broken clavicle...surgery or not?

[alienator]

Mine was pretty similar, except my clavicle was in more pieces. As a result of other injuries sustained at the time, I could not have surgery. I have a noticeable bump, today, but the final alignment is frankly amazing compared to the alignment immediately post injury. That's just my story, though. What you need to do is see an orthopod.

I know exactly how it can be to have such an injury and be short of insurance and cash (I'm not sure why anyone expects health care reform that excludes a govt option in favor of letting the private insurers do the business to work. It's not like the private insurers have done anything in the last 50 years. Screw them.). What was the cause of the accident? If a car caused the accident, and a police report was generated, you'll eventually get money in settlement to pay back medical debt. If this happened in a sanctioned racing event, you should check with your licensing organization to see what insurance they have for racers (I've used such insurance before.). If it was just you making a riding error.....well, the most important thing is that your shoulder is treated correctly. The money issue is one that should be discussed with your doctor.

Good luck.

 

[bridsmath]

I hate to be a bearer of bad news, but from my experience with this fracture I would say that you definitely require surgery to properly align the bone. If your fracture looks identical to the x-ray you linked then you have lots of displacement and the chance of a non-union (bone ends not properly aligning) is very high.
Don't sweat too much and just make the right decision. The pain-free use of your arm and shoulder is more important than staying out of debt. Just my .02 though. Best of luck, bud!

 

[kosugesan]

Thanks! i went to the orthro yesterday and he said that there's a 20% chance i should get surgery, but he wants to wait and see how the bone grows back with a figure 8 brace on. he said it should push the bones closer together and hopes a union will occur. This this is insanely uncomfortable but if it'll do the trick I'll gladly wear it for a month.

 

[alienator]

Thanks! i went to the orthro yesterday and he said that there's a 20% chance i should get surgery, but he wants to wait and see how the bone grows back with a figure 8 brace on. he said it should push the bones closer together and hopes a union will occur. This this is insanely uncomfortable but if it'll do the trick I'll gladly wear it for a month.

Good stuff. The fracture must have approximated well after the brace was put on.

 

[kosugesan]

I feel like I can't really move my arm that much. How long before most people were able to move their arms again? Also, is there any way to tell whether the bones are healing nicely without having to do an xray every week? I am scheduling an appt with the orhtro again for the end of this week or perhaps early next week. Will this be enough time to show any progress of the bones healing or not healing? I hope that the brace has pushed my bones closer together for a union to occur. I do apologize for all the questions. Thank you in advance.

 

[bridsmath]

So it's been about 3 months since I broke my clavicle and I'm still having quite a bit of pain and discomfort. I posted an x Ray a few pages back. Do you think I need surgery? I think that by now I should be able to do everyday things without pain, but even wearing a seatbelt is pretty painful.

 

[Mcski]

I broke my left clavicle on September 5th, 2009 in a road bike crash. It was a relatively severe brake, in three pieces and, like CraigB’s posting, shaped like a “Z”. I want to thank all the contributors to this forum for posting their experiences which all helped me make my decision regarding surgery (B1, thanks for the summary). I want to share with all of you an article my doctor provided me from the Journal of Bone & Joint Surgery (jbjs.org), written by L.A. Kashif Kahn and three other docs. The study is titled Current Concepts Review Fractures of the Clavicle, published in 2009, and provides recent information on many types of broken collarbones and provides some guidance on odds for a successful recovery depending on the type of collarbone brake. It also discusses the risks and positive/negative results from surgery.

Upon looking at the X-ray posted by Kosugesan, an Edinburgh table (from the JBJS article) classification would be “displaced”. If you have time, take a look at the article and then you can have a good discussion with your doctor.

My brake was more severe and I’m much older than Kosugesan at 49- age is a big factor in bone healing. I love to ski fast, and with the ski season approaching, I chose to do the surgery and was operated on September 14th. I now have a metal plate and 7 screws in my collarbone. My doctor was very experienced with this procedure (he teaches Orthopedic Surgery at the University of Vermont) and has authored many studies in his field. One of the findings during my surgery were numerous bone fragments floating around- I believe 5 to 10 small bone fragments were removed- this was not evident from the x-rays.

Approximately 12 days later, I’m healing quickly. I’m back on a stationary bike and in the gym lifting weights where possible. Most importantly, I’m back to work. I have been very impressed by the speed with which I’m able to get back to life, so to speak. I no longer need the sling and can lift my left arm all the way over my head and fully extend it out to the side and up without assistance (but I feel it, lots of physical therapy work yet to do here).

