Any experience with broken collar bones

MikeWW

This is mine



There are several smaller pieces that have splintered off that aren't obvious unless you know what you are looking at.

Anyway, do I leave it and live with the bump (assuming it joins) or is it better to get a plate? Any experiences?

imposter2.0

That kind of question would be better answered by your orthopaedic consultant, I would have thought. Also depends how quickly you would like to be back on your bike again...

I did mine several years ago, but not as bad as that (no surgery needed) - and I was still off the bike for five weeks...

bernardmcdonald

I broke mine in spring 2005 - sprint pile up at end of a 75 mile road race, and I was in the shape of my life. Gutted.

Mine was displaced like yours, but no splinters I know about. I didn't have a plate put in. Surgeon advised against it as there are or at least were at that time some long term problems with having hardware in there. I don't know if materials or surgical technology has improved much since then.

I still have a bump, but it is much smaller now and still shrinking.

I was back on the bike on the trainer inside about two weeks (no pressure on the bars), and I was back on the road inside a month - I'll go back and check training diaries later to let you know exactly how long. I was back racing inside two months (about 6 weeks if I remember correctly).

Good luck with the recovery. Don't get too down, you can get back to where you were very quickly. Listen to your surgeon, but make sure you don't stay off the bike too long.

MikeWW

The X ray is 9 days after I did it
Be very interested in your diary as to timings
Back with a specialist Monday. The trouble is getting clear advice from them can be hard.
I can live with a bump-just don't want to wait 4 weeks then if it hasn't joined trying surgery then- it gets more complicated the longer you leave it

BeaconRuth

I thought you had a season or more away from racing not very long ago because of a broken collar bone, Mike - Weren't you out of action for the 2010-2011 'cross season? Have you gone and done it again?!

Ruth

daviegb

Mike,
I crashed on Cormet de Roselend in July last year & broke my collar bone - as with yours, it was displaced. I was advised that it should heal of its own accord & that I should give it 4 weeks, then return to the orthopedic surgeon. To cut to the chase, I went back twice (after 4 weeks & again after 8 weeks, it was so displaced, the ends couldn't join, so surgery was recommended.

I ended up having surgery on 2nd January this year, where a plate & screws were inserted - a couple of the screws came loose, causing the collar bone to move. It eventually healed, but it isn't perfect - due to the screws working loose, I'm booked in for more surgery on 4th December to have the metalwork removed!

On a positive note, I've been away on 2 road cycling adventures to the French & Swiss Alps this year, so I'm happy enough with the end result!!!!

Here's a link to a couple of photos

[url=hhttps://www.dropbox.com/home/Collarbone X-Rays]hhttps://www.dropbox.com/home/Collarbone X-Rays[/url]

Good luck with your recovery


Gavin

MikeWW

BeaconRuth wrote:

I thought you had a season or more away from racing not very long ago because of a broken collar bone, Mike - Weren't you out of action for the 2010-2011 'cross season? Have you gone and done it again?!

Ruth

Yes was out a couple of seasons ago......but that was a grade 4 ACJ on the other side

djfleming22

I did mine on the Saturday broke in 2 place operated on on the Sunday ...plate put and got it taken out 16 months later best thing thing i did.... as i was cycling after 5 days after op because i had staples so was not bothered after a week had them taken out and everything healed up very well gives me no bother now whatsoever but everyone is different especially the NHS in Scotland and England... friend lives in England and they told them to wait to see if it will heal my doctor in Scotland gave me the choice ...very weird

bernardmcdonald

MikeWW wrote:

The X ray is 9 days after I did it
Be very interested in your diary as to timings
Back with a specialist Monday. The trouble is getting clear advice from them can be hard.
I can live with a bump-just don't want to wait 4 weeks then if it hasn't joined trying surgery then- it gets more complicated the longer you leave it

Can't find 2005 diary easily - damn thing is hiding somewhere since I moved back form the US in 2008. I can find 2006 onwards no problem :x

Your xray looks very similar to mine, pointy ends and all. I was sure it would never heal without the ends being at least properly aligned with each other. But I was wrong - few weeks of rest without moving much and without using a sling worked a treat. Provided you are young and relatively healthy, it should heal up good as new.

Just relived the story with the missus, and this is the chronology as best as I can reconstruct until the diary reappears:

dates i'm certain of are -
Fracture 10 April 2005 - I'll never forget having to cancel a Paris Roubaix pizza party (I was the only one of our group with satellite TV who could record it).
Raced again 28 May 2005 - our club event (a crit, I must have been mad) where wife and I broke news to our closest friend that we were expecting our first child.

less certain, but confident dates -
back on the turbo trainer ~ 25 April 2005 with no pushing on bars; wife confident I couldn't sit still longer than two weeks
back outdoors ~ 15 May 2005 going easy uphill to minimise pulling on bars; I know I rode outdoors at least two weekends before racing on the 28th because I recall conversations with different groups of people trying to pick me back up after the crash; but this road date could be a week earlier.

