broken clavicle...surgery or not?

[screwed]

Originally Posted by alyson .

hi thanks for the reply i am really nervous. when i move my arm now it clicks and it is very painfulland you can see the bones moving is this normal.......thankyou

its normal to be nervous mate, i was too, even tho i couldnt wait for the surgery to be done.
the way i look at it, if you have been like that since january, you need to have the opp. the clicking and the pain is not right, i think you should listen to your doc and get it done. a few weeks after the opp (when the anasthetic and pain wheres off) you will be glad you had it.
its a routine opp and you might even be home the same day.
i was keept in over night because the opp started about 4 pm, and went on for longer then expected (about 6 hours total) because of where all the bones were.
personaly i cant see a bad side to having the opp, and the docs know what there talking about.
you are in safe hands

 

[PACSMAN]

I broke my left clavicle and left wrist in a fall. The ER put my arm in a sling on my arm after seeing a fracture which had seperated the broken ends by 2 cm.

Unfortunately, after 1 week, this pulled apart further and the gap between the bones are now over 5 cm.

I can't see this healing without surgery so I have made the next step:
Surgery has been scheduled to have plates put on my clavicle.

I've been told that I will be able to use my shoulder after 2 weeks from the time of the surgery.

 

[RSturm]

Here is a 5 week post surgery update. Pretty much at the 1 month post-surgery mark, there was a fairly sudden improvement. Seems similar to what some people have reported after 3 or even 2 weeks. Healing times vary - much of that is probably related to age. Took me a bit longer to feel the noticeable improvement.

There are still plenty of odd twinges and sensations, but generally I would say the shoulder does not bother me now and works fine for activities of daily living. Of course, as the bones are unlikely to be fused (checkup in 2 weeks), I avoid any weights.

The positive aspect of surgery is that you can use the arm carefully very soon whereas it needs to be kept still without surgery (I think I stayed off the bike completely for 2 months after I broke my left collarbone). The downside of surgery might be a bit more pain, odd sensations (after all, lots of nerves get cut), scar, tender area around surgery and plate. Again, I just have a sample of 1 treatment on each side.

Bike riding, 5 weeks after surgery, is back to normal regarding distances, did a few 3 and 4 hour rides, although riding very self-conscious and carefully. I have been in the mountains, but stay off technical or slippery single track.

Originally Posted by RSturm .

Broke my right clavicle 5 weeks ago, had surgery 4 weeks ago. About 5 years ago, I broke the left side and let it heal by itself. Both were somewhat displaced, although the right one had more fragments and shoulder separation, which is why I decided to have surgery this time.

Left shoulder (no surgery): I can't remember how long it took, but after the ER, I never went back for another doctor visit. Was very uncomfortable for a while (but not that long, maybe 2 weeks). Initially left a large bump but it remodeled over time and by now is not very noticeable. Don't know how long I stayed off it, but no more than 2 months and used it fully (including weight lifting) a few months later. No problems, no pains, healed fast and feels as good as new. Used strong pain killers for about a week, not needed afterwards.

Right shoulder (surgery): Although I've had a number of other surgeries, this one took longer to recover from. Very hard 3-4 days post surgery, lots of painkillers, felt very weak. Back on the stationary bike after 4 days, but just feeling very weak. Two weeks post-surgery, about 20% less power than prior to crash for comparable effort. Some gentle road recovery rides starting after 3 weeks, first 2 hour mountain bike ride (but very gingerly, still hard climbing, but very careful nontechnical riding) in week 4. Shoulder is painful, especially at night with unintended moves (rolling over). Scar and plate area is tender to the touch (more so than the unoperated broken area was). Even though the bones are together due to surgery and therefore can be used for daily activities without putting weight on it (e.g. brushing teeth, taking a shower, etc. (ok, riding a bike, too)), there are sudden painful twinges. Neck ad back get stiff, too. Riding the bike tends to help (or at least improves my mood, but I think it actually improves everything). Definitely am using more pain killers than when the left was broken and still seem to have more pain. Scar is rather long and looks bad. I still use the sling because it feels better than without, just as I did on the left side after 4 weeks (where it was needed to keep the bones from moving too much).

So by week 4, I'd say the downside of surgery overwhelms the upside (e.g. being able to use the arm for daily activities). More pain, more stiffness, plate and ugly scar. Of course, the two injuries weren't exactly comparable.

More in a month, maybe the surgery catches up in terms of improvement. Much too early to say what I will do with the plate, but if I can avoid another surgery, I take that.

