broken clavicle...surgery or not?

Discussion in 'Health Nutrition and Supplements' started by James Thomas, Jun 21, 2004.

  1. Garden Girl

    Garden Girl New Member

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    Well, I saw the doc this week, 8 weeks since the injury. The bone appears to still be trying to heal, although very slowly. There doesn't seem to be much more growth than 4 weeks ago. However, I've got great range of motion, about 90% or more. The doc's comment when I showed him my range of motion was, "You'd not have gotten much better than that with a plate and screw I'll tell you." He has agreed that we should continue to wait and see what happens over the next several weeks. So far it seems that my decision to wait and not rush into surgery was the right one, the doc even agrees. I don't need to see a physio. because as he put it "Your obviously doing enough good exercises on your own, a physio wouldn't do any better than what your already doing." Even though it's not joined yet, I'm feeling really good, although I do tend to need more rest than usual. I've done a little too much in the way of lifting this past week that I'm a little sore and very tired. I went to a friends for a party last night and ended up crashing on their couch until my husband came to get me to go home. I gave up using the sling at about the 6 1/2 week mark. Occasionally I might put it back on for a few hours at a time if I'm a bit sore or been too stupid in how much I lift. Since I feel so good, I'm tempted to get back into all my regular activities like biking, jogging, swimming and horse back riding but I'm doing my best to hold off. I'd rather heal right the first time around than suffer a second injury.
     


  2. Nicoleta

    Nicoleta New Member

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    Hello everybody!
    I guess you all know why I joined this forum....yeah, I am one of the "lucky" ones that broke a clavicle. It happened just 3 days ago, May 10, 2007, doing some mountain biking. My left clavicle broke pretty bad, sticking out through my skin and forming a nice tent. Went to Emergency right away, X-ray, sling and saw the orthopaedic surgeon next day. The bones are not toughing and there is a pretty good gap between. He said we could try to wait and see if it heals by itself, but there is a chance i'll need surgery, it's up to me......So I came home, googled the issue, got this forum (great resource), and made my decision.....I will go for surgery on Monday. I am a VERY active person, this last few days of staying in bad and not being able to do too much were the biggest pain (more then the physical one caused by the clavicle). So I hope for the best, a succesfull surgery without complications, quick recovery and back on the bike and other activities soon. BTW, does anybody know a good orthopaedic surgeon in Vancouver, BC? I have scheduled the op but don't know much about that doc.....so I am ready to cancel and wait if anybody has a recommendation. I just want a very good job done :p.

    Good luck to u all in your healing process and i'll keep u posted.
     
  3. gplama

    gplama Well-Known Member

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    In follow up to my break 9 days ago and having the bone pinned three days later - Yesterday (8 days after the break) I was able to complete a 20km ITT event without any dramas. I wasn't able to get out of the saddle and sprint (much) but this was a time trial, so it was just tuck in and pedal! I ended up with 2nd place!

    The first thing I thought after the break was "oh no, six weeks off the bike at the start of the racing season"... and after reading some horror stories I was prepared for the worst. So to anyone reading this thread looking for the answer of 'how long will I be off the bike'.... I guess it comes down to a case by case basis, 4 days was my experience! It'll be a few weeks before I'm nearing 100%, but the lungs and the legs won't need any re-training when I'm back into my scheduled training plan.

    cheers,
    lama
     
  4. waspo

    waspo New Member

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    Hi lama, I'm in Melbourne too. I wish I had your Sports Orth. Any details would be appreciated.....for future mishaps of course.

    I tried finding a guy to pin mine, but was put off surgery to let it heal naturally.
    After seeing my Orth last week with a follow-up X-ray, things seem to be on the mend.
    Calcium is slowly bridging over and I'm told my clavicle should be strong in about 6 months to a year.... What?!!!:eek:

    Looks like I'm forced to take it REAL easy til then. So, no gymnastics, minimal weight training and no motorbikes........well, perhaps I can sneak that one in.

    I don't know, I find this very disappointing especially when I see that you're able to get your bone pinned relatively straight away and of course, enjoy the improvements in such a short period.
    Are you having the pin removed at a later date?

    Thanks for posting, mate! I've been waiting for this.:D
     
  5. gplama

    gplama Well-Known Member

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    Hey waspo - details have been PMed, but here they are for the benefit of others: http://www.orthopaedicsvictoria.com.au/ Martin Richardson was my surgeon.

