broken clavicle...surgery or not? - Page 32

Hi all
Just found this site after serching for problems with bone graft to broken clavicle. Thought I would share my experience.
In August 2006 I had an accident while mountain biking in Las Vegas (great ride).
I was diagnosed with a broken clavicle and bruised lungs. They told me to just let it heal naturally. 3 weeks later and 3 further visits to hospital, I was eventually operated on where it was discovered that a fragment of the bone had actually pierced straight through my subclavian artery. I had been internally bleeding for 3 weeks. I had to have an arterial vein graft and a massive blood transfusion. I also had a metal plate on my clavicle.
Unfortunately 6 weeks later the plate lifted so I went back in and had a bone graft from my hip and a replating. I have two very nice scars on my shoulder and a metal plate that runs pretty much the length of the clavicle. I also suffered nerve damage from my neck across my chest to half way down my left arm. The surgeon described me as a walking time bomb so I'm pretty lucky to still be alive. If they hadn't of operated I certainly wouldn't be.
I have about 90% movement back in my arm which is pretty good and suffer some aching around the hip area after heavy excercise and a few twinges in the shoulder. Apart from adjusting my excercise routine in the gym slightly I am pretty much back to normal. Got back on my bike 4 months after the last operation.
I basically went through hell before they decided to operate but after that first operation, even with all the complications I felt so much better and recovered pretty quickly under the circunstances.

NJones, What do you mean when you say the plate lifted? It came loose? If so, how? Did the doctor incorrectly installed the plate, or were you lifting weights to soon afterwards? You should elaborate on this for the new people who just had plates installed so they can be aware and some of us can be informed.
Glad your ordeal is over and you can live a normal life.
Thanks.

During my first operation they had to deal with the damage to the artery first before plating the clavicle. They didn't know about the artery until they opened me up. By the time they repaired the artery (4 hours) some bone fragments had been out of my body for too long so had to be discarded. They therefore didn't have enough bone available to put a full plate in so put a short one in just to get me into recovery. They warned me that I may have to have it replaced after a year or so. Unfortunately I woke up one day and had a large lump on my shoulder (tennis ball size) X-rays showed that the plate had just lifted slighly and hence the second op to have the bone graft. I was far from excercising at that point and just undergoing the Physio treatment so I guess it was just a weakness in the original plating.

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That make sense...i suppose. becaue I've read where some people had started weight training a few weeks after their surgery and end up bending or loosen up the plate.

Hello everyone - I have been reading your posts over the past hour or so as my 22yr old son has an operation on Friday to remove his plate after 7 months. He broke his collar bone on his mountain bike last April, and it was a bad break (the end was completely broken and had settled a few inches below the rest of the bone) after a week or so the doctor recommended surgery. Since then, although James has got good movement in his arm he has had a lot of pain and discomfort - which has progressively got worse - so much so that he has actually said that he is going to stop driving (he loves his car) because the pain is so bad. The surgeon is happy to take out the plate as his collar bone has healed well, but the question is; will all this post-op pain he has had go away? Oh, and another question; why did he get the pain in first place?? Sorry if this has been answered before, but I didn't have the patience to trawl through all the messages!

It has been almost a week since my surgery where they put a titanium plate in with screws and a graft from the hip. The hip is fine..no pain other than a little ache from time to time. The shoulder is sore still but getting better. I have cut my hydrocodone in half unless I've had extra activity and am especially sore. I do my exercises three times a day (or more). The pendulum and the table presses (for elbow flexion and extension). My Dr ordered a bone stimulator for me to use. I'll start that in the next day or two. I just want to give the incision a little more time before I start sticking more stuff up there. I will attempt to upload a picture for those of you that would like to see the scar. This pic was taken about three days after surgery.
My Doc talked about folks having problems with the plate bending or breaking if they try to go out and do weight exercises before the bone is completely healed. The idea is for the plate to hold things in place while the bone repairs itself. Healing takes time, time that varies by individual. This is such a great forum but one must consider that there are no hard and fast rules when it comes to how your bones are going to heal and that every fracture is different. And that surgery is not a one-size-fits-all magical cure.

I want to use the scarzone cream but am not sure how soon I can start using it. If anyone has done this...how soon did you start?

PS. I cannot post the picture. I do not know how to use URL. Sorry If you want to see...I can email it to you. my email is petermolly02@msn.com

Maybe he injured his rotator cuff??? Hopefully not! Did he do PT? After I took off my sling, my shoulder was killing me for about 2 months during PT.
Why did you not ask the orthopedic about the pain when you saw him/her? If it is a problem, you are going to have to see him again to get his pain fixed anyway.

Curb, thanks for the reply - he didn't have physio - wasn't offered (English national health!) but he was using his arm fairly freely quite soon after the op. He did tell the surgeon hence why he said he'd take the plate out. I have just asked him what the pain was like - and he described it as a constant painful ache in the plate area that got a lot worse not better and, he said twice as much when it got cold. He is home from the hospital now, went down for surgery 9:30 this morning. Surgeon wants him back in fortnight at the fracture clinic to check on progress. He's pretty spaced out at the moment, must be all that morphine - much managing to eat an Indian takeaway with one hand! Lets hope the pain will go now the plate is out.

Elsiehandle,
I broke my clavicle and separated my shoulder about 5 months ago. I too have had significant pain in the incision area as well as down the length of my front deltoid muscle after my clavicle was plated. The surgery did nothing for my separated shoulder so I have quite a shoulder bump since my clavicle is not properly attached. My pain has persisted since my accident and surgery. I don't know if it has gotten worse but it hasn't gotten better either. After my surgery, I had a crease / bruise on my front deltoid. I assume this was from traction applied when they opened me up to manipulate the clavicle for plating. I asked my surgeon about this but did not get a real answer. I don't know about English public health, but surgeons in the US don't have much bed side manner. I asked my family practice doctor and he told me that I had quite a bit of tissue trauma from the accident as well as from the surgery and that would just take time to heal. How much time? No clue.



