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Re: Broken clavicle displaced 1.7cm - surgery or not? [midgwa] [ In reply to ]
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As a kid, I broke my collarbone, which was displaced by about 2cm. The doctor didn't recommend surgery, my parents listened, and the bone healed shorter. It's bothered me my whole life. It affects any movement that requires range-of-motion e.g. throwing, push ups, stretching, swinging a racket, etc. It affects the way I sleep. I wish I had surgery.
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Re: Broken clavicle displaced 1.7cm - surgery or not? [jt123] [ In reply to ]
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Yeah saw a second specialist on Tuesday and have decided to get the plate done. This guy says he places it more anterior so causes people less issues with rubbing and irritation. Reckons he only needs to use a smaller incision compared to others and comes highly regarded so prefer to have the proper shoulder length back even though the pain has reduced quite a bit already.

Booked for surgery Friday which will be 2 weeks post break but as luck would have it, have come down with fevers today so unless this passes quickly surgery will get cancelled and start to push it out to 3 weeks before op which isn't ideal either.
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Re: Broken clavicle displaced 1.7cm - surgery or not? [Carolina-Mike] [ In reply to ]
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Carolina-Mike wrote:
When I broke mine, it was in 6 pieces and the surgery/plate was an easy decision. I was back on the trainer within a few days and back on the road a few weeks later.

I knew all along I would have a follow-up surgery to remove it, as I must didn't like the idea of having all the hardware in me for the rest of my life. Waited about 1-1/2 years to let the bone heal, and the removal was an hour long surgery with a very easy recovery. And I got to keep all the hardware! :-)

Friends with simpler breaks like yours all regretted not getting the surgery. Longer recovery and then years later dealing with shoulder issues due to misalignments, etc...

Dumb question. So they remove the plate and bolts.. aren't there a bunch of holes in your clavicle? I would assume they fill in over time, but I'd also worry about the bone being weaker until then. No?
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Re: Broken clavicle displaced 1.7cm - surgery or not? [phoenixR34] [ In reply to ]
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Yes, during the healing phase the bone will be weaker that with the fixation in place. The holes from the screws will fill in and the bone will remodel over time. Long-term, the bone will be stronger than with the fixation, and I could argue possibly stronger that prior to the break.
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Re: Broken clavicle displaced 1.7cm - surgery or not? [jt123] [ In reply to ]
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jt123 wrote:
As a kid, I broke my collarbone, which was displaced by about 2cm. The doctor didn't recommend surgery, my parents listened, and the bone healed shorter. It's bothered me my whole life. It affects any movement that requires range-of-motion e.g. throwing, push ups, stretching, swinging a racket, etc. It affects the way I sleep. I wish I had surgery.

You didn’t have a figure 8 brace? Mine healed stronger than before with very little shortening. Maybe the figure 8 brace should have been tighter?

https://www.strava.com/...tes/zachary_mckinney
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Re: Broken clavicle displaced 1.7cm - surgery or not? [sonofdad] [ In reply to ]
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sonofdad wrote:
Yes, during the healing phase the bone will be weaker that with the fixation in place. The holes from the screws will fill in and the bone will remodel over time. Long-term, the bone will be stronger than with the fixation, and I could argue possibly stronger that prior to the break.

Less than a 1/3 of all clavicle repairs require hardware removal. I still have mine in there.

Rugby Media Dude-earfulofdirt.com

Hooker training for the Sport of Scrum-Halves [Triathlon]
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Re: Broken clavicle displaced 1.7cm - surgery or not? [phoenixR34] [ In reply to ]
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phoenixR34 wrote:
Dumb question. So they remove the plate and bolts.. aren't there a bunch of holes in your clavicle? I would assume they fill in over time, but I'd also worry about the bone being weaker until then. No?

Exactly. The bone is actually a good bit weaker and I was warned that even too much weight too quickly in the weight room could snap it at one of the holes! Some of the Journal articles I read indicated it could be close to two years before the holes are completely filled. In other words, more cautious riding the first few months to avoid a re-break.

But as my Doc put it, that is an easier break to fix again, compared to the mess that results if you break a plated/screwed bone...
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Re: Broken clavicle displaced 1.7cm - surgery or not? [Carolina-Mike] [ In reply to ]
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I'll tell you my story.