I do recall that it was clear my clavicle was healing as early as my first follow up with the surgeon. So we knew early on that surgery wouldn't be essential. Surgeon warned about the exact issues that have been brought up on the thread. I guess the received wisdom is to avoid surgery unless you are sure you will need it to heal or your a pro and need to train and race very soon.

Mikey23

Can't answer your first question as that is for your medical experts...
Mine was distal so it had to be plated and was only delayed until pneumo thorax cleared up
Timeline as follows:
Break 9/7, OP 25/7, 1st exercise bike 30/7, first turbo 31/8, first ride outside 22/9, first event 29/9
Delay from 30/7 to 31/8 was because of holiday and getting the loan of a turbo. So from off to 90% fit was about 10 weeks. A younger person would have healed quicker. Hope that helps

MikeWW

Thanks all-very helpful

Mikey23

... But for what it's worth, that does look to be a pretty straightforward one that ought to heal ok by itself

pcb24

Mikey23 wrote:

... But for what it's worth, that does look to be a pretty straightforward one that ought to heal ok by itself

I hope that Mikey23 is a surgeon/specialist making that statement?! Please get an opinion of an orthopaedic surgeon and if unsure ask for a second opinion. That is a complete break and likely to require fixation. Please do not follow the advice on this forum despite your band experiences in the past with surgeons. Everyone's fracture will differ in its complexity and so you can't compare

bernardmcdonald

pcb24 wrote:

Mikey23 wrote:

... But for what it's worth, that does look to be a pretty straightforward one that ought to heal ok by itself

I hope that Mikey23 is a surgeon/specialist making that statement?! Please get an opinion of an orthopaedic surgeon and if unsure ask for a second opinion. That is a complete break and likely to require fixation. Please do not follow the advice on this forum despite your band experiences in the past with surgeons. Everyone's fracture will differ in its complexity and so you can't compare

are you an orthopaedic surgeon?

Mikey23

Nope I'm certainly not an orthopaedic surgeon which is why I preceded my post with 'for what it's worth' which I suspect is very little. and in my other post I said 'that's a matter for the medical experts'. The op asked if anyone had any experience of broken collar bones and I have and recently which I gave in good faith ...

bernardmcdonald

Mikey23 wrote:

Nope I'm certainly not an orthopaedic surgeon which is why I preceded my post with 'for what it's worth' which I suspect is very little. and in my other post I said 'that's a matter for the medical experts'. The op asked if anyone had any experience of broken collar bones and I have and recently which I gave in good faith ...

the question was directed to the poster after you who appeared to indicate that all complete breaks require fixation. this was put somewhat facetiously, since i know he is not an orthopeadic surgeon - none would use the term complete break. i also know he is not one because all displaced clavicle fractures do not require fixation - mine didn't.

pcb24

Bernard, I used the term complete break to avoid medical terminology that some may not understand. It is an oblique fracture of the mid-clavicle if you want to be anal about it! I also said that the fracture is LIKELY to require fixation, particularly if you want to get back to cycling quicker. The OP wanted to know if he should leave it or not and so i suggested that he may want to consider an ORIF (open reduction and internal fixation). I suggest you look at medical research:

In a prospective, randomized, multicenter study of more than 100 patients with displaced midshaft clavicle fractures, for example, the nonsurgical group healed at an average of 28 weeks, while the surgical group healed at an average of 16 weeks. Therefore the OP might like to consider this.

Also the strongest relative indication for surgery is a displaced clavicle with 2 cm or more of shortening according to one surgeon.

As I said ask for a MEDICAL OPINION!

bernardmcdonald

pcb24 wrote:

Bernard, I used the term complete break to avoid medical terminology that some may not understand. It is an oblique fracture of the mid-clavicle if you want to be anal about it! I also said that the fracture is LIKELY to require fixation, particularly if you want to get back to cycling quicker. The OP wanted to know if he should leave it or not and so i suggested that he may want to consider an ORIF (open reduction and internal fixation). I suggest you look at medical research:

In a prospective, randomized, multicenter study of more than 100 patients with displaced midshaft clavicle fractures, for example, the nonsurgical group healed at an average of 28 weeks, while the surgical group healed at an average of 16 weeks. Therefore the OP might like to consider this.

Also the strongest relative indication for surgery is a displaced clavicle with 2 cm or more of shortening according to one surgeon.

