broken clavicle...surgery or not?

jp91

i'm not a cyclist either but a rugby player. last december, my collarbone was snapped in two in the middle. it was extremely painful, took a long time to fuse back together and took me a while to gain just about full mobility. i went back to playing last june and things have been fine, although i would still have discomfort and a little bit of pain in the area, especially after getting hit or falling on that shoulder. just last week, i broke the same collarbone in the same area. just a stress fracture this time around but i went to see a sports orthopedist who advised me that the best solution, if i wanted to keep playing rugby, was surgery with a hip bone graft + plate+ pins to straighten the bone but also to ensure that it consolidates properly once and for all. it wouldn't be mandatory but otherwise the bone would remain fragile, due to its angular shape, and i would probably have mechanical discomfort probably for the rest of my life. i am completely stressed about what to do. i am a 29 year old female, not ready to give up rugby, but also a translation student which means i need to be able to type! i've read some great stuff on this forum, but it just makes the decision-making process harder! i'd appreciate any thoughts on my case! thanks!

katiej1

System doesn't like email address changes, had to create a new user id.
I don't know about screws as mine is a plate but if it's sticking out enough to hurt after everything has settled down following the op then something should be done about it.
I got a small infection a week after the stitches were taken out but all cleared up with yet more antibiotics. Had xrays this week ( 4 wks after op), have another xray in 4 weeks so can't drive till at least then or raise my elbow out to side. just doing basic shoulder exercises to keep it mobile. Needs to have started knitting as the risk is the plate and screws become loose.
Interesting to see the xrays with the hardware in and the bone graft.

katiej1

I'd get advice from a physio. I broke mine in June and saw a physio for about 8 weeks (this was 6 weeks after the break), he said no swimming as it creates too much movement in the shoulder and it needs to settle down. Then as it hadn't healed it needed surgery so never got past that.

katiej1

Did it heal properly first time around? If you hadn't got back all the strength and it still hurt it may not have. If they heal properly they are supposed to be stronger as the bone thickens as it calcifies and aren't supposed to break in the same place twice.

I was assessed by the National Health (Britain) with an xray in one plane and told at 12 weeks I wouldn't do any harm by resuming normal activities. I tried. They also said my range of motion was quite good and didn't offer physio. I asked if I could have physio and there seemed some reluctance. Fortunately for me I have medical insurance and I sought a physio who referred me to an orthopeadic surgeon, partly to alay my concerns about the lump (which in my eyes was huge) caused by a mal-union, the end of the broken bone. It was also inconvenient as it was around my bra strap line.

I had surgery 5 months after breaking mine. It fused but not solidly. I got pain and my physical training wasn't progressing. I couldn't lift heavy things as I could before. Speaking to some people who's fused they were up and running in 8-12 weeks.

My surgeon took 2 xrays in 2 elevations (front and at 30 deg) not 1 as before and it showed the bone was not healing as it should. After about 18 weeks there was no change, whilst it was trying it wasn't healing properly. The decision was made to plate it. The screw wasn't offered as it is less fixed than a plate. About 1-2% need a bone graft, it wasn't expected to but mine did. Lucky for me he salvaged enough from the ends of the bone , which had tried to attatch itself, to use for the graft.

The inscision was 5 inches, slightly longer than he usually likes to do, it was a fiddly job apparenty. As a 34 yr old female I was worried about a large scar but I'm sure it'll be a good talking point at parties.

But, I'm glad it's all back in the right place. I was getting back and neck pain before, this may improve things.

At 4 weeks I'm using the computer ok but with one hand or just using the other hand in a still position. Did ache after alot of use. Would voice recognition software be an option?

Im going back in 4 weeks 2nd Jan for another xray. I'm still not allowed to drive or raise my elbow to the side until it's started to fuse. Too much stress on the plate and screws may cause it to come loose which would be another op. You do have totake into account it might stop normal activities for a while.

Good luck with your decision.

wadafark

Hi Guys,

I fractured my left clavicle in the mid-shaft after a bike accident on 6 Nov. It was not a complete break, from the X-Ray, I could see that it was kind of bent upwards and fractured and formed an angle, kind of like an inverted V.

Now I'm at 5 weeks of healing and I went to see the doctor, who told me that my bone had joined, but the new bone surrounding the fracture site was still calcifying as it showed up as being opaque on the new X-Ray, and not white as normal bones do. He called this the "fluffy" bone. The doctor also advised me to start carrying light weights of about 1 - 2kgs and move the left arm in a "cleaning the table" movement, which stretches the muscles under the armpit.

My concern now is that I have an upcoming physical fitness test in mid-January, which includes CHIN-UPS! And this test affects my rank promotion! Question is, after 8 weeks, is the bone fully healed for me to do chin-ups? Since at 5 weeks, it has already joined..