    The first thing I asked the emergency department was who do I speak to about having surgery to minimize down time. The awesome people at Epworth Richmond called around while I was there - the first surgeon they called wasn't willing to operate, Martin was! My referral visit to him was super fast. I'd done the research (mostly via this thread) and said to him "lets do whatever needs to be done to get me on the bike". He respected my situation and my urgency to get back on the bike and had me booked in the following morning at 7am for the operation.

    I was lucky that I was refereed to the right person straight away, and as the x-rays show, the break was full but not a nasty separation of the bones which may have made the procedure suitable. Although, I'm no expert in such things, I break em, they fix em :)

    The pin stays, it'll last longer than I ever will!

    Fingers crossed this info can help you out - it makes posting my experience all worth while.

    cheers,
    lama
     
  6. waspo

    waspo New Member

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    Yes, thanks mate!
    I consider this information highly valuable and time saving, especiallly for future Melbournites visiting this site.

    Thanks again and good luck!:D
     
  7. BottleCage

    BottleCage New Member

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    I recently broke my Collarbone for the third time. Previosly I had broken my right one twice when I was a teenager and they just let it heal naturally. This time I decide to break the left one. Went down knew what I did immediately. After getting up off the road and sitting down. I was able to check out the break, it was a "tenting" up the skin but not through it. I knew what awaited me at the hospital since "been there done that" after the X-rays and put the figure eight brace more x-rays the doctor said to come back tomorrow and speak to the surgeon. He thought I would need surgery but wanted to have another expert have alook. Sure enough the surgeon said he would recommend surgery but it was my decision. (the break ws pretty jagged and he was concerned I would cause more damage letting it "float around till it healed".) So I agreed to have the operation I asked what I would have plates/screws or K-wires He said he would have to see when he opens me up. Well I now have two 15cm wires(very similiar to bicycle spokes in diameter) running from the back of my shoulder through the Clavicle kind of like a sis-kebob. Of course the first couple days I was still hurting a bit I stopped taking any pain relief after two days. It has been 1.5 weeks since the surgery and I have probably 60% range of motion. After a week the doctor said I could get on my indoor trainer and I had no problems. I could put my hands on the bars and put weight on the shoulder with no pain. My experience has been very positive and I am so happy I can get back to doing something quickly. I am still cautious with the left arm and try to do as little as possible but the fact I have litlle/no pain and some range of motion already is great for me. My doctor said I will (if I have no complication) have the wires removed in 6 to 8 weeks after the operation. I am very happy with the result so far and hope to be back on the road this summer.
     
  8. jhshannon

    jhshannon New Member

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    Wow. Good showing! and lucky you, I guess. I opted not to have surgery (2 docs told me my clavicle, despite being broken in 3 spots, would heal quickly). It's been 10 weeks now and there is little if any sign of new bone growth, and to boot an MRI shows torn cartilage and impingement in the shoulder too. ROM is decreasing so I have to step up the physical therapy. I sometimes wonder if I shouldn't have just gone in for the sugery right from the start. I am traveling a lot over the next 3 months for work and pleasure so the scalpel is not an option.

    On the bright side, today I rode my bike for the first time in 10 weeks: went a whopping 4 miles (in NYC traffic, which is nerve-wracking). It looks to be a slow road to recovery but I'll get there....

    -jhshannon

    :) :) :)
     
  9. jetnjeff

    jetnjeff New Member

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    Any one ever hear of steroids (hormones) that speed Bone growth?

    Someone mentioned it to me. I looked up a few things on the web and although it is is scientificese, it looks like there might be something to it.

    My doc is also checking on using a sonic bone stimulator from exogen.

    Faster healing is what I am looking for. My 3 week X-rays were as expected. Figure 8 brace has move the bones together.

    The doc says I must be healing cause of the lack of pain.

    My range of motion is mostly back, but it did not hurt that much all along. I have a mutant MTBers high pain threshold though. So I judge my ROM on discomfort.
     
  10. skt785

    skt785 New Member

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    I've worn a bone stimulator for a few weeks now. There's no way to tell if it's helping. I seem to be healing fine but I have no way of knowing if I would have anyway.

    I wore one after my clavicle break when it wasn't healing and it didn't seem to help then, but my doc is very firm about my wearing this now in an attempt to do everything possible to aid in recovery. It's a little bit awkward but it's not visible and I've just gotten used to having it on. Probably not a bad idea to add in to your treatment regimen.
     
