broken clavicle...surgery or not?

[willy81]

Drydock, Your clavicle break xray was almost the spitting image of mine..almost exactly five months ago. My break was from a high-speed auto crash, along with about twelve other broken bones in my torso. Then when you throw in some fractured vertebrae, broken knee-caps and a bum left eye due to the concussion and almost going through the windshield..well the word basket case comes to mind. However, the CB was of major concern (like your sports) because I am a competitivfe swimmer and shoulder rotation is paramount. At first I had a nice mid-bone break like yours but with no displacement. But after they got done rolling me around like a Panda Bear while they took a zillion CT, MRI, and xrays, I ended up with a 140% displacement at the break site.  The Ortho-trauma doc walks into my room spends 30 seconds with me and says, "Make an appointment with me when you get out."  For this he charges me three grand. Then when I see him at his office he pulls the same **** that everybody else gets: [COLOR=FF00AA]the break is going to shorten your frame, your going to be asymmetrical, your going to end up with a non-union..mal-union, etc. [/COLOR]But, of course for a mere $20K I can be make you whole again with a little surgery and you will be good as new!  Thank god I was just too sick (fever), fighting off pnuemonia, and hurting form all the other broken bones to go through with it. Later, I found out that broken bones basically just heal themselves by fusing together in a rather complicated procedure.  So, at around 6 weeks I started back swimming in a 25yd. hot springs pool. Then at at about 9-10 weeks I was back training in the lake. I missed the Masters Nationals in LA but such is life. Sure, I have a nice little lump where the bones fused together but am not lopsided or have other deformities from it. I wrote about some of the research I did on the subject in some early postings. And, also prophetically said this is probably one of the most hotly contested subjects in medicine...which seems to have come out lately on this board. Lastly, in the end it is every individuals choice to do what he thinks is the best course of action.  I cannot help but feel though, that I was being pushed in the wrong direction by a surgeon that was most likely only concerned about the money. And, feel extremely lucky that I let nature takes it course and didn't line some greedy guys pockets on my dime. Anyways, I do not think about the collarbone much anymore..but all of the broken ribs are a different story.  They still like to let me know that they are still not 100%..especially if I bend to much on them. Well, good luck..it just takes some time that is all..

part of your answer is about how expensive a surgery is does that mean that if you were a multi millionaire or if your insurance covered every single penny of the operation you would go ahead with it? Let's be honest, The surgeon of course is interested about the money but he will give you back something you lost, he will repair your broken CB. I would blame a doctor only if he performs an operation that the patient does not need only for the money but in your case you need, at least theoretically, the surgery to have your CB repaired. If your broken CB does not bother you it is a different matter and you will realize it after some years. I don't love my money more than myself so preferred to give it away to have my broken CB repaired.

 

[alienator]

Let's be honest,

Honesty is not in your skill set Faux Doc *****. If you were honest, you'd admit dispensing medical advice as you do is ****ing stupid and irresponsible.

 

[steven ss]

Originally Posted by willy81 .


I checked all your past posts I did not find anything.
but since you say that you are fractured and don't have a clean break then probably there is no displacement,
the two fractured pieces are still in contact to each other but they form a small angle.
I have seen Xrays of fractured ribs and as far as I know they mend in considerable shorter time than full broken ones.

in my opinion you must keep your arm in the sling and be extremely careful since a clean break could happen anytime if you overload your clavicle.

What I meant was, I posted earlier stating I didn't have them with me. Sorry for the confusion.

 

[willy81]

I checked all your past posts I did not find anything. but since you say that you are fractured and don't have a clean break then probably there is no displacement, the two fractured pieces are still in contact to each other but they form a small angle. I have seen Xrays of fractured ribs and as far as I know they mend in considerable shorter time than full broken ones. in my opinion you must keep your arm in the sling and be extremely careful since a clean break could happen anytime if you overload your clavicle.

What I meant was, I posted earlier stating I didn't have them with me. Sorry for the confusion.

yes, I was a little confused but I eventually understood what you meant, anyway, when you have them available upload them here, your case is very different and it is good to have an idea about it.

 

[Sweden]

I have been following this thread for a year now. Now I think it might be time so I will share with you my own experience and what I did to optimize my healing of my collarbone. I will not give medical advice since I am an accountant and not a doctor.

I had an accident with my mtb one year ago, with the top 4 ribs broken and the collarbone on the same side. The helmet might have saved my life.

There is a lot to think of in order to optimize the healing process. I have learned from talking to my doctor och from reading alot. I have also learned from my own experience what worked and what didn´t.

My break was a mid break and it was a leaning break. There was one loose smaller piece just at the break.

My doctor said that my break had good chance to heal of its own. Although it was a little bit displaced some part of the bone ends touched each other, but not much. Although the bone ends now formed an angle of about 30 degrees instead of straight as before.

