Clavicle Error - Broken Collarbone

Infection, Irritable scars, nerve damage etc.

I'm not against the idea, I was just hoping it'd take care of itself.

Buddha, what was your break like?

Like this...

Break at the distal end so notoriously slow healing due to poor blood flow. It's basically healed like this, with a bumpy bit of bone sticking up.

Break at the distal end so notoriously slow healing due to poor blood flow. It's basically healed like this, with a bumpy bit of bone sticking up.

Thats what mine is like now, except the chunk at the end is bigger, and much further away from where it should be. I'll be getting one of these hook plates.

Infection, Irritable scars, nerve damage etc.

I'm not against the idea, I was just hoping it'd take care of itself.

I wouldnt worry about a scar.
As for nerve damage, the skin around my previous break is a bit numb, thats it.
I'm glad I had the last one done.

This is from my last one. That long screw was causing me pain, was glad to be rid of it. The photo underneath is what the plate looks like.

Mine had to be pinned as it wouldn't join which was why I was off the bike for so long.

Regarding the cost of the operation I have no idea but my op took 4 hours!!!!!! Muscles were so knotted up they had to fight like fuck to get everything lined up. I hate to think how much 4 hours of surgery would cost.

Ben

I wouldnt worry about a scar.
As for nerve damage, the skin around my previous break is a bit numb, thats it.
I'm glad I had the last one done.

This is from my last one. That long screw was causing me pain, was glad to be rid of it. The photo underneath is what the plate looks like.

So they removed the screw later on?

Looks gnarly.

Why do they use such rudimentary B&Q woodscrews?!

So they removed the screw later on?

Looks gnarly.

Why do they use such rudimentary B&Q woodscrews?!

I dont speak American so I dont exactly know what gnarly means, but yes, it wasnt much fun and a lot of recovery involved (this was also because I'd been smashed into by a red light breaking motorist). They took out all of the hardware about nine months later.

And that was their term, not mine! But quite fitting. They look like B+Q screws because the surgery is pretty much DIY with humans. You drill holes in one bit of the bone, affix the plate, drag the other bit of loose bone over, and drill again. Then peel the flesh back into place and staple it back together.

Then peel the flesh back into place and staple it back together.

I knew I had a pic of this somewhere:

That totally concurs with what I've been told / have discovered. Basically anywhere other than the UK they cut you open within a few days, plate you up and you're good to go in a month. To some extent the 'wait and see' approach is valid as, for example, in my case, healing was relatively swift for the type of break and I'd rather not be sliceed open. But what it creates is massive uncertainty for most patients (myself included).

And unless you see a sympathetic specialist most doctors couldn't care less about a mere collar bone break. I feel for you dude.

Australia clearly follows the same methodology. 3 times I went for xrays, 3 times I was told "holy shit, that's bad it needs to be pinned" and even went in for the surgery eventually.. but they'd waited so fuckign long it'd started joining up and they felt it less risky to pin rather than 'manipulate'. Dicks.

This thread has got very busy. Good luck to all.

The UK can be overly-conservative at times with management but many people, particularly those who are sedentary or not too fussed about full end range high-level function of the shoulder-girdle are happy to wait-and-see.

Metalwork provides immediate stability and a 'mesh' for bone growth. It doesn't mean that you're shoulder will be perfect afterwards. Most long-term issues will come from disruption of the acromio-clavicular joint surfaces with associated pain and crepitus with over head or twisting activity. Manual therapy can be useful for addressing these factors but cosmetic appearance is another matter with the typical 'step-deformity' a common issue.

Long-term, having metalwork in situ isn't ideal either. The collar-bone is designed to break on impact to protect other structures, bit like a car bonnet crumple zone, and if you were to have a future crash with metalwork in place the outcome could be more complicated.

Again, good luck to those operated and non-operated.

That totally concurs with what I've been told / have discovered. Basically anywhere other than the UK they cut you open within a few days, plate you up and you're good to go in a month.

