You really need to see a good ortho. I got two different opinions outside what I was told at the ER. (Distal fracture)

Of course, I didn't want to go through surgery on any part of my body. However, based on my doctors recommendations, I went forward with the surgery. There quite a bit of info out there, is there something specific your are asking?

i broke my clavicle and scapula on a motorcycle crash <30 MPH. Given that the scapula was broken I already had to have surgery they fixed my clavicle as well. I would for sure go see a Dr that specializes in those sort of things if you can. Typically if the bones are not overlapping they would prefer to let it heal on its own. All that being said it feels 100% better to have the surgery. I had to wait almost 2 weeks to have surgery and it was terrible it always hurt and you cant use your arm, once you have the surgery you feel better and have some limited movement. Go see the best Dr you can find and see what they say.

I had surgery earlier this year but I didn't have to choose since my bone ends were never going to come back together again on their own. I knew as soon as I saw the x-ray I was going under the knife. It was obvious. Clavicle surgery was not that bad and I am very happy with my results. But, its still surgery and not to be taken lightly. Here is my take on it after having gone through it again and actually have a choice.

All and all, if I ever have to go through this again, I would not have surgery IF my doc told me I'd heal well without it. If, and only if, that was not the case, I would not hesitate to do it again. I would most definitely not do it just to get back on the bike sooner. The key opinion you are looking for is what is your prognosis if you do not have surgery. If you are satisfied that you'll be fine without it, don't risk it. But if you do need it, it is not that big a deal barring complications which I understand are rare.

The pluses of surgery are that you will be fixed and right away. No waiting to see if the bone ends come back together and heal right. There is still recovery but its quite possible your recovery time will be shorter with surgery than without if it is a significant break. I was back on the bike in 5 weeks and that was after a pretty bad break and without much in the way of effort on my part to speed things up. (If I was a pro and riding bikes was my livelihood, I'm sure I could have cut a week or two off that pretty easily). If you use your arm for your work, the possibility of a quicker recovery may be a big deal for you. I have a desk job and it was my left arm so not an issue at all for me.

The downside is, well, its surgery. They will be putting a 6-7" slice in your shoulder, messing around a bit in there and running some screws into your bone. Its invasive. You could get an infection. They have to hack through some nerves so your upper chest likely will be numb for a while (mine still is 3 months later) and may stay that way. You'll have a plate screwed to your bone which you'll have to live with forever, or worse in my book, you might have to have it surgically removed someday.

Thanks for the feedback. I'm very conflicted. I just got done talking to a radiologist, that I know on a personal level, and he said he would not have the surgery if it was him. At first, I was all in on the surgery but now having serious doubts.

My biggest concern is if I don't have the surgery will I lose any functionality or ROM in any of the affected joints.

Mine was a double displacement that had tented (x-ray looked like a boat going under a raised drawbridge where there was about a 1" piece of bone just doing it's own thing) so surgery was necessary. Plate and six screws hasn't hindered me from doing anything since.

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"You can never win or lose if you don't run the race." - Richard Butler

I had the option per a sports ortho.

I chose surgery because I felt like having asymmetrical shoulders might be a long term problem in doing things that I like to day (swimming, riding aero, etc). I also chose surgery because while it increased the overall recovery time, it decreased the likelihood of a non-union. Finally, surgery produced a solid structural member of my upper body immediately. day before surgery, I could not wash my opposite arm pit. Day after surgery I could (of course the wound healing takes quite some time, so that is a trade off).

I almost didn't choose surgery because, the docs told me that I would be fine without it but would be a little narrower and lower on one side. I did not want to take the risk of general anesthesia. I was worried about the loss of feeling radiating from the incision (this is a very real thing, it is a pretty huge area right after surgery, I am 2 years out and now the area is quite small, but it is still there). I have never been operated on before, so recovery was a 100% unknown factor to me (that turned out fine, but I did VERY poorly coming out of it). They ask if you have an adverse reaction to being under, I had no knowledge. Turns out, my answer is Yes.

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i was given the option... I chose the surgery and had the plate and screws installed, and couldn't be happier about it... After a year, I was able to have the follow-up surgery to have the plate and screws since removed...

sure, I have a tiny loss of sensation on the back of my shoulder, and I have a 5 inch long scar above my clavicle... but I just consider these to be cosmetic, and not really a big deal to me... considering that natural healing would have left me with a large bump at the re-fusion point, and permanently uneven shoulders, I am totally happy that I chose to go with the surgery instead...

My sister in law just went through this so I researched the issue for her and spoke with an orthopedic surgeon that I know and trust. Here's the skinny:

• surgery for clavicle fracture is really only indicated for those fractures where there is significant displacement of the fracture fragments. i.e.; the ends of the bone are over-riding or far apart. In these cases, delayed healing or non-union (non-healing) are more common and surgery confers a definite benefit. I believe that the recommendations are more than 20mm of overlap or separation but please don't quote me on this.
• Surgery does not shorten the time of rehab or healing of this injury
• Surgery is associated with a higher complication rate, specifically surgical complications such as infection or hardware issues.
• up to two thirds of patients who have the surgery have a second procedure to remove the hardware because it is bothering them. This is not universal and is changing over time with different hardware being used.