The downsides were clearly explained by my doctor- I have a small area below the incision where the nerves are dead (this may get better, but no guarantees); there will be a 4 or 5 inch scar across the top my left pectoral, and there is a 4 or 5 inch narrow & thin plate under my skin. I’ll update my post in about a month when they take the tape off and I’ll have a better idea of what this will all look like. Innovative operating techniques are enabling inside-out sewing (can’t see any stitches), super glue, and taping, which work together to reduce the visibility & size of the scar. At this point, I can’t see the metal plate under my skin- other than the incision, it all looks normal.

I hope this helps. Good luck to all of you.

 

[baker3]

I hope this helps. Good luck to all of you.

It helps heaps thank you

 

[bridsmath]

Hi again everyone,

I thought I'd give an update on what is going on with me. It has been about 5 months since I broke my collar bone and decided not to have a plate installed due to no displacement and a mid fracture. I am now working out 4 to 5 days a week with no pain or discomfort. The only issues that I am having are a tiny click in my left shoulder which could have been there before the accident for all I know and the anatomical condition of my collar bone. Although it has managed to find it's way around my body very well it is still fairly sharp at a point. I saw my ortho a couple of days ago and further discussed with him a minimally invasive procedure to "burr" the fracture site of my collar bone. He said in his opinion it is a very reasonable request and that I should experience a lot less discomfort with backpacks, guitar straps etc.

I'm going to be going through with this operation in the next 3 to 6 months when I will know for sure that the bone has completed healing (it probably already has, but just being safe).

I am so glad that I did not have an implant installed, which is what I was practically begging for initially. I am going to end up with a very small scar and a fully bonded clavicle.

If anyone ever finds themself in the same situation as me where you are uncomfortable with the shape of your clavicle after a fracture, I would recommend talking to your surgeon (preferably a shoulder specialist) about recontouring it.

 

[gfrodel]

Pease help! Im 20 years old and just broke my clavicle into 4 peices snowboarding last week. I went to a highly recommended orthopedic surgeon and he says i lie right in the middle if i should get surgury or not. I included a link to my xray and hopefully someone has had a similar looking xray and knows what i should do. I did manage to make it worse from the time of this xray. the left side is now displaced about 150%. just to note, you can see the realtion with the measuring unit in centimeters in the middle. I'm not in pain and onlt take tylenol when i go to bed. I decided to schedule surgury for next wednesday but am having deep second thoughts about complications and a nice scar if its unneeded. someone give me some help before next week please!

clavicl picture by flipsk8er231 - Photobucket

 

[gplama]

I decided to schedule surgury for next wednesday but am having deep second thoughts about complications and a nice scar if its unneeded. someone give me some help before next week please!

My right clavicle was operated on about two years ago (search back in this thread for pics etc), pin right through the middle after snapping it in half - not a single issue with surgery, recovery, or to this day. When I did my left one I wanted that operated on too, but it wasn't required.

 

[Mcski]

Pease help! Im 20 years old and just broke my clavicle into 4 peices snowboarding last week. I went to a highly recommended orthopedic surgeon and he says i lie right in the middle if i should get surgury or not. I included a link to my xray and hopefully someone has had a similar looking xray and knows what i should do. I did manage to make it worse from the time of this xray. the left side is now displaced about 150%. just to note, you can see the realtion with the measuring unit in centimeters in the middle. I'm not in pain and onlt take tylenol when i go to bed. I decided to schedule surgury for next wednesday but am having deep second thoughts about complications and a nice scar if its unneeded. someone give me some help before next week please!

clavicl picture by flipsk8er231 - Photobucket

Welcome to the forum, Gfodel. I feel your pain and wish you the best. It has been three months since my surgery, and the tape has been removed. The scar is noticeable. Of course, the length of the scar depends on the type of surgery. If I was 20 years old, with many days of visiting the beach ahead of me, I'd prefer not to have a 4-5 inch scar across the top of my upper chest. My break was significantly more displaced than yours, and I'm 49, so a plate was a good choice. At 20, your body's ability to heal is remarkable vs. 49. If you have the time, let the forum know what you choose to do. Bridsmath decided not to have surgery and healed well and is young (22 yrs) like yourself. Good luck.

 

[alienator]

Pease help! Im 20 years old and just broke my clavicle into 4 peices snowboarding last week. I went to a highly recommended orthopedic surgeon and he says i lie right in the middle if i should get surgury or not. I included a link to my xray and hopefully someone has had a similar looking xray and knows what i should do. I did manage to make it worse from the time of this xray. the left side is now displaced about 150%. just to note, you can see the realtion with the measuring unit in centimeters in the middle. I'm not in pain and onlt take tylenol when i go to bed. I decided to schedule surgury for next wednesday but am having deep second thoughts about complications and a nice scar if its unneeded. someone give me some help before next week please!

clavicl picture by flipsk8er231 - Photobucket

In internet forum is the worst place to seek medical advice. A second opinion from another doctor would have been better. Frankly, I think having surgery for cosmetic purposes is stupid and vain, especially when weighed against risks of surgery and possible adverse outcomes, but I'm not a doctor.

