broken clavicle...surgery or not?

[willy81]

So, I mostly need some sort of peer support (we all do, don't we?). And reassurance that I'm doing things right and that I should just be patient. Even though I'm a bit anxious and a little bit stubborn so I'll probably end up trying some small stuff which I probably shouldn't.

this is what we, bsbs and me, are offering here. Support and some guidance according to our experience. It is normal to be anxious, impatient, frustrated and angry, these are the usual feelings after a surgery like this. nevertheless you can't change anything and the progress will take its time, try to occupy yourself with something else until you get again strong enough to get back to your sport activities Dane Girl, as I told you if you have an experienced Doctor, he/she will fix everything there are Ca supplements you can take if you have osteoporosis, this is easy for your doctor. relax, everything will be fine as to all of us.

 

[Dane Girl]

bsbs1876 I agree, and anyone who has seen my X-rays says I really need to get the surgery. I haven't met one person who thinks that I shouldn't get the surgery except for the first ortho I saw. He thought I should do the wait and see approach. The day I went to the ER they had said I needed surgery that day but they couldn't do it because I had eaten that day already. After going to the ortho I got confused because he said I should wait and see if it would heal on its own because of the risks involved. He was concerned about how I was thin and the plate being painful to me and possibly not holding. But when I saw the second Dr., he didn't think those things were a problem. He left the decision up to me because he said that since I was only a stay at home Mom I wouldn't need my shoulder as much as someone who does sports. Well that made me kind of angry but I see what he means. But in my opinion I still need my shoulder to work properly as much as anyone else. And my quality of life would probably suffer if I just left my shoulder this way. Anything But, I do take supplements and I have been for a few years. I have repeatedly had problems with very low Vit D levels and I have to take high doses of Vit D to keep my levels up. I take a supplement that has Calcium and Vit D and at times I have to take prescription therapeutic doses of Vit D. Since I am a vegetarian I also take B complex vitamins. I actually tried to eat some chicken and turkey after my fracture but I have a really hard time eating it and I prefer not to. But I will if it is necessary for proper healing. I will ask the Dr. about this. I don't think that my diet is why my fracture did not heal. It looks to me that it is in an impossible position for union. But I guess every case is different and maybe it is possible in some cases. I actually eat very healthy. I cook all my own food and I do not eat out much at all. I eat a lot of fruit, vegetables, beans, nuts and grains. I believe I do get enough protein. I do however have hypothyroidism which is under active thyroid. I have had it for 13 years and I take meds daily for it. Usually people who have this have trouble losing weight but I have trouble keeping it on. I constantly have my levels checked and they are always perfect the Dr. says and she wants to keep my meds the same. I think some of the reason I don't gain weight is from eating so healthy and being really active most of the time. I don't do hard core sports but I am always busy doing things so I think I burn off a lot of calories. Anything But, you said that you had a lot of pain in your shoulder joint after the OP but did you have that before the OP also? I have a lot of pain in my shoulder joint and I wondered if I have an injury there as well. The Dr. just thinks it is from my shoulder not being properly supported by my collarbone that is causing the pain. I am going to ask him about again on Wed. Oh and I do have people to help me with my Dogs. My husband and friends and family are going to help me with them while I am healing. And I have no intention of trying to handle them in a way that could pose a problem for my healing collarbone until I am sure I am fully healed. Glad you are doing better Anything But! Definitely try to be patient and don't do too much. It's not worth it. I can't wait for this to be behind me. I will try to update as I go through my journey. And Alienator, I will ask my Dr. about Fosamax at my appt. on Wed.

 

[Dane Girl]

Also it will be very interesting to see how my surgeon handles my tattoo and my incision. My whole shoulder on that side is tattooed right where the break is. So I wonder how my tattoo will look afterwards. I know it is going to mess it up some. Oh well, I would rather have a working shoulder and maybe my tattoo will help to camouflage the scar some. It is an old tattoo anyway and I don't wear clothes that show it a lot anyway but it will be interesting to see how it all turns out with the tattoo there.