I have been to the physical therapist many times since my surgery. With the PTs help I have rebuilt much of my strength and mobility. The pain however persists.



All of those involved in my recovery; orthopedic surgeon, family practice doctor, and physical therapist have encouraged me to have the plate removed if the pain persists. I still have a few months before the bone has healed and they tell me there is no hurry. I have to admit I am hesitant. If my pain was caused by surgery trauma why would more surgery help? Also, I don't seem to be able to get straight answers from the surgeon about the complexity of the removal surgery. I have an incision scar about 5 inches (12.7 cm) long, just above my clavicle. Will the removal scar be just as long? Will they have to apply as much traction to remove the plate as they did to put it in, causing more trauma and ultimately more recovery time? I just get that "don't worry we'll take care of it" answer. I really don't care about the scar. Another scar wouldn't make the scar plus clavicle bump from the separated shoulder look much worse.



Since I am in many ways in the same boat as your son, I would be great if you keep the forum posted.

Hummer, what do you mean by traction, what is it, or that? Also, 5 months and you have significant pain? Or just minor pain that sometimes is annoying?

I have minor pains and it's been 4 1/2 months since I had my plate. I have some pain and tenderness in a small section in front of my shoulder about the circumference of a golf ball and that area used to be numb. Maybe the nerves are coming back.

But if it significant pain you are having, and, what significant means to me - is close to extreme, important or big, which means in medical terms means something is seriously wrong and I find it difficult that everyone is not taking you seriously about this pain.

Please elaborate more if you care to.

Hi Hummer; the bed side manner in the UK is as hit and miss as I'm sure it is over in the States...! Unfortunately I wasn't with James when he saw the surgeon post-op (about 4 times or so) so can't say exactly what the surgeon said to him with regards to the pain he was having - but did say the plate should come out. James isn't the most communicative with his mum as most sons aren't! I can tell you however, that his original scar sounds much the same as yours 5 inches along the clavicle, and I have been told (I haven't seen it yet) that they used the same scar line to open him up last Friday. James did elaborate and said he had also had pain going down his arm and into his elbow (nerve pain?) but it definitely was causing him grief when he did things like putting on a coat, driving (as I said earlier he was even going to stop driving - which must mean that it hurt) and I remember once when his girlfriend playfully thumped him on the shoulder he really did wince with pain (that was Christmas just gone). As of yesterday, he has movement back in his arm albeit slowly, and he can carry a plate of food for instance. He didn't take any painkillers either, because of the drowsiness - but obviously if it was hurting him big time, I'm sure he would have done. He is going back to work tomorrow because sod's law he started a new job last week, and can't afford to take the time out, but I'm worried because he has to commute into central London on the tube (subway) and believe me that's crowded! I will keep you updated with his progress - it'll take a couple of weeks for the bone to heal from the screw holes, and then we'll see if the residual pain he was getting goes away.

Hope all goes well with you..

Elsiehandle,

Thanks for the reply. I really do appreciate the information. It looks like I am on track for a similar experience. Occasional updates would be great.

I often travel on business to London. I have been on the tube often during rush hour and know how packed it can become. Tell him to wear a sling. At least those that see the sling will try to keep to themselves.



Curb,

With regard to the "traction" I mentioned. Perhaps that is not the correct term, but I believe after they made the incision on my shoulder they had to pull the skin back out of the way to make room for all the bone manipulation, plate placement, and screw attachment. Any time I have seen a surgery performed on television, they place hook like instruments with rounded or paddle like tips under the skin and just pull it back opening up the incision so the surgeon can see internal area of interest. That pulling and opening I believe is called "traction." That traction, although necessary, causes soft tissue trauma. This may be just bruising but it can also cause nerve damage.

Elsiehandle mentions that in her sons second surgery an incision similar to the first was made along the scar line of the first surgery. Well, ouch, the first 5 inch incision wasn't that much fun. Now, plate removal should be simpler than putting the plate in. For one, the bone does not have to be brought back together. I should be as simple as open, take out the screws and gently pry off the plate. How much soft tissue trauma will that cause? No one seems willing to tell.

Hummer - his first day back to work was sore! By 11am he was really aching (he is a desktop support tech) and his left arm was also giving him jip because he was having to use mouse and keyboard with that hand! Luckily they let him go at 3pm to miss the rush hour. He did use his sling on the tube and at work - and he said that wasn't too bad; but it just makes me cringe to think that someone'll bang into him! Actually - I slapped him in the arm yesterday (ooh it made me go all funny when I realised!) when he made a cheeky remark to me - and the look he gave me! Blimey - can 22yrs olds sulk!

I will definitely keep in touch over the next few weeks.

PS very nosey I know - but where do you work when in London? (just curious)

Hey all, I'm three weeks out from my surgery and doing well. I am typing this message without any problem and have gone back to work. I still ache a lot and am working on stretching the muscles slowly. No lifting, pushing or pulling. I am back to sleeping in the bed instead of the reclyner. Although I'm not real comfy yet. I am wearing the bone simulator faithfully. The scar is not too bad really. It is a little sensitive of course. But all in all I am happy I went ahead with the surgery. I feel like the recovery from the surgery is easier than after the accident happened. I'm looking forward to my first x-ray with the plate in. I think it will put my mind at ease to see what it looks like in there.

If I could figure out how, I'd post a picture.
Thanks for sharing all your experiences! This forum has been a huge help to me.