 

[bsbs1876]

Originally Posted by RSturm .

Here is a 5 week post surgery update. Pretty much at the 1 month post-surgery mark, there was a fairly sudden improvement. Seems similar to what some people have reported after 3 or even 2 weeks. Healing times vary - much of that is probably related to age. Took me a bit longer to feel the noticeable improvement.

There are still plenty of odd twinges and sensations, but generally I would say the shoulder does not bother me now and works fine for activities of daily living. Of course, as the bones are unlikely to be fused (checkup in 2 weeks), I avoid any weights.

The positive aspect of surgery is that you can use the arm carefully very soon whereas it needs to be kept still without surgery (I think I stayed off the bike completely for 2 months after I broke my left collarbone). The downside of surgery might be a bit more pain, odd sensations (after all, lots of nerves get cut), scar, tender area around surgery and plate. Again, I just have a sample of 1 treatment on each side.

Bike riding, 5 weeks after surgery, is back to normal regarding distances, did a few 3 and 4 hour rides, although riding very self-conscious and carefully. I have been in the mountains, but stay off technical or slippery single track.

Thanks for the update! Glad to hear you are healing up well. You will be on to the weights in no time by the sound of it.

I think what it comes down to is each break is different. I didn't get surgery on mine 3 years ago and it drives me NUTS regularly. Mind you it is tenting out of my skin still and my shoulder is clearly much shorter so it most likely is just more severe of a malunion than your left side got.

All the best in the coming weeks getting back to riding.

B

 

[willy81]

Originally Posted by bsbs1876 .


Thanks for the update! Glad to hear you are healing up well. You will be on to the weights in no time by the sound of it.

I think what it comes down to is each break is different. I didn't get surgery on mine 3 years ago and it drives me NUTS regularly. Mind you it is tenting out of my skin still and my shoulder is clearly much shorter so it most likely is just more severe of a malunion than your left side got.

All the best in the coming weeks getting back to riding.

B

you still can go for the surgery even if the bone has formed some kind of union, malunion you said.
the doctor will separate the two piece and align them perfectly, you will be symmetrical, again!
you will heal much faster than us because your muscles have already recovered from the impact.

I know someone who had the surgery after one year of the accident and in 6 weeks he was back in his sport

 

[bsbs1876]

Originally Posted by willy81 .



you still can go for the surgery even if the bone has formed some kind of union, malunion you said.
the doctor will separate the two piece and align them perfectly, you will be symmetrical, again!
you will heal much faster than us because your muscles have already recovered from the impact.

I know someone who had the surgery after one year of the accident and in 6 weeks he was back in his sport

Hey *****,

I am going in for the operation. I have been waiting for it for a while now because my surgeon is in such high demand. In the meantime I am living on an ibuprofen diet . I will be sure to post here during my healing process. I will be going in early in the new year.

Thanks for your input!
B

 

[nick00less]

Surgery-best choice I made. I drive a semi truck for a living delivering beer. It's a physically demanding job that requires me to physically touch each case of beer I deliver at each stop. It can be up to 1,000 cases a day. Each case can range from 10lbs to 50lbs. I'm using full range of motion with my arms in this job. 8-10hrs of work. Crazy right? I love what I do. Keeps me in shape. I'm 3 weeks post op (plate plus 6 screws) and feel great. However my doctor says NOT to lift my arm at all and to keep it in a sling for 6 weeks (until December 17th) then I can work on ROM. Even though my arm feels completely normal I'm going to take his advice. I'm often tempted to raise my arm a little just to see how it feels but I know as soon as I take an inch, ill go a mile. Therefore I choose not to entertain my curiosity and simply keep my arm to my side until my doc says its ok to start moving it again. My doc says at the 10 week mark I can start pushing and pulling with it again. My biggest concern right now is how soon will I be able to resume the life I was living before the surgery happened (mainly the work I was doing at my job). Has anyone had a fast recovery that allowed them to resume full activity (minus contact sports) ? Was anyone able to return to a physically demanding job 10 weeks after surgery?

 

[willy81]

you must listen to your doctors instructions, it will be a big disappointment to have your plate and bone broken again because you lifted to much weight. You will have to pay again for the surgery and lose time.

 

[nick00less]

I have a feeling you're absolutely right. Ill keep this forum updated with my progress. 2 more weeks then no sling! Can't wait. I've been wearing it since October 12.