Personally, I would go with the surgery if my clavicle was anywhere close to the limits where the operation would benefit healing. Even though an operation (or two) sucks, everyone I know who had this done returned to training (stationary bike) faster. But that is purely anecdotal.


Best of luck.

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Jeffrey Sankoff, MD
TriDoc Coaching/TriDoc Podcast
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I broke mine about 12 weeks ago, I went to the ortho about 3 days after. He recommended surgery since the bone was in 3 pcs, there was significant shortening and the bones did not touch.
I went in for surgery a week later and received a plate and 9 screws. My time line was dictated by my doc and I followed it pretty close. I am doing IM Chatt so I needed to keep up some fitness throughout recovery.

4 days post op- back on bike trainer sitting up with sling, also treadmill walking, 10 incline as fast as I could walk for 1 hour.
5 weeks post op- Begin running outdoors. I went for a 10mi run, it hurt like hell, I couldn't swing my arm, it felt like it was popping in and out of the socket.
6 weeks post op- Begin riding outdoors again, first ride 2.5 hrs.
8 weeks post op- Begin swimming, started with about 1000m total, broken down into 50s.
10 weeks post op- I am riding 5hr rides, 15mi runs, 3k swims.

11 weeks (now) - Still have some ROM restriction and some muscle pain due to atrophy. No effect really on S/B/R but little things like taking a shirt off, moving to quickly hurt. Still no heavy lifting.

Training is back to normal for the most part and I will be ready for Chattanooga. Search for my original post ( Broken clavicle- x ray included) there was some good info shared there also.

Good luck and hope you recover quickly.

Had my surgery yesterday. The day was one the worst days of my life. I had intense burning pain from muscle spams around my trap and levator scap. Wife had to take me to ER last night and got some Valium to help with that. Doing a lot better this morning, but wishing right now I had not done the surgery. I think in the end I'll be glad I had the surgery but not so much right now. Only time will tell. Thanks for sharing.

Corby

Too late now re your decision, but I once broke mine completely apart (single break in the middle) and the two ends of the bone, while not overlapping, were about 1cm apart. I chose not to have the surgery. First 3 weeks were miserable (sleeping sitting up), but 9 weeks later I could use the arm gently and 12 weeks later pretty much fully healed. Now I'm completely fine with full normal motion and never any pain (11 years later). I have a bit of a bump on my clavicle, but would rather that than a scar.

I hope you heal quickly. Find the painkillers that work best for you!

The surgery is tough, I felt like I made 10 steps back when I got it. Within a few days it gets much better, the worst part is wearing a sling 24/7 and not being able to go to a drive thru.
Just a suggestion from my experience, start moving your elbow everyday, a few times a day so you keep at least that rom.

Agree, first few days post surgery were the toughest but start with the ROM exercises right away

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"You can never win or lose if you don't run the race." - Richard Butler

They managed to keep 8 pieces of my clavicle and threw the rest away. I also demolished my AC joint so I don't have one of those.

There was no option for me but surgery. 10 screws and a plate + taping it to the coracoid process for stability and I'm 95% of where I used to be.

It's tight at times and I really can't do push ups or bench press. I have lost a few degree ROM for external rotation.

But really I go through life and don't think about it. As I get leaner my new clavicle (aka the plate) is more pronounced & I've got a cool scar.

You can palpate the distal end of the plate through the skin, where the plate begins and a couple of the screws. Great party tricks and you separate the queasy chicks from the non queasy ones quickly that way.

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Brian Stover USAT LII
Accelerate3 Coaching
Insta

Yes, prior to the surgery I was making my wife quite queasy by moving my medial part of the clavicle around.

Good luck on your recovery postop!

I fractured my clavicle playing rugby about 10 years ago. It was displaced and I wanted to return to athletics so I saw an orthopedic surgeon. Instead of a plate & screws, I had a single ~6 inch screw inserted along the length of the clavicle from lateral to medial to realign the 2 pieces. The procedure involved a 3 cm incision over the mid clavicle and a 1 cm incision on my upper back. Approximately 4-6 weeks later they removed the screw through the 1 cm incision, so the clavicle was realigned and I have no permanent hardware. This seems to be a great alternative to the traditional plating technique if feasible for the fracture type. No residual neuromuscular side effects, and I have no restrictions on weight lifting, ROM, doing tri's, etc.

Hope this will help. Broke my clavicle into three pieces (and four ribs) on July 12. Surgery July 14. I am now swimming, biking (trainer only) and running. I post updates including cool surgery pics here: http://bit.ly/1p2nPmZ

I hope you feel better soon.

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That's great. Hope I'm there that soon.