  11. Garden Girl

    Garden Girl New Member

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    I didn't have much pain neither. I'm at week 9 and have practically all my range of motion back. X-rays at 8 weeks still show the bone broken but new growth visible. I'm even lifting various objects of different weights with that side, although if I do too much, I feel sore. What info have you uncovered on these steroids? Where can I learn about them?


     
  12. Garden Girl

    Garden Girl New Member

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    My bone is broken in three places as well and two small pieces are floating freely out of alignment. Although I'm not healed yet, I'm doing very well. I have included as part of my healing plan, a calcium pill & an Echinacea pill every morning, spinch in my diet at least twice a week, and a special shake I make my self though out the week. It is made with liquid egg whites, vanilla soy milk with heightened vitamines, 2% milk, vanilla yogurt and some fruit usually raspberries. I'm sure all these things are contibuting to how well I'm doing since I have practically all my range of motion back and experience very little in the way of pain.
     
  13. jetnjeff

    jetnjeff New Member

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    Here are some links:

    http://edrv.endojournals.org/cgi/content/full/19/1/55

    http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/hypopit/gh.html

    http://www.urmc.rochester.edu/pr/news/story.cfm?id=1267

    http://www.med.wayne.edu/wayne%20medicine/wm2001/watson-ortho%20surg.htm

    http://www.ingentaconnect.com/content/apl/eid/2007/00000016/00000004/art00005?crawler=true

    http://www.aans.org/education/journal/neurosurgical/dec02/13-6-1.pdf

    While not hormonal:

    http://www.vitamins-supplements.org/herbal-supplements/comfrey.php

    http://www.manufacturingcenter.com/med/archives/0700/0700et.asp
     
  14. factory61

    factory61 New Member

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    FWIW: I raced motorcycles for a number of years and have broken around 18 bones in my body.


    IMO - Surgery always as a last resort, find the best doc available that specializes in that particular surgery, and make sure you don't rush back activities that may irritate the fracture and slow healing. A couple of weeks of patience can save you months/years of problems.

    I broke clavical, had it pinned and raced my motorcycle 10 days later (signed a new sponsor the day before fracture and had several performance bonuses attatched). The pin stripped, eventually poked through my skin, had to have it removed. I am still having issues a couple of years later as a result. Thought I was tough at the time and making the right decision. Looking back, I was foolish and whatever financial gains/bragging rights were'nt worth it.
     
  15. Garden Girl

    Garden Girl New Member

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    Wow, 18 bones! You must be a glutton for punishment. Thanks for adding your opinion. Having had so many bones broken, you've got to be some kind of an expert by now. Did you just have a pin or were there plate and screws too?
     
  16. factory61

    factory61 New Member

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    Tried to get by with just a long pin since it's less invasive. Don't recommend it if you are going to try and remain active. Plate and screws are much more sturdy, but they will probably have to disrupt some muscle and other "soft" tissue.

    It also depends how many pieces the clavical has broken into and where the fractures are located.
     
  17. axejunkie

    axejunkie New Member

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    Just thought I would share my experience here - I broke my collarbone playing flag football on January 13 (yes, flag football - another player dove and landed on my chest while I was on the ground). I saw an orthopaedic surgeon and he felt surgery would be the best route, saying there was more than 2cm of separation and I would likely have a shorter bone and less range of motion without surgery.

    I had surgery 12 days after breaking it. The doctor pinned the bone together and I was in a sling for 10 days. Lots of pain and percocet was my best friend for a week or so.

    I started physical therapy at 6 weeks and that went for a month. I made some good progress and got most of my motion back.

    I had follow-up surgery on May 17 to remove the pin and that was much easier than first one - took about 20 minutes to perform and I didn't need a sling. I'd say I'm at 90% now, just need to get some strength back which I'm working on.

    All in all I'm satisfied with how things went. Course I'll never know how things would've gone without surgery, but the shorter bone reasoning was enough to scare me. Hope this helps some of you in the same situation I was.
     
  18. santanaf

    santanaf New Member

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    I wanted to take a minute to share my story since I found so much useful information on this board. This thread helped me to make my decision to go for surgery.

    I am a very active 29 year old male. I lift weights 4 times per week, play baseball and softball, run, cycle, and work on my house, doing everything from electrical to plumbing to heavy contrsuction in my spare time. I am a computer programmer by day.

    I had a trip to the Bahamas scheduled beginning 5/30/07...