I was very worried when I heard the doctor strongly advicing not to operate. I was almost in panic actually, because this couldn´t heal looking like that!

I will continue the story...

 

[steven ss]

How are you going to end on a note like that, I am in suspense!!!

 

[Sweden]

[SIZE= medium]I never had an operation. No doctor would let me (I talked to more than one). At least not in my city. The private clinics might have though, I guess.[/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]I skip the whole story and instead here are some of my conclusions of what helped my healing.[/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]Figure 8 brace on directly. Tightened it every day the first week.[/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]Rested the collarbone totally for the first 12 days. Did nothing. I think 10 days would have been enough. The rest helped the bone ends to attach to each other.[/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]Day 13 I let the figure 8 brace go and tried to do things as normal. This was from advice from my doctors. Started doing light excercises. I excercised everyday for 20 minutes up to 2 hours from day 13. When I felt weak I rested. When I felt mild pain I continued. If I felt dangerous pain I stopped. That hardly ever happened. I used no weights, the training was light and only what I could do. I could hardly raise the arm actually. So I used the other arm to help, but never over shoulder height. Not until 6 weeks had passed I was allowed by the physio therapist to raise the arm over my head. And I did! It really hurt and was difficult. But I just continued the training every day.[/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]Over time the bone realigns actually. And it straightens out. This is amazing to see actually. I have documented the whole thing with measures and with photos. Still up to month 5 after the accident the break looked horrible. I would say after 8 months it started to look rather good actually, straightening out more for each month. Now after 1 year the healing process still continues![/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]I have no pain any more. That went away after about 6 months but I “knew” the whole time that if I take some pain excercising in the beginning, that will pay of in the end with no pain, which has come true.[/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]Why does one person heal good and another one heal poorly? I think I know what made the difference in my case. Besides good genes, I needed food supplements! This turned out to be very important in my case and not until I started the D-vitamins I could see the bump starting to reduce its size. Maybe it was a coincidence, maybe not. The other supplements are silicea, magnesium and K2. I took no extra calcium since I had access to unpasteurized and un homogenized milk from which calcium is easier to obtain for the human body.[/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]Actually I was told by doctors that the bump would get smaller over time but no one told me that it would get bigger first. The bump got bigger and bigger the first 4 months after the accident. The collarbones diameter at the break was about 2,0 centimeters at the break zone before the break. 4 months after the accident the bumps diameter was 3,8 centimeter. Now 1 year after the accident the bumps diameter is down to 2,6 centimeter and it is still getting smaller, week by week! And the angle that was 30% after the accident is lot less, I would guess about 10-15 degrees.[/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]There are training excercises to straighten the out the collarbone, to get the angle back to 0 degrees again. This I have found out my self, and they have worked for me. But I didn´t do them with weights/bodyweight until 4 months had passed.[/SIZE]
[SIZE= medium] [/SIZE]

[SIZE= medium] [/SIZE]

 

[pnkcoral]

*****, *****, *****,

There you go with the fear factor again. What am I suppose to realize in the future that I do not realize now? I am not going to go over again why I chose not to have surgery, that was all posted months ago. Sure, I will be honest, money was a factor with me when I found out how expensive the operation was going to be. But, that would have been covered easily with my insurances. No, what I discovered--which was very similiar to what Sweden went through-- was two schools of thought and action on clavicle breaks. The old way which was the norm up to about 10 or 15 years ago was to just let the thing heal on its own. Then at some point some a doc discovered that you could speed up the whole process by drilling a bunch of screw holes and throwing a plate with some screws in there. What really amazes me is that the clavicle bone which is pretty narrow in places would even accept this sort of treatment. So, yes I see the reasoning behind the plate..especially in nasty, multi-breaks and such. But, I really had to ask myself is it really worth the risk of infection, nerve damage, floating screws, and new breaks at the ends of the plate site, etc, etc. Not to mention the cost and the fact that at some point you go back and have them cut it all open again and pull the hardware store out? No thanks.

Today, I decided to really put it to the test. I swam two miles hard at the lake. My wife was really stunned, "She said your back better than ever." I do not know if that is true because I have not timed myself in a pool. But, today I swam a mile backstroke at a good pace and then practically sprinted a mile freestyle to finish up. And, you know what? There was no pain, nada, nor did it even ache like my old rotor cuff injuries. No, I do not know what is going to happen with it in the future. Any thing can happen. I did not think that a girl could be so absorbed in texting that she would stop in the middle of a freeway so that I smashed into her going 65-70 miles an hour and almost got killed but it happened.

Nope, I am just happy to be back swimming...