 

[Clara M]

Hi everybody,
as you can see I am new to this forum and I have to admit that I found it by searching online for more info about this whole broken clavicle story
I have had a pretty nasty break while horseback riding, fell on my right shoulder and broke the clavicle in several places as they called it a comminuted fracture.
It's been exactly 8 weeks since the accident and I haven't had surgery, first of all because I am more than scared of it and second of all because the surgeons I have consulted have different opinions. I have seen 4 surgeons , 2 have suggested surgery and 2 the traditional treatment. I am not a professional rider but I would like to be able to throw a football again or do some sports again...
Thing is I am in Romania and haven"t had the options you probably would have in other countries. I mean for the first 3 weeks they (people from the ER) put me in some circles made out of bandages and cotton that were strapped at the back with some rubber bands, imagine something like a primitive figure 8 but it also had bandages around the belly tighten pretty hard so that the rubber bands would form a Y at the back holding the shoulders back and straight, pullling them at the same time downward.
After 3 weeks they told me to buy a figure 8, which of course I ordered online since I have made my own research and just asked the surgeon if I could switch to it.
Now it's been 2 moths and I am still scared to death of surgery and the only thing that suggests the possibility of a surgery is the little fragment of bone that hasn't really gone back (my break is kinda how a twig would break- a green not mature piece of lumber-as they say), so this little fragment has come closer to the rest but it's not there yet and it's end is somehow poking the skin, when I actually lift my arm and try to do the exercises my surgeon has shown me.
I have been reading a lot lately and am desperate because I really don't want surgery, plates or screws built in, complications (of which I have read a lot- and really want to avoid ) and such but I also don't want to have a deformed shoulder since I am a 27 and still want to wear tank tops or dresses that actually don't cover your whole neckline.
Since I am in a country where the medical care is at it's worst, I will be going to the neighboring countries for a consult, thing is I really don't know what to do if the doctors tell me to have surgery just because I am going to a private clinic and they want to make $ off of me.
I am scared of a huge scar but more of the complications and general anesthesia, on the other hand I am scared that I won't be able to lift my arm high enough to put my own jacket on a hanger.
I am doing now some simple stretching exercises till my next visit to the doc, still wearing the figure 8 and sleeping on a bunch o pillows ... I am really at my wits' end...

 

[Clara M]

I forgot, but of course it goes naturally that I would appreciate any information, opinion or comment!
thanks for reading!

 

[nick00less]

I was nervous about surgery too. My clavicle broke in the middle of the bone. My x ray showed one piece pointed down and the other pointed straight up poking at the skin. My doctor first suggested we see if they fuse back together. After a few weeks of not coming close to each other again my doctor said I can live with it if I choose to. The only other recommendation was surgery. I'm like you. I want full use of my arm again. I opted for the surgery and its been the best decision I've made. I have a plate with 6 screws. It seems like a lot of hardware but I don't even notice it nor see a big difference when I stand in front of a mirror. I was on the fence too about surgery. Scared out of my mind. But once I got over the anxiety of anesthesia and being in a operating room I started to actually look forward to having it done. Anesthesia sounds scary but it's like blinking your eyes. One second their closed, the next their open. I went to sleep and woke up so fast it felt like surgery was only minutes. Even though it was really 3 hours. Yes I was groggy. A little sore. But the physical soreness I had after surgery actually felt way better than the soreness I had right after I broke my bone. You can tell when something's not right in your body. After i broke my bone i felt like something was out if place. But after having this surgery everything felt normal again on the inside. I was still sore for a few days but after that the pain was gone. I felt completely normal again. My advice, go for the surgery. You've seen what no surgery has done for you so far. Find a good, experienced doctor. I'm 25 and I don't want to live like this forever. I'd rather sacrifice 3 months of healing time vs. the rest of my life having to live with an impaired arm that hurts all the time.

 

[bbninja]

Just a little update from me its been 1 year 4 months since i broke my collarbone, I cant stress surgury enough. As of today and has been for proabbly a year now i use my arm as if nothing happened and have zero issues. My arm moves and works as if nothing ever happened. All the stories i read on here about waiting to see if it heals, well looks like about 80 percent that i see on here do not heal on theer own and you end up getting surgury anyways, so why wait>?

I had surgury the next day and had zero physical theropy because my arm moved 100 percent fine after they put the plate in. To be honest with you i would hate to fall on my side again as hard as i did the day i broke it but it is what it is, That force broke it originally and would shurly break it again under the same force but so what. I still have no feeling around the cut though, feels really wierd to the touch and when showering when the water is directly on it feels really odd but that is probably the worst of it, Pain was minimal, i was perscribed 100 perks and took 2 and they wonder why our society is addicted to pain meds,.. Well did you really need to perscribe me 100 perks. Anyways that is a completly different issue,.