The doctor also told me that the healed clavicle will not be prone to fracture as it's stronger than it was before the fracture? How true is this? Then how come I've read so many stories of people re-fracturing their healed clavicle again? Will the chin-up fracture my clavicle again..

I'm in a huge dilemma. Help!

K/c

Hello everyone

I broke my collarbone while I was away at school on December 3rd. The day I broke the collarbone the hospital told me I would need surgery to repair the collarbone. When I came to my hometown I got a second opinion which told me that I probably wouldn’t need surgery and that my best route was to us the figure-of-eight bandage to heal. So it’s been a week of trying the figure-of-eight and the x-rays show there’s no change in my broken collarbone. I need to get back to school in January therefore leaving me not much time to take action.

So I’m confused on what I should do; stick with the figure of eight and wait it out or go ahead and get the surgery done.

wadafark

Hi K/c,

At one week, there won't be much of a difference because the separated bones are still trying to fuse together. You'll see a much noticeable difference at 4 weeks, after which your recovery will become exponential.

Try taking Calcium with added Vitamin D supplements. I took it from day 1 and my doctor was surprised that my bone had joined together at 5 weeks, although the new bone covering the fracture site has not fully calcified yet.

And wear the figure-of-eight clavicle strap religiously, according to my doctor, it helps to make the bump smaller. Mine's about the size of a marble.

My only concern now is chin-ups!

K/c

Thanks so much for the advice; I’ll definitely try the Calcium with added Vitamin D supplements. Hope I can get a speedy recovery like you.

Thanks again Wadafark

katiej2

The docs seem to differ in their opinions. I took calcium and lots of other stuff the first time round and it made no difference, I still needed an op. I was also told it wouldn't make a difference as to how the bone healed. In the uk they don't use fig of eight bandages as they say there's no proof they help in the healing process and they can cause sores as they should be tight. I just had a sling.

My surgeon is very good. His biggest piece of advice in helping bones heal is DO NOT SMOKE and don't take NSAID's for an extended period.

katiej2

If you have the op you won't be back at school in January. I've been off work for 5 weeks already. You would need to give it a few weeks to see if it heals, won't see much difference in te short time you've given it.
You could get a third opinion.

katiej2

The bone should be stronger but only if it heals properly. The calcification around the bone thickens it in that area so once it's fully healed it's stronger. Your doc and or physio should be able to tell from an xray if you should be doing chin-ups.
Just thinking, and I'm no expert, chin-ups target the back and biceps. Do you have to do push-ups? They might give you more problems.

Grammarsow

HELP - I broke my clavicle 6 weeks ago whilst racing triathlon in Florida - advice was to get it seen when I got home (back in the UK) as I would need a small procedure! Having seen my own GP he's sort of handed the surgery decision back to me as I have relatively good movement (not a full range), but still pain and week as a kitten and part union and calcification - I have another appointment mid Jan - I've posted my xrays, the first taken 21 November and the second on the 13 December - the 'bump' where the bone is sticking up - hurts like hell, especially driving (wearing seat belt) My aim is to run the Marathon D'Sable - rucksack needed - does the pain subside? do you get a full range of motion return? I'm terrified of not being able to swim again or at the same standard I was - opinions wanted PLEASE!!!!

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katiej2

Hi

Your GP is a general practitioner. You need to ask for a referal to an orthopeadic surgeon. Surely the expert should be making a recommendation to you based on your xrays, your lifestyle etc, not saying it's your decision.
If you had gone to A&E you would have a referral to a fracture clinic where in fact you see the surgeons registrar at 6 weeks and again at 12 weeks if it's not healed. I was told at 12 weeks mine was ok, I also had good range of motion. But I also went private and was told it hadn't healed. You should have 2 xrays at different angles and this didn't happen at the hospital (if you read back through the posts you'll get alot of info). I knew myself because I had pain and it wasn't getting stronger. Infact the lump seemed to be getting worse. My collarbone was plated 6 weeks ago, I wouldn't call it a small procedure. I assume you don't have health care?
Secondly a good physio will tell you what is and isn't right.
If you are based in the Midlands my physio is very good and works with professional athletes and their rehab, my surgeon is excellent and very experienced too. If you wanted another opinion you could see them.

The pain around my bump did subside. I had a high impact accident as I was thrown in the air off my motorbike. The soft tissue and ligament damage was quite bad. About 6 weeks afterthe accident I had a further 6 weeks of accupuncture and ultrasound to calm the area down.

Dan_jr

I fractured my collar bone in three plces on Monday and it is very painful. Should I have surgery to fix it? I ask because I play the drums and I want to know if it will affect my ability to play or not.