broken clavicle...surgery or not?

[alienator]

Does anyone else have any input based on my xray? I feel like I would be a good candidate for surgery. It's been over 4 weeks since I broke it and it's still giving me constant pain and discomfort. Also, when I turn my head to the right I get a piercing pain at the fracture sight which shoots down to my elbow. Have I done some nerve damage? I can actually see the tendant travelling down my neck and over the fracture site, maybe it is interfering with that?

Thanks again, you've all been so helpful.

First, there shouldn't be a tendon running over the fracture. Tendons don't insert mid-shaft like that. They do very near the bone ends. You're asking a lot of questions that should be directed toward a doctor. Nerve damage? Of course it's a possibility.

What you need to do is get a second opinion. Also, anytime you don't feel a doctor is being responsive to your questions you should seek another doctor. Definitely find another orthopod. Now's not the time to be searching for a someone that will do the exact procedure you want. If you find another orthopod, and he/she says they'll fix it with plate and screws, take it. It's likely you need that fixed sooner than later. Surgeries tend to get more complicated and more painful the longer they take place after the initial injury (especially surgeries on deformities/non-unions such as yours).

As for finding the next orthopod, you can ask friends and family for recommendations. You can call an emergency room and ask who the orthopod on call is. Another is to pick an orthopedic group that covers a lot of specialties. It can be a challenge sometimes, but keep at it. When I broke virtually everything around a shoulder girdle, the alleged best shoulder guy in the city refused to see me. He said my shoulder was too high risk for him.

Good luck with your search and collarbone.

 

[Farmguy]

Does anyone else have any input based on my xray? I feel like I would be a good candidate for surgery. It's been over 4 weeks since I broke it and it's still giving me constant pain and discomfort. Also, when I turn my head to the right I get a piercing pain at the fracture sight which shoots down to my elbow. Have I done some nerve damage? I can actually see the tendant travelling down my neck and over the fracture site, maybe it is interfering with that?

Thanks again, you've all been so helpful.

From when I broke mine, I was told it will not really start to knit till almost 6 weeks and mine hurt for a while longer than that, 2-3 months I think, full strength not till Jan and I broke mine in August. Calcium starts building at 5-6 weeks in a soft mass than slowly hardens to bone over a few months, pins are just a "cast" placed inside to allow a quicker return to normal life, the bone will still need to time to heal.......patience.....patience.....patience.
Mine was broke it 2 places, z type pattern, I still feel a twinge once in a while still, broke last year.

 

[alienator]

From when I broke mine, I was told it will not really start to knit till almost 6 weeks and mine hurt for a while longer than that, 2-3 months I think, full strength not till Jan and I broke mine in August. Calcium starts building at 5-6 weeks in a soft mass than slowly hardens to bone over a few months, pins are just a "cast" placed inside to allow a quicker return to normal life, the bone will still need to time to heal.......patience.....patience.....patience.
Mine was broke it 2 places, z type pattern, I still feel a twinge once in a while still, broke last year.

If that's what you were told, you must have had a very unusual case. My clavicle was in 4 pieces and in need of surgery; however, the surgery couldn't be performed for fear of making permanent some right shoulder/arm paralysis that I had after the accident. Still, within 3-4 weeks, I was in aggressive physical therapy, and at 6 weeks the fractures had healed enough to be released from the orthopod.

Pins, plates, and screws aren't just forms of a "cast." They're intended to hold bone ends in good approximation for good, quick healing. They're used to hold grafts in place. They're used to hold bone ends in position to prevent shortening of the bone as it heals, and they're used to hold bone ends immobile in cases of slow healing or non-unions. Full strength is not only a function of how well the bone heals but also how quickly a person resumes normal activities.

 

[Mihai_Mishu]

Hello guys! I found a lot if interesting facts about broken clavicles here, thanks! I broke my right one yesterday riding my bike in a crazy way, in the middle of the bone and the gap was big between the 2 ends and after the second x-ray, it had shortened but still the doctor was leaning towards surgery, an I really want to avoid surgery. It was not painful, I only felt pain when moving my arm, and even then not much. The doctor "propped" me up an said to come back on Tuesday for some further decisions. I really want to avoid surgery because I'm not keen on their technology here, I'm afraid of infection because it's summer... and I have enough time to take care if the natural healing process. Now, a day after it still does not hurt unless I move the arm to much. I'll try to post some news on Tuesday about how the visit to the doctor went. Take care! And please give me feedback on what you think of my situation if you can. Thanks!
P.S. it's my first bone fracture ever, I'm 22 and I'm a keen cyclist since...well since I was very little and I'm not going to give up cycling after this accident, just gonna enjoy it without jumping or doing crazy stuff.