Yep, this would happen. And you'd be in a cast anyway.

What also shocked me, when I broke the head of a metacarpal, nobody attempted to set the fracture, which would be a common practice back home.
My knuckle is now slightly deformed (collapsed) and it still hurts after almost 8 months. I was about to be sent for a surgery - I was actually given time to think about it - but the week later there was another doctor (mine was called to some emergency) who said it's not really needed and that sometimes bones heal all crooked. Fuck you! Why don't you break your hand and let it grow back crooked?
The other orthopedist was a fella, who year earlier told me, that "People have worse things and live" when diagnosing shoulder impingement so severe, that I had a cut tendon. I was about to have surgery on that shoulder back home about ten years ago, but I was too busy with my work. Here, some hack is telling me to go home and chill out when I wasn't even able to lift my arm and didn't sleep for a week.

I'm not saying, that outside the UK standards are higher or anything (because they're not), but doctors are more thorough on average.

I think it has a lot to do with savings. GPs don't like to send people to specialists, specialists don't like recommending invasive treatment.

If you are healed up with ongoing pain and Physio hasn't helped then a corticosteroid injection can work well to relieve symptoms, albeit sometimes temporarily. A surgeon I'm not but if you need some hands-on work, specific professional advice or would like to discuss and arrange injections please free to PM me.

The UK can be overly-conservative at times with management but many people, particularly those who are sedentary or not too fussed about full end range high-level function of the shoulder-girdle are happy to wait-and-see.
meant to add early (but work got in the way!) I do think surgery is the best option for most of the people here who obviously want to get back on their bike asap, but you've got to be aware of the posible complications.

Yep, this would happen. And you'd be in a cast anyway.

sorry eei, cast for collarbone?

Yes, they do that if it's a complex fracture. A nasty one - armour type... My friend had one with elevated arm and he only needed a lampshade to finish off the look.
Now more probably they'd use pins to keep the bones together.

The bone will naturally align. Was it a clean line break?

Australia clearly follows the same methodology. 3 times I went for xrays, 3 times I was told "holy shit, that's bad it needs to be pinned" and even went in for the surgery eventually.. but they'd waited so fuckign long it'd started joining up and they felt it less risky to pin rather than 'manipulate'. Dicks.

^I can't get these to work together, is there some software issue?
"The bone will naturally align", do you own a mirror? Don't get me wrong Hipster, you're an attractive man but your shoulders are quite individual and full of character...

Went back for my one month check-up this avo, expecting to be told that it's nearly there, and was told that it's made very little progress and that if it's not looking better in another month they'll operate. The x-ray was a joke... the bone is just floating around. I'm feeling pretty miffed (furious) about the advice I've received up until today, which was entirely at odds with what the bloke today said. Another month with this cunting sling hanging round my neck just to be told I need an op? Let me.

...So the (touring) holiday I've been looking forward to for 18 months goes up in smoke.

Fuck, shit, cunt.

Dude, I really feel for you. I only had to endure two weeks of floating around broken bits before I had surgery. I had it done on the NHS and it was two weeks ago on monday - I'm now off painkillers, not using a sling and am allowed to do most things except lift my arm above shoulder height (I'm not allowed back on the bike for another couple of weeks...)

As it sounds like you still have bones floating around and a doctor who doesn't seem to be inclined to consider surgery, I STRONGLY recommend getting a second opinion from a shoulder specialist orthopaedic surgeon. If you have private insurance then all the better.

I am a total pussy when it comes to pain (I had a general anaesthetic to remove two wisdom teeth) and was very against the idea of surgery if it could be avoided, but I spoke to two different shoulder specialists at King's College Hospital and made the decision after a week of floating bones and exquisite pain to opt for surgery. From the surgeons I discovered that until relatively recently 95% of all clavicle fractures were treated conservatively, but a big study in 2006 showed significantly displaced (>2cm) midshaft fractures have a high rate of non-union (ie. failing to connect together at all) and has tipped the balance towards surgery in these cases.