    On 5/22/07 while playing center field in a softball game, a ball was hit into shallow left center and I was sprinting to the location. Going to make a back handed catch I decided the only way to make it was to lay myself out. As I dove the ball carried under my and my glove did as well, this placed all of my momentum and weight onto the top of my left shoulder, which forced my shoulder down and fractured my clavicle.... hence this post.

    Here is the initial x-ray http://www.santantonio.net/files/xray.jpg

    I immediatly knew it was broken. The clavicle end was pushing up against my skin and I could clearly feel the bump where the skin was slightly tenting. The pain was bad, but not terrible. I was able to run off the field after it happened yelling "I'm out I'm out". I called my wife and told her I was broken and to meet me at the hospital.

    Since I drive a manual transmission, with the encouragement of my teamates I decided to call an ambulance. The ambulance came and the worst part was the ride in the stretcher over the bumpy gravel road. I didn't take anything for the pain because I really don't do well with any sort of narcotics. I get nausious easily and vommiting all night is way worse than the pain.

    When I got to the hospital I got the above x-ray taken and was given a sling. When they were putting the sling on me the pain was so bad that I started to vommit. Once that was done and some color came back into my face, I was ready to head home. Before I left the dr. on call talked to the ortho and told me the break was severe enough that I may need surgery.

    By the morning of 5/23/07 the pain was managable. I slept on and off and kept waking myself up my moving my damn arm... stupid dreams. I was taking ibuprofin to keep swelling down, but that is all. We scheduled an ortho appt for later in the day.

    The Orthopedic Surgeon I met with was part of Commonwealth Orthopedics in INOVA Alexandria complex. His name is Daniel E. Thompson. My wife and I were very happy with him and with the information that he presented. He told me that I would probably heal without surgery but there was the potential for a non-union. I gave me a timeline of 6 months with 2-3 in a sling. He then told me that surgery was an option, but totally up to me. He would use a titanium plate to join the two halves. He said the sucess rate is better, same 100% recovery time of 6 months, but I would be more comfortable in the short term. Without surgery I would heal with a shorter shoulder and a lump, with surgery I would have symetry again but would have a scar. I told him I was taking only ibuprofin for pain and he was fairly surprised.

    I opted for surgery and was scheduled just two days later by Dr. Thompson's excellent surgery scheduling assitant. They worked with us to get us an appt on 5/25/07 at 1:00 pm.

    I didn't eat from 12:00am on the day of surgery and drank only two sips of water.

    Between the initial consult and the surgery I took nothing for pain since it wasn't really necessary. I was having surgery at INOVA Alexandria Hospital in Virginia, and met with my anesthesiologist regarding my concerns with anesthesia. She performed a local block on my shoulder and put me under very light sedation. I don't remember much about that day, although I had many conversations with the Dr. about treatment, rehab, the sling vs figure 8, and even an patient who broke the titanium plate... I have no recollection of this.

    After surgery I woke up around 5:00pm feeling very nausious with my sling back on an a lot of iodine on me. My left arm was 100% numb and dead to me. I could feel nothing, it was so creepy. As I woke up I was very dizzy and started vommiting a lot when I started to be moved. I was perscribed Phenergan for nausea and Percocet for pain from the intitial hospital visit, and abenol (I think) as a stronger than advil alternative, but I was hoping to take nothing.

    On the way home I kept throwing up in the car and when I got home I went straight away to bed. I slept the rest of the day on and off and didn't eat anything. The pain wasn't anything yet, but my arm/shoulder was still dead and the dizzyness was severe, so I laid very very still. The last time I threw up was at 8:00 pm

    At 11:15 pm I woke my wife up and told her the pain in my sternum area was starting to come in a little bit, so she gave the the abenol in hopes of heading it off. The feeling was slowly coming back into my arm. The Dr. said to stay ahead of the pain with painkillers, but my nausea was keeping me from taking anything. I then woke up again at about 1:30 pm with what felt like an Elephant standing in the middle of my chest. The ibuprofin I was taking was doing nothing. I was literally writing in pain, but I didn't feel dizzy or nauseaus anymore... woot.

    I tried to just take the pain but I couldn't. After a conversation with the on call Dr. and 4 hours of excrutiating pain in my sternum and shoulder, I took two percocet and was out and asleep without pain in about 15-20 minutes. I slept soundly. When I woke up around 12:00 pm, by jerking my arm again, I didn't have much pain, but I didn't much feel like getting out of bed. After a day of eating saltines and bananas, and drinking Gatorade, I ventured out of bed around 5:00 pm and headed to the television. I didn't have much pain but was taking 1 percocet every 6 hours that first day.