 

[Sweden]

[SIZE= 12pt][COLOR= rgb(34, 34, 34)]One of my doctors, who is also is a surgeon who perform operations of collarbones, said that if he were to break the collarbone he would never have it operated!: it would heal by itself! This he told me two months after the accident. I didn´t get the impression that this was something he just told me to stop me from worrying, it felt honest.[/COLOR][/SIZE]

[SIZE= 12pt][COLOR= rgb(34, 34, 34)]There were several reasons for this, he said, but the main reason was that a broken collarbone that heals on its own usually reaches the best strength. The reason for this is that the break is not fixed! If the break is fixed, eg with a plate, the body will have too little incentive to heal the break really well. Why fix something really good when it doesn´t seem to need to be fixed? the body might reason. Just look what happened to the worlds best speedway driver in 2012 who was unfortunate with the healing after the plate was inserted.[/COLOR][/SIZE]

[SIZE= 12pt][COLOR= rgb(34, 34, 34)]Most people who break the collarbone several times are those who have had it operated, the doctor told me.[/COLOR][/SIZE]

[SIZE= 12pt][COLOR= rgb(34, 34, 34)]Another reason was that under an operation so many tendons and nerves are cut off. Do a test for yourself! Stand in front of the mirror and flex your neck! For those of you who don´t know how to do this: keep your head still, bite hard, and then look as frightened as possible.. [/COLOR][/SIZE][SIZE= 12pt][COLOR= rgb(34, 34, 34)]J[/COLOR][/SIZE][SIZE= 12pt][COLOR= rgb(34, 34, 34)] You will now see many tendons that are visible through the skin. They just “pop out” and most people don´t know they are there. Several of these tendons pass directly over the collarbone and continues out toward the axis. You can imagine what happens to them when the surgeon gets started with the knife.[/COLOR][/SIZE]

[SIZE= 12pt][COLOR= rgb(34, 34, 34)]Still really nasty breaks will need to be operated, there is no other reasonable alternative if the break ends are too far from touching.[/COLOR][/SIZE]

 

[steven ss]

After I heal, do you think it would be OK to resume skydiving?

 

[alienator]

After I heal, do you think it would be OK to resume skydiving?

Ask your doctor, but collarbone loads during canopy deployment are likely not very high. The legs likely take higher loading. You can always pack the parachute so that it deploys more slowly.

 

[steven ss]

Originally Posted by alienator .


Ask your doctor, but collarbone loads during canopy deployment are likely not very high. The legs likely take higher loading. You can always pack the parachute so that it deploys more slowly.

now that i remember, you're right, idk why i thought most of the load is on the shoulders.

 

[alienator]

now that i remember, you're right, idk why i thought most of the load is on the shoulders.

I managed to go back to jumping about 10 days after breaking my back and an arm a few years ago, just by packing my parachute to snivel more than it normally did.

 

[drydock]

Originally Posted by Sweden .

[SIZE= medium]I never had an operation. No doctor would let me (I talked to more than one). At least not in my city. The private clinics might have though, I guess.[/SIZE]
[SIZE= medium] [/SIZE]
[SIZE= medium]There are training excercises to straighten the out the collarbone, to get the angle back to 0 degrees again. This I have found out my self, and they have worked for me. But I didn´t do them with weights/bodyweight until 4 months had passed.[/SIZE]










[SIZE= medium]hi sweden, can u post a link to these exercises/u post these exercises[/SIZE]
[SIZE= medium] [/SIZE]

[SIZE= medium] [/SIZE]

 

[Sweden]

[SIZE= medium]Warning: these excercises worked for me. There is no guarantee they will work for you. When I did the excercises I willingly risked my collarbone to break again, even though I was careful, I was aware of the risks. Apparently my collarbone ends had already attached good to each other.[/SIZE]

[SIZE= medium]After 5 weeks I started with the exercise called “shrugs”: week 5-7 without weights, and from week 8 with 2 kilo dumbbells. This was from instruction of my physio teraphist. I guess most people do this exercise after collarbone break. Obviously the collarbone is stretched out, especially in the contraction phase.[/SIZE]

[SIZE= medium]I knew that dips would be a great exercise as well. Unfortunately dips is performed with full bodyweight and that can´t be done. Actually I started doing real dips when 1 year had passed from the accident. I think dips will help my continued healing now year number 2.[/SIZE]

[SIZE= medium]But after 5 months. I started doing a VARIANT of dips. It is dips that is performed with straight arms. All the time during the exercise STRAIGHT ARMS that are never bent in the elbow. Needless to say the range of motion in this exercise is very short. Still, a huge warning for this exercise because I was worried that the collarbone might break again if it had healed poorly. In my case it worked fine though. The excercise might be reffered to as "the opposite of shrugs". I pushed as long as I could in the contraction phase and in the top phase I let the collarbone be stretched out as much as possible. Again, I am sure that many experts will strongly advise NOT to perform this exercise too early, or not at all. I thought 5 months was long time enough waiting, but I don´t know what the overall recommendations are. Of course I was very carful in the beginning not putting all my body weight on in the stretch top phase. But after a while I started doing that too. I am 38 years, 188 centimeters tall and weigh 79 kilos.[/SIZE]