 

[Dane Girl]

Here is a picture of how my shoulder is tattooed. The Dr. was surprised by how the fracture is not really noticeable on the outside. I think the tattoo does help in disguising it but also I don't think my bone is sticking up that much either. I can definitely feel that it is out of place though!

 

[Anything But]

***** 81, that's what I need. Support and the possibility to talk about this. I can't talk about it so much with friends, it's different when you've had it and know how it feels. And here if people are sick and tired of the subject, it's easy to just skip these posts. Dane Girl, my knowledge about vegetarian good is limited to the fact that the vitamin B intake is not so good from vegetables, as you know. And of course, you'll need to think more about the proteins. I have a friend who was a vegetarian, although after having a child she's started to eat chicken and she eats fish and egg and I think dairy products as well. I know many vegetarians are eating much more healthily than most of us. I felt some pain after the injury. Day 5 it got easier. I actually think the bones stopped grinding on each other at that point and their position worsened. Two days after that I got the decision about the operation. On that weekend I used my arm a lot more, because it sort of didn't matter and I didn't have so much pain. I didn't feel like taking pain killers either. Your fracture seemes clean but the bones are quite far apart. I wondered before my operation whether or not the surgeons could refresh the fractured surfaces with some kind of file, but I think it was fresh enough. And I don't think they do that, but Truthfully, I really don't know. I've had very little pain altogether. When it happened I felt too snaps but they weren't so big. I felt pain, but didn't immediately know if it was just the impact or something worse. I've felt similar pain but after shaking myself a moment noticed that it was just the first shock and there wasn't anything really wrong with me. After I fell, I was asked if I was ok. My first answer was "I can't tell yet." After some 20-30 seconds I said I had broken my clavicle. No one really believed me first. Not just there, but in the ER as well. Wow, I wonder how your tattoo will look after the surgery. At least it should be easy to get the lines right, it's almost like a guideline.

 

[Anything But]

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The questions I would ask my surgeon if I were you: What about the AC-joint? It's the joint between the distal end of your clavicle and that crooked bone called acromion. Unfortunately, my pictures are of two projections. First and last (both post op.) x-ray are taken slightly from above. But same thing shows on them as in straight x-rays that I have home. After the surgery the distal end of the clavicle is a bit higher than before. The ligaments were probably streched during the operation. If you google "normal clavicle" and/or AC-joint, you'll probably notice that the end of the clavicle SHOULD be in line with the acromion. Yours doesn't seem to be, but a little higher. I am not a radiologist (obviously) so I can't say if your joint is within the sort of "acceptable variations". Often they are treated with the sling or sometimes with a tape. It takes quite severe rupture before it'll be operated, although the pravtice might vary depending on which country people live in. Still, I think it's something you should or could ask on your next appointment.

 

[Anything But]

Here is a picture of how my shoulder is tattooed. The Dr. was surprised by how the fracture is not really noticeable on the outside.

Maybe not at first . If you look the picture of your shoulder and the x-ray, you see the proximal part pointing at the middle of your trapezius when it should point at the corner of your shoulder, more or less. But it looks sort of nicer than my shoulder. The trapezius muscle from a bump near my neck and the estää of the shoulder was dropped downward and was significantly shorter than the other side. Makes me wonder how diagonal your fracture is. The shoulder looks nice, its's just the clavicle pointing up to the sky...

 

[Anything But]

*swearing sound* The trapezius muscle formed a bump near my neck and the rest of the shoulder was dropped downward and was significantly shorter than the other side.

 

[alienator]

this is what we, bsbs and me, are offering here. Support and some guidance according to our experience.

Actually, that's a lie, *****, and you know it. You dispense actual medical advice and make claims that you can't support and that you would no doubt deny should someone take your advice and have an untoward outcome. Apparently you don't read your own posts or can't see though the cloud of BS you dispense.