So again if you barely brake the bone maybe it wuill heal on its own but if you fly threw the air and land on your shoulder and crush the bones together its a easy decision in my book.

Also i had surgury at 10 at night and was home in my own bed by 3 am , they will let you out if you can move and eat,. Worst of it was i could not sleep on my stomach for 2 months, to me that was the worst pain lol, i do not liek to sleep on my side but i had to (

GL all, personal experince just get it done, its not open heart surgury dont worry about it.

 

[willy81]

ClaraM,
I think you must go for the surgery,
if it does not take place in Romania where else could you go? what neighboring countries do you consider?

can you upload here a photo of your X-rays?

 

[alyson]

hi its aly,
thanks gang for the input i really appreciate it, i just wait get it over and done with so i can hopefully get back to some normality...
like i say thanks again plz keep informed on how you all doing ,........

 

[Clara M]

Hi everyone! thanks so much for the responses! so this is how it look like after 6 weeks, the doc said it started healing, I for myself can't see it the way he does but well, it's now 8 weeks and 1 day since the accident and I just finished my stretching exercise...I can reach my left ear with my right hand but it's hard. The doc said patience and baby steps! So I am going down that road now. In two weeks I am going to Hungary to see a doc there and see what he tells me. I thought of surgery in Austria and Germany as well but it's pretty hard to travel by car there and flying is not an option right now.
Anyway if i get surgery I won't do it in Romania, my surgeon told me a horror story about a guy who had it and got a nasty infection and they ended up cutting again and again.....
I am still freaked out by surgery and plates under the skin, I've read an article about the types of fixation and all that stuff they use like screws, plates and wires....and all of those can wonder off or get loose or harm you in so many ways....and if i get surgery and screws ...I want them out after a period! One surgeon in Germany said something about some special elastic screws they could use to put that piece back in it's original place and that could be installed with a small 2 cm cut...I would do that but then another specialist saw the xrays and said they might need to use plates after all
so you see...everyone has a different approach and opinion...I am going completely crazy...because it's not like shopping for clothes...we're talking about screws and titanium plates being put in your body....
uffff

 

[willy81]

Clara, if I was in your position I would try to find a Sport Surgeon in Austria, they are very experienced for this kind of accidents because every year there are many similar accidents in winter sports.
You should not be afraid of the surgery, it is simple and there will be no problem at all if it is done in a well organized hospital by an experienced doctor.
You will feel a little uncomfortable with the plate and screws the first weeks but after you will get used to it, the doctor can take them out after 18 months (this is what will happen in my case) and since I am worried to much about the appearance of scar in the second operation a Plastic Surgeon will do all the stitches. So don't worry about the aesthetic part of the surgery. There are solutions.
Plates and Screws is the best method, they are strong to hold the bone at its proper place and the plate is "Pre-contoured" so it has exactly the shape of your clavicle. There are tens of pre-contoured plates, your doctor will choose the one with a shape same as your clavicle.

 

[bsbs1876]

Originally Posted by Clara M .

Hi everybody,
as you can see I am new to this forum and I have to admit that I found it by searching online for more info about this whole broken clavicle story
I have had a pretty nasty break while horseback riding, fell on my right shoulder and broke the clavicle in several places as they called it a comminuted fracture.
It's been exactly 8 weeks since the accident and I haven't had surgery, first of all because I am more than scared of it and second of all because the surgeons I have consulted have different opinions. I have seen 4 surgeons , 2 have suggested surgery and 2 the traditional treatment. I am not a professional rider but I would like to be able to throw a football again or do some sports again...
Thing is I am in Romania and haven"t had the options you probably would have in other countries. I mean for the first 3 weeks they (people from the ER) put me in some circles made out of bandages and cotton that were strapped at the back with some rubber bands, imagine something like a primitive figure 8 but it also had bandages around the belly tighten pretty hard so that the rubber bands would form a Y at the back holding the shoulders back and straight, pullling them at the same time downward.
After 3 weeks they told me to buy a figure 8, which of course I ordered online since I have made my own research and just asked the surgeon if I could switch to it.
Now it's been 2 moths and I am still scared to death of surgery and the only thing that suggests the possibility of a surgery is the little fragment of bone that hasn't really gone back (my break is kinda how a twig would break- a green not mature piece of lumber-as they say), so this little fragment has come closer to the rest but it's not there yet and it's end is somehow poking the skin, when I actually lift my arm and try to do the exercises my surgeon has shown me.
I have been reading a lot lately and am desperate because I really don't want surgery, plates or screws built in, complications (of which I have read a lot- and really want to avoid ) and such but I also don't want to have a deformed shoulder since I am a 27 and still want to wear tank tops or dresses that actually don't cover your whole neckline.
Since I am in a country where the medical care is at it's worst, I will be going to the neighboring countries for a consult, thing is I really don't know what to do if the doctors tell me to have surgery just because I am going to a private clinic and they want to make $ off of me.
I am scared of a huge scar but more of the complications and general anesthesia, on the other hand I am scared that I won't be able to lift my arm high enough to put my own jacket on a hanger.
I am doing now some simple stretching exercises till my next visit to the doc, still wearing the figure 8 and sleeping on a bunch o pillows ... I am really at my wits' end...