 

[Mcski]

In internet forum is the worst place to seek medical advice. A second opinion from another doctor would have been better. Frankly, I think having surgery for cosmetic purposes is stupid and vain, especially when weighed against risks of surgery and possible adverse outcomes, but I'm not a doctor.

I agree with alienator- the internet provides information- some good, some not so good. Medical advice is best left in the hands of an excellent doctor. Seek out a second opinion.

 

[bridsmath]

In internet forum is the worst place to seek medical advice. A second opinion from another doctor would have been better. Frankly, I think having surgery for cosmetic purposes is stupid and vain, especially when weighed against risks of surgery and possible adverse outcomes, but I'm not a doctor.

You make me seem like a bad guy! Haha, just kidding. I'd say the reason I'm having my operation done is mostly for anatomical reasons. I wish I could show you how much the bone points up. It's sooo uncomfortable...

 

[bikingfamily]

Help! My teen daughter broke her clavicle about 4 weeks ago and it has started to grow back together but is overlaping. Her orthoped. thinks it looks ok but we are worried that being slightly offset is going to interfere with her symetry and balance. She cycles competively and has the potential for professional advancement. Has anyone had the same experience that can offer some insight.

 

[alienator]

Help! My teen daughter broke her clavicle about 4 weeks ago and it has started to grow back together but is overlaping. Her orthoped. thinks it looks ok but we are worried that being slightly offset is going to interfere with her symetry and balance. She cycles competively and has the potential for professional advancement. Has anyone had the same experience that can offer some insight.

If you're concerned, seek a second opinion, but if an orthopod thinks it looks fine....it might be. Have discussed your concerns with the orthopod?

FWIW, it's pretty common for bone ends to overlap in clavicle fractures and for those fractures to be allowed to heal without surgical intervention.

Your best bet is to discuss your concerns with the doc and maybe seek a second opinion, if you're still concerned after said discussion. Asking medical advice online can be a lot like letting Bernard Madoff handle your investments.

 

[bikingfamily]

If you're concerned, seek a second opinion, but if an orthopod thinks it looks fine....it might be. Have discussed your concerns with the orthopod?

FWIW, it's pretty common for bone ends to overlap in clavicle fractures and for those fractures to be allowed to heal without surgical intervention.

Your best bet is to discuss your concerns with the doc and maybe seek a second opinion, if you're still concerned after said discussion. Asking medical advice online can be a lot like letting Bernard Madoff handle your investments.

Thank you for your reply Alienator. We are currently seeking a second opinion. It is actually her coach that has the true concern for alignment. I agree with your comment about medical advice online. I guess I am really wondering if any other cyclists have noticed a difference in their pedal stroke and or any overcompensation of other parts of their body due to the change in their sholder alignment. Not so much medical advice but experience advice from other cyclist whom have experienced the same issue.

 

[bridsmath]

Thank you for your reply Alienator. We are currently seeking a second opinion. It is actually her coach that has the true concern for alignment. I agree with your comment about medical advice online. I guess I am really wondering if any other cyclists have noticed a difference in their pedal stroke and or any overcompensation of other parts of their body due to the change in their sholder alignment. Not so much medical advice but experience advice from other cyclist whom have experienced the same issue.

Hi bikingfamily,

I broke my clavicle about 6 months ago and decided not to have it surgically repaired. I have a little bit of overlap and the bone has managed to heal. I think it really depends on the amount of overlap you have, but I figured I would post my situation because I have full range of movement and functionality. I lift weights 4 days a week with no pain or discomfort. The only bummer is the alignment of the bones makes it very uncomfortable to wear backpacks, guitar straps etc. I think that if I were to have had the plate and screws installed it still would have been uncomfortable, so I'm happy with my decision. I hope your second opinion works out and wish the best of luck for your daughter!

 

[mila12]

Hi, this is my experience. I´m 22 years old and I broke my right clavicle 8 months ago and after all this boring healing process I refractured it 3 weeks ago and the surgery was my only option. I got a plate and 6 screws on my collarbone and a bone graft from my left tibia ( not too bad). This is my 4th day after surgery, I´m taking my pain medicine only when i go in bed.....this process is frustrating and bored but it´s the best way to recover your life as soon as possible, of course no one wants a big scar (I´m a girl and it was my concern) but it´s a small price, also I was frightened about the surgery and the pain but now I undestand that everybody is different and tolerates the pain a different was. I hope this can help some of you to make a future decision