 

[willy81]

AB just remember that every day you will feel better I felt some strength around 3.5 weeks after the operation and then again at 6th-7th week. I didn't have a real pain in the muscles, mostly weakness and a strange feeling, a numbness, something like that this area were a bit senseless, the first 6-8 weeks are critical because the plate holds the whole load of your arm, the two fractured parts are still loosely connected, as Hard Calus forms and as more Calcium is deposited between them, they begin to form a more rigid structure and you will feel it, then you will feel stronger. And the same story will repeat continuously, after 2-3 of months you will not be so much occupied with your shoulder, you can get back to your normal activities but still you better avoid lifting heavy and also avoid any impact. It is an unfortunate situation, you get angry with yourself, frustrated and lots of negative feelings, I have been through, but still there nothing you can do. In the first weeks I wanted to talk about my injury all the time and my friends had the same reaction as yours. They just wished me to have a speedy recovery and they didn't want to speak about it further. In fact they couldn't tell anything because the whole situation was not familiar to them. Only persons who have been through this can understand and give some support.

 

[Dane Girl]

I totally know what you mean ***** 81. It almost seems like everyone forgot that I still have a dangling arm and that my collarbone is still just sitting there unattached to itself. For a while my husband didn't think the surgery was necessary because I was getting around better and doing a lot of things around the house that I usually do. The fact is I got really good at doing things with one arm and I pretty much had to start doing things because I was bored out of my mind! What they didn't know was how much pain I was in while doing all those tasks. They didn't see me take crying breaks because the pain had become too much. I admit that the pain is no where near what it was the first few days that I broke it but that doesn't mean that the pain is gone now. I just live with it and I am used to having it everyday and I just go on with what I have to do regardless of the pain. However I will make sure that I do not push myself after the surgery because I want it to heal correctly. There is no way I will chance doing something that will make it not heal. It was so confusing when I saw different doctors and they would say different things. One tells me to keep the sling on and the other says I need to move my arm so that it doesn't freeze up and to get rid of the sling. Now how are you supposed to move your arm while you are trying to get the bone to grow together? I still wonder if I did too much and that's why mine didn't heal together, but then every time I look at my X-ray I think nah, it didn't heal because look at it! It is not in a position that it can easily heal together. The frozen shoulder thing is not any fun at all! And when my shoulder was starting to freeze up the one Dr. told me I needed to work towards raising my arm strait up to the sky to get it loosened. Well, that didn't seem to make sense to me since I was trying to let the bones mend together. I did some stretches and my normal everyday stuff trying to get my shoulder loosened but I have not gotten back any sort of normal ROM. I can definitely do more than I could because I can use my arm from the elbow down but forget anything that uses the shoulder too. I am worried about my shoulder becoming even more frozen after the surgery because it is already very compromised. Hoping that with my collar bone in line I will be able to relax my muscles more since they won't be taking the brunt of holding my arm up as much (and the sling will help at first too) and then my shoulder can get more normal. I know I will need PT and I am so looking forward to it! I can't wait to stretch out my shoulder!!! It feels so stiff and tight. And it has this whole time and the Dr. never told me any exercises or anything to do to help it. I looked up some exercises online and did some of them but again I was afraid of disrupting the healing so I could never decide which ones to do and how many. This whole experience is so confusing! Thank you for letting me vent because you are right ***** 81 you can only talk about your injury so much to your family and friends and then the are sick of hearing about it. And they don't know what it is like anyway. It's so nice to be able to talk with others that have shared this experience.

 

[Anything But]

Dane Girl, I would've started the pendulum after three weeks If I wouldn't have had the operation. I actually was permitted to start them the day after the operation, but officially the time was one week after it. 2 months after the operation I start working with a rubber band. Low movements first. And every time I have to think my scapula and keep it low. Frozen shoulder explains the pain you're having, I guess. Well, partly at least. It's supposed to ease off by itself in time even without physio, but the time it takes could be 1,5 years. It shouldn't be sore the whole time, though, in the end it's just stiff. Of course, not having it at all would be nicer and many have told me it's useful to have the physio, but tough since many say it hurts. I think you're right, bones that are not even close have no possibility to heal together. No matter what you do, they won't just form a bony bridge and be healed. And now I'm sleeping in the bed again!! I'm so so happy!