Did anyone have reservations getting back on the bike when they were ready for it? My wife doesn't think she could ride for awhile if this happened to he.

A couple points.

First, don't get discouraged in the first couple weeks. At least for me, improvement was definitely not linear. At week 3 I still thought I was never ever going to recover. At week 5 post surgery I went on a 20 mile out door bike ride and 6 weeks after that I'd ridden enough that I was basically back to where I was before the crash. Once you start getting better, the rate of improvement really accelerates.

As for the wife, and me to some degree too, it was a bit tough psychologically when I started riding again. Partly because of my injury but also because my injury led to a lot of story telling my wife started to realize how common this is and so did I in a way I had not before. She started to think about the general dangers of cycling in a way she had not before and that happened to me a bit too. I also think it really freaked her out how blasé my riding buddies were about it. She said its sick that we do an activity where this is "normal" and I think she might be kind of right on that one ;-) I know I have a big fear of facing my wife if there is a "next time." I think I have gotten my one free pass so for that reason alone I worry more about crashing than I did before.

But, as time has gone on, she's OK with me riding and while not happy about it she is even so far holding her tongue about my plans to do a couple crits before the season is over.

Time heals all wounds and not just your bones.

My Ortho cleared my to ride my bike a month before I was comfortable enough to do so. I wanted that thing pretty firm before risking going back to square one. First ride was on more of a commuter bike without clipless pedals.

Did anyone have reservations getting back on the bike when they were ready for it?

I did. My crash was pretty bad where I spent four days in the hospital afterwards; it happened in late September so by the time I had healed up enough to ride (also had to replace my bike) it was winter, so I didn't get back on the road for the first time until the following spring. It took a few rides to get past that, and I find that I still ride defensively where I'm constantly aware of surroundings such as traffic, road conditions etc.

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"You can never win or lose if you don't run the race." - Richard Butler

I too was released to ride before I was physically comfortable to do the kind of riding I wanted to do. I think my doc was thinking I'd be pedaling to the store on my cruiser and I was thinking riding meant mixing it up in a pace line. I did ride alone for the first week and a half because I just did not feel I was in sufficient control to be riding in close proximity to others. I also really avoided rough roads. Not because they hurt (they did a little but not as bad as you'd think), but because I had completely lost my ability to bunny hop potholes.

Even after I rejoined the group rides, it was several weeks before my handling skills came back to where I was before.

Sorry to hear your post-surgery isn't going well. I broke my left about 2.5 years ago in a stupid training crash. I had the butterfly fragment (loose free floating piece) and elected for surgery after a week of letting the body do its thing. Doctor showed me how much my shoulder had already shortened and I was under the knife two days later.

Having never had surgery before it was pretty stressful but as soon as I woke up it was a night and day difference with reduction in pain. I only took the rx drugs for a couple of days afterwards and was up and moving quick. I had my first outdoor ride 3 weeks after (maybe a skosh too soon) and was back road racing in 6.

Now, here is the part about getting back on the bike too soon. Shoulder wasn't the problem. I had my break about a week before the start of the road season and was putting in a ton of volume and had a really high level of fitness. Even though I rode the trainer during the healing process I didn't have much load on my joints. I entered my first ~3 hour road race feeling fantastic and by the end I could barely pedal due to pain and inflammation in my knee. I didn't take the time to build back up to a super hard effort and as a result I missed (or had awful performances) in several subsequent races because of knee pain. I ended up needing to take several more weeks off to let the knee inflammation calm down and get back to normal. I still have super loud knee-popping on one side from it. I worked extensively with my PT throughout for the knee to make sure there was nothing permanent of it.

Your other consideration post-op is whether to do PT for your shoulder range of motion and strength. I was able to be pretty much (apparent) full function quickly so I passed on the PT but in hindsight I would have done it. Being a roadie only I don't have much upper body strength and my post-surgery shoulder muscles are somewhat weaker as a result. Although my ROM doesn't suffer the strength is a slight issue. Maybe I need to do more pushups.

Glad you got the surgery. I broke my right clavicle in a TT (see my blog for details). Both the ER doc and my sports med doc were 50/50 on surgery, and both of them were cyclists. It took me 2 weeks to get in to see the hand surgeon (who was a Cat 3 cyclist). He wasn't trying to pressure me, but I could sense his feeling. Once I said OK, he schedule me the next day. BTW, the 2 weeks were hell. With a background in pharmacy, I hate being on opiates. I had never been in so much pain. My wife was really worried about me. I was able to ride the recumbent, but couldn't run. Two days after my surgery I was off the opiates and able to ride pain free on my road bike on the trainer.

Having had many surgeries before, I think the big issue for most people is how your body reacts to the surgery, not the repair. I hope in a few weeks the side effects wear off and you'll feel better. I've very happy I had the surgery done vs having an out of whack shoulder.

Good luck and hope things turn out for you!

-Pete

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"Most of my heroes don't appear on no stamps"
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