As I said ask for a MEDICAL OPINION!

well googled.

of course the OP should get a medical opinion, he indicated he was being treated by a doctor. he was looking for some input from people who had experience of broken collarbones, and that's what he got.

you should read the entire thread and relax just a little

pcb24

Actually Pubmed is my preferred option of choice as opposed to google . I was merely correcting the mistakes in your post back at me. You shouldn't take offence and I apologise if that's the case.

Mikey23

Interesting discussion guys and apologies from me for my ill judged comments...

bernardmcdonald

pcb24 wrote:

Actually Pubmed is my preferred option of choice as opposed to google . I was merely correcting the mistakes in your post back at me. You shouldn't take offence and I apologise if that's the case.

what's to get offended about. simple difference in opinon.

pubmed used to be the gold standard when i was a researcher, but it doesn't include all journals. i find it can be quite selective, and when i need comprehensive covereag google is better.

wrt studies on clavicle fractures, i am sceptical of research by surgeons that concludes that you are better off treated by them than not being treated by them doctors publish studies that recommends they be kept in work shocker!! hold the front page.

MikeWW

Thanks all
Seeing a specialist tomorrow. Opinions/experiences are very useful and I'm not relying on BR for a detailed prognosis but in reality is its nip and tuck as to whether to plate or not so real world experience is very helpful.

bernardmcdonald

MikeWW wrote:

Thanks all
Seeing a specialist tomorrow. Opinions/experiences are very useful and I'm not relying on BR for a detailed prognosis but in reality is its nip and tuck as to whether to plate or not so real world experience is very helpful.

after all the hot air, good luck. i hope you have good news and get back on your bike asap.

MikeWW

Thanks. A bit gutting as I was 1/3 of the way through the cross season and starting to go OK. Really miss the Saturday cafe rides and mid week chain gangs but hopefully it won't be too long

Mikey23

I think medical opinion is sometimes divided about whether intervention or leaving nature to sort it is the best policy. There was no choice in my case but nearly 4months on, it still feels exactly like having a metal plate and screws in your shoulder... Funny that. It aches constantly and disruption to nerves and blood vessels around the op area means that the shoulder is numb. I won't even know for some weeks whether the bones have united properly. Happy with results and the NHs have been fantastic and cycling, driving and working normally but it's not ideal...

MikeWW

Well, 5 weeks tomorrow since the break and was back at the hospital today.

X ray doesn't look much different unfortunately



They reckon its 50:50 on healing on its own but want to give it another 3 weeks

GiantMike

I broke mine on 19 May and it still hadn't healed by mid August. Looked similar to yours but without the splinters.

The surgeon said that it wasn't likely to heal and gave me* the following healing stats:

60% heal on their own
20% don't
20% heal badly
* well, that's what I remember him saying but I'm no expert.

He also said that mine looked like a 'high energy impact'. Basically, higher energy breaks are less likely to heal*. I had mine plated in early Sep and it feels quite good now and I don't routinely think about the injury or op. I'm just waiting for the next x-ray on 6 Dec, but plated he estimated a 98% chance of a good heal. To help the healing they took a section of my pelvis to put between the 2 bits of collarbone and this was by far the most painful part of the whole operation and subsequent recovery and if I sit still for more than a couple of hours this gets quite 'tight'. Post-op I have a 5.5 inch scar on my shoulder and a 3.5 inch scar on my hip but they have both healed really well with internal stitches.

Good luck

shockedsoshocked

5 weeks seem a massive length of time to give you already. I snapped the head of the clavicle off getting T-boned by a car (imagine a match where you've snapped the head downwards), and the doctor initially gave me a week, saying if it wasn't showing the tell tale signs of knitting surgery would follow. Luckily it was knitting well and i had mobility back in it after about 3 weeks. The advice I got at the time was if it hadn't started to knit in that time frame it wasn't going to. Whether that's true or not is another matter.

As an aside, I broke my hand last week, and have waited over a week to see a hand fracture specialist. A week without a hand has been extremely frustrating, you must be pretty fed up by now!

MikeWW

Thanks for the comments guys-very helpful.
I'm really torn as to what to do at the moment- and it is very frustrating-could be worse though

trekvet

Two points I haven't seen mentioned yet.
First, to leave it is by far the cheapest option as far as the cash-strapped NHS is concerned.
Second, have heard somewhere that if the bones mend you could end up with a "short shoulder" (term bikers use) if the bones overlap and because of the resulting misalignment, back pain for ever more. If it were me I would want it plated til mended then plate (and screws) removed, ie. an expensive proper job.
That's my non-medical opinion.

FatTed

I doubt any orthopaedic consultant treats clavicle fractures on the bases of cost to the tax payer. To suggest such is insulting and even worse if its true.