one of the very few unlucky ones). On balance I'd probably still say "go for it" but just be aware that there are risks.

I'd be very interested if anyone has any advice on what I should / should not do to give it the best chance of union this time round, as I've looked on the Internet but not really found anything particularly helpful from a patient perspective.

 

[byfred]

I'm not really a cyclist, but broke my collar bone in July 2003 falling off a horse and think that whilst surgery may be the answer you do need to be aware of the risks/complications involved.
Initially I went along the route of wait and see and when things hadn't improved and there was no sign of union after 2 months I had surgery to pin/plate my clavicle.
Initially this seemed successful - the pain vanished overnight and I was back at work within a week. A couple of weeks after that I experienced a numbness in my middle and ring fingers and over the next 2 weeks this numbness spread up my arm towards my elbow to the point where i'd lost all feeling in 2 fingers and half my arm. To cut a long story short, the plate and pins were removed 4 weeks later and x-rays showed that there had been some union. The feeling returned to my fingers and arm and MRI scans have shown there to be no permanent nerve damage.
Unfortunately over the next few months I began experiencing increased pain in my neck and the original fracture site which revealed that there is no union. After many scans I had my clavicle pinned/plated and bone grafted again a week ago. ...so far so good!
Whilst I definitely agree that in some cases surgery is the best option, please be aware that there are risks and that I was lucky that the nerve damage wasn't permanent - even so I'm still here with a broken collar bone almost a year and a half after the original accident, so it isn't always the quickest way either!
From what I've read though, it seems to be doctors who favour the "wait and see" approach, whilst patients generally report that they are very glad that they went ahead with the surgery (i.e. I was one of the very few unlucky ones). On balance I'd probably still say "go for it" but just be aware that there are risks.

I'd be very interested if anyone has any advice on what I should / should not do to give it the best chance of union this time round, as I've looked on the Internet but not really found anything particularly helpful from a patient perspective.

When I hear the stories some of you have experienced, I wonder if it really was the "clavical" that I broke. It really hasn't given me any problem at all. In fact, I can almost believe that Tyler Hamilton was able to ride the Tour de France with his broken. I could NEVER have done that in a 1000 years.

 

[pcoopes]

Hi Guys

I've just been told today that I will need surgery on my broken collar bone. It was snapped in half when I was hit by a motorcyclist six months ago (I was a pedestrian).

Just wondered how you guys have found everything since. How much healing time was involved after the surgery?

I'm debating whether to have the surgery here in London or to wait until I get home to Perth so I am trying to find out more about the after surgery recovery.

Look forward to hearing from you or anyone else!

Thanks
Peta

 

[Steve P]

I don't understand how some of your guys were able to do a "swm marathon" and just go on about using that arm. When I broke my collar bone I couldn't even move that arm. I pretty much just sat on a couch for about two weeks wearing that weird figure eight contraption they put on you. I seriously could not move my arm though because it hurt so bad. The doctors never even mentioned surgery to me my bone just healed on it's own. It only took about a month to heal up and I could actually do stuff again. It's just blowing my mind that some of you are tlaking about still being able to do stuff with it broken because I couldn't move it hurt so bad.

P.S. I broke mine on a road bike during a really fast descent...I hit a pot hole in the road that I didn't see.

 

[byfred]

I don't understand how some of your guys were able to do a "swm marathon" and just go on about using that arm. When I broke my collar bone I couldn't even move that arm. I pretty much just sat on a couch for about two weeks wearing that weird figure eight contraption they put on you. I seriously could not move my arm though because it hurt so bad. The doctors never even mentioned surgery to me my bone just healed on it's own. It only took about a month to heal up and I could actually do stuff again. It's just blowing my mind that some of you are tlaking about still being able to do stuff with it broken because I couldn't move it hurt so bad.

P.S. I broke mine on a road bike during a really fast descent...I hit a pot hole in the road that I didn't see.

Mine only hurt for the first three weeks.........the most painful thing was to use a fly-swatter. I never even thought of surgery and my doctor never mentioned it either. It's been all up hill since then and I have full movement and no pain, just a lump on the site of the fracture.

byfred

 

[pcoopes]

Mine didn't hurt too badly after the first few weeks, its more just restrictive in that I can't seem to lift heavy objects or sleep on my side etc.

The bones are still separated after six months and the Doctors think there may be a muscle in the way preventing them from rejoining and healing. This is why some cases do require surgery and some don't.

Hey - you guys who have had surgery - can I ask what the scarring is like??

Thanks!
Peta

 

[mpcar1]

Hey,

I was wandering if anyone could help me...

20 months ago I broke my clavicle from a direct fall onto the point of my shoulder resulting in the fracture to be fragmented, near the AC joint aproximately 3 cm towards the middle.

Subsequently, the bone has now fused in a Z like fashion. An the bone is aproximately 1 cm short.

Symptoms I now suffer are a shrunken shoulder, scapula (shoulder blade) being out of alignment and constant muscle pain surrounding due to the shoulder 're-aligning'. However I appear to have reasonable strength and movement of the shoulder.

I am seriously considering surgery to straighten and lengthen the bone, as personal training, remedial massage and heat packs are providing little comfort.

Is there anyone out there with or who has had similar issues?

Marcus

 

[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]

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)

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. http://www.smileycentral.com/?partner=ZSzeb001_ZNxdm006YYUS

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)

 

[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.

 

[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

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

 

[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

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