 

[buggerit34]

I broke my clavicle June 21st (pretty painful but still was a fun ride prior to the fall). I have been presented the option of surgery or the old fashioned "let it heal as is". I have never broken a bone in my 33 year life span and am weighing the pros and cons of surgery. I would like input if you have experience. I already have back problems so I am leaning toward the surgery in order to alleviate potential future complications. Please let me know what your experience has been. Thanks!

Sounds like me, first bone break @ 34. My break was near the shoulder joint. First Dr said let heal, second specialist said let heal if your not too active or surgery if you want to play tennis properly again for instance, but also cleary outlined risks of surgery. I went for surgery and for me, best decission I made. My more detailed thread is somewhere within this forum, but in short I was good 6-8 weeks after surgery. Won a golf event 10 weeks after surgery, had the screws & plates removed 8 months after surgery (optional but I wanted out) collar bone a little tender for 2 weeks after screws removed but coplete recovery with full movement and scar that isn't so bad. Now over 12 months since plates removed and all good. Very gald I did not wait and see as per 1st Dr's recomendations. Good luck

 

[stacenut]

I definitely recommend the surgery for a faster, more comfortable healing period. I broke my collarbone while playing wallyball on an all mens (except me) wallyball team. My teammate went for my play and crushed me against the wall with his body...I weighed 124 lbs, he weighed 250! My doctor initally said it would heal on it's own, however 4 months later I was still in pain and had limited mobility as my shoulder had frozen up as well. The surgery was painful the first few days, but no more painful than the initial break. The physical therapy was the worst, but it finally worked as the plate kept everything from moving.

That was 3 years ago and today I have full mobility back. I have occasional pain, however that is to be expected with any fracture. I have opted to keep the plate as it actually adds the bone line of my collarbone...people really can't even tell as my surgeon was incredible and my scar is paper thin....no thick scar tissue! I only wish I had opted for surgery initially as I used a lot of my sick leave while I hoped it would heal. I've been told that surgery isn't offered unless the doctor sees that it may not heal on it's own...clavicle fractures are usually not operated on.

I wish you the best of luck and health....I hope this helped you.

Stacenut

 

[Clavicle]

Super thread - best on web!

I was wondering whether anyone had much experience with complications from ORIF surgery.

About 6 weeks ago, a motorist turned left into the cycle lane I was cycling along and I went over his bonnet. Fortunatley, I got away relativley unharmed thanks to cycle hemet, but I did sustain an open commutated fracture to the distal third of my clavicle. I had an ORIF that day, together with wound debridement etc. Recovery was going tremendously until a fortnight ago, when the wound started looking a bit odd. Went back to hospital, and it turned out that the screws had bent and the wound had got infected. The next day I had all the metal work taken out and given strong antibiotics to clear the infection.

The good news is that my clavicle is now infection free. The bad news is that the two parts of the clavicle are obviously overlapping - I can both see and feel one the end of my bone through the skin and the overlap is very obvious (as well as very uncomfortable - it keeps swishing around, however still I try to keep it). Further, my doctor says that he doesn't think it will heal on its own, but that nothing can be done for about a month until all the soft tissue has healed.

I'm finding this news pretty frustrating - I'm a v. active 27 year old female, and to be told that I have to wait another month to get back to where I was 6 weeks ago is very annoying (as well as messing up most of my summer plans).

My doctor has been absolutely brilliant through all this, so am really just posting to find out whether anyone else has had a similar experience / whether there is light at the end of the tunnel. Alternatively, does anyone reckon it might be worth getting surgery sooner rather than later?

Thanks!

 

[bridsmath]

Hello again everyone!

I have seen a couple of doctors so far and am having a hard time talking them into having the surgery. I am a bit over 1cm overlap and from what I understand most doctors prefer to let that heal naturally. I personally am very uncomfortable with my bone healing in the shape that it is in and feel that it will cause me problems in the future if it is not properly aligned. Does anyone have any suggestions for me to convince my surgeon to operate? I feel like my mind would be at peace knowing that my bone is healing straight, whereas right now I am having a lot of physical and mental discomfort/pain 6 weeks into the natural healing process. I live in Canada so our health care is free and I cannot just hand him money to do it

Thanks again!

 

[alienator]

Hello again everyone!