    By 5/27/07, Sunday, I was not taking painkillers during the day only to sleep, and that was only because I was scared of the pain from the first night.

    My mobility after surgery was greatly improved, and the scar is not too bad. My trip to the bahamas was decidedly low key, but not painful. By day 3 post opp I was completely off of pain meds and had little to no swelling.

    My followup appt gave me this cool x-ray http://www.santantonio.net/files/screws.jpg

    I am 10 days out and I had my stitches out and had a good conversation with my Doc. Right now the main problem is that am *without* pain. This means I don't really know my limitations. I don't feel like I need my sling at all, but I wear it to protect myself from people when taking the metro to work. I need to keep stopping myself from doing things I shouldn't now.

    Physical therapy starts on Monday, 6/11/07, and I hope to be completely without sling by 6/25/07. I will post back here as time progresses.

    If anything, I can say get the surgery. By coincidence, a co-workers 22 year old son had almost the same break doing almost the same thing within 1 day of mine. He has opted for the natural healing method with sling. He is still in a lot of pain right now and has limited mobility.
     
  19. santanaf

    santanaf New Member

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    Well, I am now at 1 month post op. Everything has been great for the last 2 weeks especially. As I stated in my previous post, surgery was good, somewhat painful in the short term, but has since been fine.

    The only serious pain I've really had in the last few weeks was at my CS joint on my sternum. This was mobilized a bit much during surgery so it feels a little off, sort of a sharp pain from time to time, but has been greatly reduced from weeks 3 to 4. I ran my right (non injured) shoulder into a door frame while trying to avoid someone with my slinged arm, and the jarring movement it send through to the CS joint on my left was terrible pain, but that is more or less the extent of the pain I've had.

    I go to the Dr. today for my 1 month followup and I began PT about 2 weeks ago, 6 sessions so far. The PT has been wonderful, all passive ROM excercises, but just getting flexibility back into my weakened shoulder. After the first session I felt like I went from 30% to 60%. Now I am fully mobile in my injured shoulder, and oddly, I have a greater ROM in my injured shoudler than my uninjured one. Go figure.

    PT is Mount Vernon Invoa Physical Therapy, working with Lisa, Laurie, and Beatrice. As I said before, all are great.

    So my followup today I am guessing he will say, "You can stop using the sling, you can start stregthening in PT, and keep taking it easy."

    I'm guessing another 2 weeks until the bone is completely healed.

    Update on co-workers's son, he's still in a sling and still having a good deal of pain. He has limited to no use of his injured arm still. We will probably be 100% about the same time, but getting there for him is a harder journey.

    The cost of my surgery was just north of $7,000. Thank God I have insurance. ER visit, PT, and Surgery will total about $10,000 :eek:

    Wish I hadn't tried to catch that ball.
     
  20. phil_norhtstar

    phil_norhtstar New Member

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    Very glad alll went well on your orif.
    Got my left clavicle broken on May 14th. Had my orif performed that night too. All went well actually. No nausea, no dizziness, scar is quite long. About 10cm or so. Looks fine anyway. I was hoping to go back to work by the end of June. I spent 2 weeks vacation before travelling to city where i work. About an 8 hours drive. Just so, i had to see a new ortho for my follow up check ups. My first ortho gave me 6 weeks timeline for unpinning. My second ortho had to observe that period too. So, my second ortho decided to remove my pin on the said timeline after reading the result of my x-ray. It shows a good callus formation surrounding the break, good alignment. I am not into meds actually but i know that there's no bony union yet. Really! But then i have to trust what my ortho says. So my pin was removed that day. Unfortunately, i had it broken again. I don't know how it happens but i woke the next morning with a pain and bump in my shoulder. I knew it was broken, i could even hear a creeking sound everytime i move my shoulder. Now i am recovering on a figure 8 brace 'coz my ortho discourages orif on the clavicle. I insist to have a second surgery though. See, all the pain and waiting for recovery from my surgery was wasted. I don't know if my bone has still the chance to unite hearing that an orif might hinder the bones from healling naturally. I have to wait for an additional 4 weeks to see the result. Imagine how much time i've lost for just a simple crack on my shoulder? I don't know what to do, I want to blaim my ortho for what happened. I could have waited long enough until my bone totally unites before unpinning. Could somebody give me an opinion. Thanks!!!:(:mad::(
     
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