Hi Clara,

Let me be an example of why you might want to be more scared of not having the operation. I broke my collar bone 3 years ago and have not had surgery yet. I live my life with a usable but regularly sore and weak left shoulder. I am self conscious of my deformed shoulder and don't like to wear tank tops or large necked shirts let alone going shirtless at the beach in the summer. Scars fade and look normal. The bone protruding out of my body looks creepy (yet my girlfriend insists it's cool - bless her soul). When exercising I favor my right (good) side so it is noticeably more muscular and toned. The side with the broken collar bone clicks and pops all day. My neck and back are sore on that side all the time.

I will be going in for this surgery in the near future to fix my malunited clavicle and wish I would have insisted on it initially. Understand that each break is different and the approach taken depends on this but I am telling you my experience to try to comfort you in the fact that not having surgery can result in unsatisfactory results.

All the best and take care,
B

 

[Clara M]

Originally Posted by bsbs1876 .


Hi Clara,

Let me be an example of why you might want to be more scared of not having the operation. I broke my collar bone 3 years ago and have not had surgery yet. I live my life with a usable but regularly sore and weak left shoulder. I am self conscious of my deformed shoulder and don't like to wear tank tops or large necked shirts let alone going shirtless at the beach in the summer. Scars fade and look normal. The bone protruding out of my body looks creepy (yet my girlfriend insists it's cool - bless her soul). When exercising I favor my right (good) side so it is noticeably more muscular and toned. The side with the broken collar bone clicks and pops all day. My neck and back are sore on that side all the time.

I will be going in for this surgery in the near future to fix my malunited clavicle and wish I would have insisted on it initially. Understand that each break is different and the approach taken depends on this but I am telling you my experience to try to comfort you in the fact that not having surgery can result in unsatisfactory results.

All the best and take care,
B

Hi! and thanks not only to you but all of the people answering to my post!
I will actually go and see this doctor in Hungary and see what he says and if he tells me that I need surgery if I ever want to have 100 % of my shoulder back then I will have it, but surely not in Romania. I will ask for a detailed description for the procedure he thinks best for me and then I will research more and I will make up my mind, but can you guys tell me from your own experience what is better, plate? screws? I mean can you actually feel them under the skin? isn't it weird? and for how long do you have to keep them in? because my fracture is kind of healed and they probably have to break it again and remodel it...that means more time with a plate inside your body right? Just some details if you care to share! thanks a lot!
this has been already very useful!

 

[RSturm]

It seems like this thread is creating an exaggerated impression about the advantages of surgery. The vast majority of fractures will heal by itself and just about as quickly as without surgery. Surgery is needed for a small number of more complicated cases. Professional cyclists are more likely to get surgery because it allows return to riding quickly and they don't lose much of a season, not because it heals better or is less risky.

Here is my left side, looks rather displaced. Yet this is definitely not a case for surgery and indeed I had no surgery. Sling and it healed quickly by itself, although initially with a big bump. But over time (years, not months), even that bump decreased as the remodeled itself. Hardly noticeable now and the shoulder is as good as new even if it is a little bit shorter. Absolutely no problems.




My right side will always look a lot worse because of the surgery scar. After about 2 months too early to say what the long-run outcomes are, but the recovery process post surgery is certainly no easier and maybe even harder than letting it heal by itself. The big plus of surgery is being able to lightly use the arm almost immediately. While maybe not a very difficult operation, this is not minor surgery and has the risk of serious complications.

Here is my right shoulder for comparison. The reason for having surgery this time was that there were several bone splinters and they were also vertical, plus a shoulder separation. Nevertheless, even this is not an unambiguous case for surgery. A simple break as above, let it heal by itself and most of the time it will.