I have seen a couple of doctors so far and am having a hard time talking them into having the surgery. I am a bit over 1cm overlap and from what I understand most doctors prefer to let that heal naturally. I personally am very uncomfortable with my bone healing in the shape that it is in and feel that it will cause me problems in the future if it is not properly aligned. Does anyone have any suggestions for me to convince my surgeon to operate? I feel like my mind would be at peace knowing that my bone is healing straight, whereas right now I am having a lot of physical and mental discomfort/pain 6 weeks into the natural healing process. I live in Canada so our health care is free and I cannot just hand him money to do it

Thanks again!

If you're having a difficult time convincing orthopods to operate, there's likely a reason. Orthopedic surgery can and does have serious potential side effects and hazards. I think with all the cyclists and athletes in general we see getting surgeries done for collarbones, wrists, and etc, we've mistakenly come to believe that is the norm. It's not. Those athletes and their doctors are operating under different circumstances, complete with different priorities.

As for healing straight, you'd be amazed at how effective the bone healing process is. Granted, once healed you'll have a knot about the ol' fracture site, but the bone will look a lot more normal than you think as the body reabsorbs bone in the healing process.

My inclination would be to trust the doctors. You got a second opinion. That it agreed with that of the first doctor isn't insignificant. Almost always the best advice is to be a good patient and follow the doctor's orders, especially regarding activity, limb use, and etc. It seems a pain in the **** now, but later you'll be happy you followed his orders.

 

[bridsmath]

Thanks again for the reply, Alienator. I'm very well aware of the risks of surgery and actually went over them with my first doctor who said he would do the surgery but recommended I wait and see how it heals. The reason I chose to think about it and discuss it at my followup (Aug. 10th) is because, like most people I'm sure, it makes me uncomfortable going against a doctors recommendation. I'll have to explain to him everything I am thinking at my next consultation. I am also being told by friends and family that if the bone is able to heal on it's own then cosmetic surgery is an option down the road. I know a few young ladies who have had their "knot" recontoured by cosmetic surgeons. I know to most people that sounds absurd, but this accident has been causing me a bit of depression and I am having a hard time coming to terms with the asymmetry of my shoulders. The tenting of my skin is so prominent that it is very visible even when I wear a t-shirt (the overlap is jagged and pointing up). This probably has to do with the fact that I have a small frame. This along with the functionality and mobility of my arm are what leads me to the plate/pin surgery. It is my understanding that the plate can be removed at a later date, so the protrusion of the implant would be temporary and I would be willing to deal with that. I am also willing to trade for a scar which would not be visible through my t-shirt. I hope someone out there understands where I'm coming from. Thanks again for all of your help.

 

[alienator]

Thanks again for the reply, Alienator. I'm very well aware of the risks of surgery and actually went over them with my first doctor who said he would do the surgery but recommended I wait and see how it heals. The reason I chose to think about it and discuss it at my followup (Aug. 10th) is because, like most people I'm sure, it makes me uncomfortable going against a doctors recommendation. I'll have to explain to him everything I am thinking at my next consultation. I am also being told by friends and family that if the bone is able to heal on it's own then cosmetic surgery is an option down the road. I know a few young ladies who have had their "knot" recontoured by cosmetic surgeons. I know to most people that sounds absurd, but this accident has been causing me a bit of depression and I am having a hard time coming to terms with the asymmetry of my shoulders. The tenting of my skin is so prominent that it is very visible even when I wear a t-shirt (the overlap is jagged and pointing up). This probably has to do with the fact that I have a small frame. This along with the functionality and mobility of my arm are what leads me to the plate/pin surgery. It is my understanding that the plate can be removed at a later date, so the protrusion of the implant would be temporary and I would be willing to deal with that. I am also willing to trade for a scar which would not be visible through my t-shirt. I hope someone out there understands where I'm coming from. Thanks again for all of your help.

Hey, I completely dig where you're coming from. Not everyone is comfortable with the appearance of healed bones. When I did my collarbone, I also did another 26+ fractures (The ER doc stopped counting. He said it was getting silly.) in my torso. As a result, not only do I have a lump on my collarbone, but the shoulder on that side is 2 cm closer to my spine than the other. So, when I wear t-shirts, the left side of my collar ends up against my neck, while the right side hangs off. The t-shirt makes me look like I'm standing tilted to one side. But, hey, I dig scars, mangled bones, and lumps. They're memories that never fade.

The lump on your collarbone will reduce, in size, as it heals, but how much is unknown.

I'm not really advising against surgery. That's not my place. What I'm advising is that you make sure you're fully informed. Also be sure that you discuss all your concerns with your doctor. It's important to him/her to understand what sort of outcome you want/expect. If you're not comfortable with your current doc, then definitely find another.