 

[willy81]

it is not possible to get a Frozen Shoulder just because you kept your arm in a sling for 3 weeks, you immobilized it or you use it very little. Frozen Shoulder is a pathological state, it happens when the Rotator Cuff tendons (Google it) dysfunction due to an injury. Your RC tendons did not get injured when you broke your clavicle. Your surgery is in 3rd of December, right? The only wise thing to do is relax and get ready for the big day, be confident that you do the right thing and wait for that day with great anticipation. I understand the psychological state you are now, you feel a little betrayed, abandoned but it is not possible other people to understand you if they have not been through this. And even if they have, OK they understand you but you still have to wait some days and this ruins your mood. You wished it could happen now, I am sure. When I had my accident I went straight to my doctor and asked him to do the surgery the day after and so it happened. I didn't had to wait days or weeks but I understand how difficult it is to live with a broken CB. I lived only for an evening/night. Don't pay attention to what your husband says, you need the surgery and you will realize what I am saying later, after a few weeks. Bones can't realign without a surgery, it is very simple and I can understand it even before my accident, I don't understand why some people can't. If you go back to this thread you will read my first questions after the surgery. I remember back then I asked if I am going to have the same strength as before. My shoulder was so weak after the surgery that I could not believe it would be the same again. A guy told me you will be 100% as before and he was right, I can confirm that even though I still have the plate/screws inside. I am very strong and I believe after I have the plate removed I will take my absolute former strength. If you feel your shoulder "frozen" just do this: Bend over and have your arm move back and forth or in circular like a pendulum. This is an exercise you will do after the surgery IF you feel your shoulder frozen. After the surgery you better keep your arm into the sling for at least 4 weeks, you better sleep with the sling as a precaution, the sling restricts your movements and it is not possible to move your arm, and you better put a pillow under it which will restrict you rolling to the side and place load on your affected shoulder. This is what I did and I didn't sleep on my shoulder for at least 10 weeks. Now relax and we. bsbs and me, are here for more help.

 

[willy81]

Dane Girl, I would've started the pendulum after three weeks If I wouldn't have had the operation. I actually was permitted to start them the day after the operation, but officially the time was one week after it. 2 months after the operation I start working with a rubber band. Low movements first. And every time I have to think my scapula and keep it low. Frozen shoulder explains the pain you're having, I guess. Well, partly at least. It's supposed to ease off by itself in time even without physio, but the time it takes could be 1,5 years. It shouldn't be sore the whole time, though, in the end it's just stiff. Of course, not having it at all would be nicer and many have told me it's useful to have the physio, but tough since many say it hurts. I think you're right, bones that are not even close have no possibility to heal together. No matter what you do, they won't just form a bony bridge and be healed. And now I'm sleeping in the bed again!! I'm so so happy!

If you want to play it more conservative, wait at least 3-4 weeks before starting the pendulum exercise. It is not a frozen shoulder, sometimes doctors would like to use "big" expressions to make people believe they are Gods. A frozen shoulder means the RC tendons are torn some how or they suffer of tendonitis. There is one thing you/we must understand, we broke our CB after a severe crash, fall, OK? The whole muscle system around this area has suffered a severe impact, OK? how is it possible to escape unharmed? simply it is not, thus our muscles have suffered quite a lot. and this is the reason we have/had pain around there. As I told you earlier I had one of the most severe crashes and some of my muscles came back 16 months after the crash. time will heel the muscles, no doubt.

 

[berygu]

Originally Posted by willy81
A frozen shoulder means the RC tendons are torn some how or they suffer of tendonitis.