The study is here:
http://www.ejbjs.org/cgi/content/abstract/88/1/35

will post more tomorrow, including some pics if I can work out how to.

hang in there.

I'm not saying, that outside the UK standards are higher or anything (because they're not), but doctors are more thorough on average.

I think it has a lot to do with savings. GPs don't like to send people to specialists, specialists don't like recommending invasive treatment.

Sad but true.

I think not wanting to recommend invasive treatment isn't because of money, it's because if surgery can be avioded it's a good idea... For most people.

a big study in 2006 showed significantly displaced (>2cm) midshaft fractures have a high rate of non-union (ie. failing to connect together at all) and has tipped the balance towards surgery in these cases.

The study is here:
http://www.ejbjs.org/cgi/content/abstract/88/1/35

Thanks for that link - bizarrely enough the first author cited for that paper is the surgeon who operated on my first collarbone break! Small world.

I think not wanting to recommend invasive treatment isn't because of money, it's because if surgery can be avioded it's a good idea... For most people.

I'm curious what was the reason behind the fact, that I had to wait 7 weeks for an ultrasound to find out if I have tumour or not...
It would take longer, but I rung the radiography and had a go at them. Some people just don't get the idea of emergency.

I might be stating the obvious, given the photos on this page, but it is probably worth pointing out that if you go down the surgical route you are basically signing up to two operations - the majority of people (two thirds of my surgeon's patients) who have surgical fixation have the plate and screws removed 9-12 months after the original op, mainly because there is so little meat between your clavicle and the outside world that the plate itself can cause irritation to the skin, particularly when wearing rucksacks/shoulder bags etc.

dublinkevin - good luck with the op on Monday. was it your decision to have your metalwork taken out first time round?

I might be stating the obvious, given the photos on this page, but it is probably worth pointing out that if you go down the surgical route you are basically signing up to two operations - the majority of people (two thirds of my surgeon's patients) who have surgical fixation have the plate and screws removed 9-12 months after the original op, mainly because there is so little meat between your clavicle and the outside world that the plate itself can cause irritation to the skin, particularly when wearing rucksacks/shoulder bags etc.

Hmm, obvious or not, this is interesting as I had no idea. One of the reasons I didn't push for surgery (when I was first seen by a doctor in London he told me "surgery is an option") was the feeling that I'd rather not have a metal plate in my body for the rest of my life. Had I known they take them out, I would have probably have tried to push the fracture clinic doc in that direction.

Interestingly, the doctor who told me surgery is an option in my case was German. The fracture clinic doc who later said "let's wait four weeks and see if it starts to heal correctly" (after two weeks of no movement) was British. An insight into the continental vs British approach, I suppose.

^I can't get these to work together, is there some software issue?
"The bone will naturally align", do you own a mirror? Don't get me wrong Hipster, you're an attractive man but your shoulders are quite individual and full of character...

If it's a clean break, the bone will align naturally is more accurate. It's like the path of least resistance thing with water. So if, like me, your bones are smashed all over the place they will not necessarily heal straight.

I'm sorry to hear things aren't going too smoothly on the clavicle front.

Mine, although slightly overlapping, has healed up really well. I took my sling off after 4 weeks and was given the all clear by the doc at 4 1/2. I've been doing physio since week 2 which has really helped and now I can lift my arm over my head and be normal.

The doctor said that although the bone has fused, I can't play contact sports, bench press or fall off my bike for 4 weeks. As much as I want to get riding again I think I might keep it to just the rollers for another month as I'd be gutted if a small spill screwed it up again.

Thanks for the advice everyone (esp. DFP). Rest, protein, calcium and physio FTW. Heal up soon peeps

Just to add to the 'injury of the week', my girlfriend Sassy has broken hers too as of yesterday (among other things), a clean brake, so should heal up quite fast.