One thing I would advise is talking to your doctor about physical therapy and getting started on physical therapy as soon as possible. PT is where you can make big gains in range of motion. It can be painful and suck mightily, but it's worth it. Besides, PT is one of the reasons the gods invented Percocet.

Good luck!

 

[nasoj007]

Hello to all of you that have been as unfortunate as I,


I broke my collar bone about 6 weeks ago on a motocross bike. I am 42 years old and a very active individual. I was as well told to let it heel on it's own. However, It is broke in two places and is shaped like a Z with a 15mm piece that is vertical. I, as well as many of my friends, think it is wrong to let it heal in this manner. I have a very large bump (edge of the bone) where the bone from the neck area is sticking up in the skin. The doctor keeps telling me to let it heal like this that an operation is risky due to infection. I have had four doctor's opinions and 2 were against the operation and 2 stated it was an option. Since my normal Doctor has convinced me not to have the operation and the bone is healing I am concerned about such a late operation.

My wife is also not carzy about the operation. It is still very discomforting after 6 weeks and the bone under the skin continues to cause pain but it appears that the bones have begun to fuse back together. I would really like the operation. Any suggestions from those of you that have had a similiar break? I am really struggling with how bad this looks (bone protrudes approx 20mm more than the good collarbone.

Thanks
Craig
Michigan, USA

From the sounds of it you and I have the exact same break. I was in a car accident 8 weeks ago (110kph off of a 100ft bridge) and was lucky enough to walk away with a broken collarbone and a lot of bruises. It snapped at the shoulder and less than an inch from the bones connection near the neck. It sticks out about the same amount and the end twisted so I have a shard of bone poking up into my neck.
The doctors weren't even gonna give me a sling until I asked for it. I've had numerous x-rays and am going for my second ctscan to see if I am going to be operated on. The specialist told me they probably won't because of the amount of time that's passed since the accident, unless it 'scares' them'. The neck side is very dangerous because of the obvious arteries and nerves, one doctor told me that if the bone had broken inward instead of outward 'I probably wouldn't be talking with him'.
I'm worried about it for a few reasons. One is what happens if I have another accident? What if that bone goes inward, it doesn't seem as secure as it was? Second I still feel a lot of movement and grinding/clicking sensations, it really doesn't feel like the bone has healed fully. I also have the neck and back pain that some people have described and the area around the bone is still tender to touch.
I was told that the break I have is pretty rare( most of the doctors hear haven't seen it before) so it nice(in a way) to see I'm not alone in this.
Good Luck All.

 

[roadhouse]

bontrager makes excellent carbon fiber clavicle replacements, ask Lance.

 

[bridsmath]

Hello again everyone,

Just writing to those of you who wanted the surgery but were not able to get it. I have seen 4 surgeons now, most of which recommended that I do not have a plate installed due to the nature of my fracture. The last specialist I saw agreed with the others but offered me an alternative solution for cosmetics. I am going to see him again in a few months to discuss recontouring my clavicle to restore some symmetry. This is a much less invasive surgery and he said that he has done it for models in the past.

I am over 2 months into the natural healing process and am able to do pretty much anything with some pain that occurs randomly depending on the weather and other things. Most of the discomfort I have is when I wear a seatbelt or backpack and the strap runs over the sharp bone that I have protruding out of my skin. I feel like the operation I am going to be discussing with my surgeon will help with this in the long run. Of course the incision will be uncomfortable for quite some time, but in the long run I will definitely benefit.

If you are stuck in a situation like mine I would suggest asking your doctor about this.

Good luck!

 

[alienator]

Hello again everyone,

Just writing to those of you who wanted the surgery but were not able to get it. I have seen 4 surgeons now, most of which recommended that I do not have a plate installed due to the nature of my fracture. The last specialist I saw agreed with the others but offered me an alternative solution for cosmetics. I am going to see him again in a few months to discuss recontouring my clavicle to restore some symmetry. This is a much less invasive surgery and he said that he has done it for models in the past.

I am over 2 months into the natural healing process and am able to do pretty much anything with some pain that occurs randomly depending on the weather and other things. Most of the discomfort I have is when I wear a seatbelt or backpack and the strap runs over the sharp bone that I have protruding out of my skin. I feel like the operation I am going to be discussing with my surgeon will help with this in the long run. Of course the incision will be uncomfortable for quite some time, but in the long run I will definitely benefit.

If you are stuck in a situation like mine I would suggest asking your doctor about this.

Good luck!