*****, i disagree, frozen shoulder is when the shoulder capsule becomes inflamed and stiff, restricting ROM and causing pain.I developed Frozen shoulder from wearing my sling 24h a day for 8-9 weeks after the surgery. I needed 3 months of physical therapy to regain my ROM. I had lots of shoulder pain all this time i had frozen shoulder, my anterior deltoid was very stiff.
Now, i finally regained full ROM and my shoulder doesn't hurt anymore, but at 6 months post op i started to have discomfort where the plate is, hope i didn't broke the bone with all this PT. People tell me that at 6 months the bone is healed and a new refracture it's possible only if i fall again on my shoulder, not if i pull fitness elastic bands over my head. An xray can tell exactly, but i have done many before and it's not good to make one right now.

 

[willy81]

OK you can call it Frozen because the ROM is not normal but usually this term is used when tendons have a problem, and certainly it is more severe than the typical stiffness of a post op case or because you left your arm in the sling for some weeks. Anyway, I had very little stiffness, my ROM was almost the same in the 4th week mark when I raised my arm up but it took much longer to feel my muscles strong again

 

[berygu]

Originally Posted by willy81

OK you can call it Frozen because the ROM is not normal but usually this term is used when tendons have a problem, and certainly it is more severe than the typical stiffness of a post op case or because you left your arm in the sling for some weeks.

You're right, there are different causes that can trigger frozen shoulder (arthtritis, immobilization, injury) . Probably from immobilization is less serious, but i needed lots of rehab to be back.
*****, you think at 6 months post op pulling an elastic band (10 kg resistance) over my head cand break the bone again? I am 27 years old , 74 kg , 1.78 m .

 

[willy81]

x-rays can tell about the progress and show how much Hard Calus has been formed in the fracture site, when the black gaps turn into white it means that the two parts are connected with a more rigid connection, the hard calus which will turn to actual bone with time, Normally by six months the fracture site is almost full with it and it is not possible to harm your bone by lifting 10Kg, I could lift them by 3 months. So, you better have a recent xrays and show it to your doctor, he will tell you about your progress. Usually after such a long time only if you fall over in an extended arm can make your bone break again. But hey, you don;t need to lift that heavy to get all your muscles flexible again, even if you move your arm with 2Kg will bring them back online. You better work with relatively little weight and many reps, try 2kg and make 50 reps, this will make blood circulation increase more and bring more fibers back.

 

[berygu]

Originally Posted by willy81

x-rays can tell about the progress and show how much Hard Calus has been formed in the fracture site,
when the black gaps turn into white it means that the two parts are connected with a more rigid connection, the hard calus which will turn to actual bone with time,
Normally by six months the fracture site is almost full with it and it is not possible to harm your bone by lifting 10Kg, I could lift them by 3 months.
So, you better have a recent xrays and show it to your doctor, he will tell you about your progress.
Usually after such a long time only if you fall over in an extended arm can make your bone break again.

But hey, you don;t need to lift that heavy to get all your muscles flexible again, even if you move your arm with 2Kg will bring them back online.
You better work with relatively little weight and many reps, try 2kg and make 50 reps, this will make blood circulation increase more and bring more fibers back.

This is my last x-ray, taken at almost 5 months post op.

 

[Anything But]

***** 81, I don't have adhesive capsulitis, I thought Dane Girl had, as she said, and she has had the sling for 12 weeks if I remember correctly. I can have a T-shirt on and I've noticed for a week now that I raise my left arm without thinking it, whole getting dressed that is. I don't do really extreme abductions/elevations because that caused some pain at the PT. I don't have any problems with my shoulder yet. We'll see how it goes when I actually start the exercises. Berygu, I can't see the line of the fracture although it seems thinner at some point. It would be interesting to see a picture taken just after your operation. Your plate takes some of the strain anyway. Btw, how's your scar? Is it still attached to your clavicle still? I rub my scar (quite gently though) because I want the skin and tissues to move more freely, at least at some point. I also put some lotion on it, I don't know if it's so popular among men, the lotion I mean.