[SIZE= medium]This was my story of best excercises for straighten out my broken collarbone. There is no guarantee these will work for any body else.[/SIZE]

[SIZE= medium]I think the main thing in mending the collarbone is to rest totally the first 10-12 days and after that go back to your normal life and doing excercises in a phase you feel comfortable with.[/SIZE]

 

[willy81]

I think the main thing in mending the collarbone is to rest totally the first 10-12 days and after that go back to your normal life and doing excercises in a phase you feel comfortable with.

your CB will never mend properly without a surgery, don't fool yourself the two parts can fuse together but they will not have the same shape not at the same angle as before, you know that, if your CB shortens enough your trunk will be asymmetrical. if you feel OK it is highly subjective and differs from person to person.

 

[alienator]

your CB will never mend properly without a surgery, don't fool yourself the two parts can fuse together but they will not have the same shape not at the same angle as before, you know that, if your CB shortens enough your trunk will be asymmetrical. if you feel OK it is highly subjective and differs from person to person.

Another irresponsible post completely lacking in credibility. Willy81 has no ****ing clue what he is talking about; yet he persists in spreading bad information. He is not a doctor. Full stop. His experience is only that he broke his collarbone. He assumes knowledge he does not have.

 

[pnkcoral]

Sweden,

Yes, I would agree with you that for the first two weeks keep the broken clavicle, shoulder, and arm as immobile as possible. Fortunately, I was on my back for two weeks after my accident because of all the other injuries. Therefore, I think it worked to my advantage. However, I draw the line with any sort of dip exercises. There are a few movements that I always realized put an inordinate amount of strees on the collarbone and dips would be one of them. Even though I am now doing light weights: curls, bench press, wrist curls, etc. I also do some yoga exercises every day and like to do back rolls-- that kind of roll that shoulder a little.

Now, they say that having surgery will preclude having these sort problems with a broken clavicle: weakness and pain in the shoulder, numbness or tingling, loss of shoulder motion, loss of endurance, and cosmetic deformity. I never really had any numbness or tingling and very little pain or weakness even after first two weeks. I always had a good range of motion in the shoulder and at 6 weeks had full range-- swimming about 1/2 mile at a time. As far as loss of endurance I am beginning to already wonder if the new fused bone is stronger than it was before the accident. Or it could be because I am going longer distances swimming and at a faster pace. Yesterday, I swam two miles almost all out and that shoulder and broken bone did not feel a thing. Actually, it felt like it enjoyed it. As far as any deformity is concerned.. I kind of get a kick out of that reason. I have always had a sort of scoliosis (curvature) of the spine. I never had it diagnosed and just always figured that it came with the territory or was induced by my swimming career. When you swim a few zillion miles butterfly you are just naturally going to have hunched shoulders. Anyway, I keep looking for some difference in my rather poor posture and I nor my wife can see no change. I feel that was a reason that was conjured up the the Ortho surgeons to try and scare patients into an expensive surgery. But, they overlook a nasty scar and metal plate poking out of the skin.. Go figure..

 

[67Rally]

It is sad to see how this thread turned from being helpful for people to a vehicle for personal attacks. I hope we can bring this back to some measure of civility.

Remember, physicians treat each person based upon symptoms and diagnosis individually. Each of our clav breaks are unique to us and our own situations. It is best that we keep to our own situations rather than to chide or push someone to get a procedure merely because that is what we did for our own situation. In speaking with one of my two ortho docs about this, they have seen several patients have successful clav break shaft unions without surgical intervention.

For me, the idea of having a scar or the appearance of asymmetrical clavicles was secondary to having full use and stability of the shoulder. My bare-chested modeling days are in the rear-view mirror however my scar is almost indistinguishable from a short distance. I have to point it out to people as it is difficult to see as is the plate/screws. My wife can clearly see it all...but she does see it at close range.

 

[alienator]

There can be civility so long as people don't pretend to be doctors and stop dispensing medical advice. Civility is not the appropriate tack when people dispense medical advice, as dispensing said advice is reckless. Medical advice should only come from trained professionals who have examined the person in question and know that person's medical history, including the history of the injury. Medicine is not a paint by numbers field. Recounting and sharing experiences is one thing, and it's a thing that's fine, a thing that's normally done. Telling someone what will or won't happen with their injury and what their outcome will or won't be is not a responsibility of people on internet forums, is not something within the skill set of the vast majority of people on internet forums, and is not even something that responsible doctors will do.