After recontouring, the surgery site won't be tender for a long time. I've had my tibia shaved.
It had a huge lump from multiple funky fractures, so during a surgery to do a bone graft and install an internal bone growth stimulator, the saw bones shaved off the lump. It's grown back some, but not quite as much. I think the pain you feel post surgery will feel like what a bone graft donor site feels like. I have had bone grafts done twice, and the donor sites weren't sore for a terribly long time. They were only really sore for less than a week. Of course how you will feel and for how long is dependent on how sensitive you are to pain.

Good luck and congrats on your upcoming scar. Getting a scar is just like opening presents on Christmas day!

 

[Ferro20]

Ho letto il tuo post sul recontouring della clavicola e mi ha sollevato il morale. Immagino sia un intervento estetico per rimediare alle deformitÃ* date dal callo osseo cuando gli ortopedici non vogliono operare, optando per scomode fasciature a 8. Le mie ossa si sono allineate abbastanza bene ma nel punto in cui i due monconi si affiancano per un cm si è formato un callo osseo molto alto e a picco che solleva tutti i tessuti facendo sembrare la spalla ancora peggio di quello che é. Come funziona questo intervento ???? E' in artroscopia ???? Lascia grosse cicatrici ???

 

[bridsmath]

After recontouring, the surgery site won't be tender for a long time. I've had my tibia shaved.
It had a huge lump from multiple funky fractures, so during a surgery to do a bone graft and install an internal bone growth stimulator, the saw bones shaved off the lump. It's grown back some, but not quite as much. I think the pain you feel post surgery will feel like what a bone graft donor site feels like. I have had bone grafts done twice, and the donor sites weren't sore for a terribly long time. They were only really sore for less than a week. Of course how you will feel and for how long is dependent on how sensitive you are to pain.

Good luck and congrats on your upcoming scar. Getting a scar is just like opening presents on Christmas day!

Hey thanks again for all of your insight, Alienator. You've been really helpful to me. I'm really looking forward to replacing this nasty bump with a scar, haha.

Take care!

 

[Ferro20]

Hey thanks again for all of your insight, Alienator. You've been really helpful to me. I'm really looking forward to replacing this nasty bump with a scar, haha.

Take care!

Better a little scar than a nasty bump. Even better if the scar is more little than the one needed for the collarbone fracture in origine, usually 10 cm.

 

[kosugesan]

Hi,

my name is Leo and i just spent the last couple of hours reading everybody's post. I just broke my collarbone earlier today(5 hours ago) and i'm in much pain. i just had one of the most painful moments trying to change my tshirt. my doctor told me that i might have complications, but it is likely for it to heal by itself. He said its rare but there's always a chance, especially with my type of fracture for the bone to grow into my lung. That really freaked me out. I'm hoping that I don't have to go through surgery because I don't have health insurance(just turned 25 so can't be under parents anymore). I personally don't mind a bone sticking out of my neck a little. I'm more concerned with it healing in a timely manner as well as a successful healing process without surgery. I found an xray picture online of what is almost identical to my xray. For any of you who have experience looking at the xrays, could you please take a look at mine and tell me how severe it is? I measured the distance of the fractured gap and its about 10mm. I've had a sling on it since i went to the doctor and the only time i took it off was to change. I felt sharp pains on my collar(which i assume is expected) and some on my shoulder. Is this normal? Please let me know. I'm tyring not to panic, but you know how that turns out when you' hurt, Thank you for your help in advance.

View attachment 11046

- Leo

 

[kosugesan]

Hi,

i'm not sure if my first post went through but if it did and i just don't see it i apologize for the duplicate. I've been reading all the past posts and I thank each and every one of you who posted a reply. Its a lot of help. I broke my clavicle about 6 hours ago due to a motorcycle accident. I went straight to the doctors and got an x-ray. I don't have an electronic copy of it but i did find one almost identical to it online. Imageshack - img2pg9 and also http://www.wheelessonline.com/image2/clv51.jpg I fear that i will have to get surgery because my doctor said he's not a orthopedic and the xray shows signs of complications during its healing.process. I just turned 25 and have not been able to stay on my parents health insurance. I get partial medical benefits from work I believe, but am not sure if they cover surgeries and such. Regardless I would like to avoid surgery if possible because it would still be costly. From those who have seen their x-rays and have experience with this healing process, does my x-ray look like i will need surgery? Or can it heal back to normal, but with a bump on my neck? I don't mind the bump because as of now it doesn't look that big. The main complication my doctor talked about was the bone growing towards my lungs with a possibility of it piercing it. Have any of your doctors mentioned this? I'm going to schedule an appointment with an orthopedic this week, but i'm starting to get very worried and would like to know some opinions about my xray from those with this painful experience. Thank you in advance.