Broke my left clavicle in a crash on 7/4. X-ray showed a few fractures and about 2cm displacement. Dr said surgery not needed. Each time I went back for a follow up the PA said it looked like it was healing. At 3 months post crash (and being in a sling the whole time) it was not healed. CT scan showed non-union. I had surgery a few days after the CT. The pain from the clavicle is gone, but the 3 months in the sling caused me to develop a frozen shoulder. I'm looking at extensive PT to unfreeze the shoulder. I wish I had the surgery right away
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Re: Broken clavicle displaced 1.7cm - surgery or not? [midgwa] [ In reply to ]
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I haven't read all the responses but it does depend. In my case my clavicle was broken for me by some a$$hat who took a rec touch football league too seriously kneed me in the the upper back to prevent me from making a 1 yard dump pass reception. Compound fracture in 3 places with 1 piece floating in the middle. ER doc said it probably could heal on its own fine by could opt for surgery. but I didn't want to do surgery since I was already in the hospital for something else a few months earlier. Big mistake on my part not just because it took me a good 6 months before I could even do a proper pushup or lightly jog without pain but the fact that it healed "crooked". There is a pronounced bump sticking out of my left collarbone and my left shoulder is pulled in/down a bit (not sure how much but my t-shirts don't fit right as the front collar rests against my throat at times naturally and it has affected my range of motion).

I'd recommend you make sure a specialist can agree that the chances of it healing in the right position are good or you'll be in my situation and not like it at all.
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Re: Broken clavicle displaced 1.7cm - surgery or not? [justgoing] [ In reply to ]
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I think if you're an adult, surgery is the only option. But a kid might be able to have an easy natural union and get easy healing.

Rugby Media Dude-earfulofdirt.com

Hooker training for the Sport of Scrum-Halves [Triathlon]
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Re: Broken clavicle displaced 1.7cm - surgery or not? [midgwa] [ In reply to ]
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how did the surgery go? any issues?

I'm about the same age (late 30's) & broke mine 14wks before my first full IM. Opted not to do surgery per doctors advise...even though the displacement looked pretty bad. X-rays showed no visual improvements after 3mo...but was able to recover and complete the race.

Took a while to get full/97% range of motion back and still have tightness & discomfort on really cold days...
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Re: Broken clavicle displaced 1.7cm - surgery or not? [Tritops] [ In reply to ]
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Your x-ray was very similar to mine, so yeah could have gone either way with leaving it or having the surgery.

It's now about 3 weeks post surgery for me, the first week I struggled to be able to lift the arm but after the pain and swelling from the surgery settled I was able to start get a lot more range of movement. Followed up with my surgeon 10 days post who cleared me to go back to unrestricted activities with lifting, pulling and pushing. Said the plate won't budge it's just a comfort thing from my point of view.

Just been slowly trying to build back strength through the shoulder as given I had to wait 2 week post fracture to surgery it's really been 5 weeks where I haven't really been able to use the shoulder much.

Still don't have full ROM but starting physio tomorrow to help. Probably got about 85% range atm.

Don't seem to notice the plate as much anymore. Have started to put backpack straps over my shoulder without much irritation. But sometime have the seat belt straps pull on it.

Only other issue is I still find it difficult to sleep on my right shoulder and the pressure is a bit uncomfortable, but this has been gradually improving so hopefully in a couple more weeks it won't affect me as much.

All in all fairly happy with going down the surgical path, feel as if I've been able to get back to my normal activities quicker. Still yet to go back out for a ride, but that's more a confidence thing for now, but keeping fit on the trainer and back running.
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Re: Broken clavicle displaced 1.7cm - surgery or not? [midgwa] [ In reply to ]
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Great to hear. Keep riding inside. No rush to go outside as the road vibrations are pretty hard on the hurt side.

LOuis :-)
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Re: Broken clavicle displaced 1.7cm - surgery or not? [midgwa] [ In reply to ]
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I can no longer sleep on the right shoulder like I used to. Doesn't hurt anymore but feels odd.
Turned into a stomach sleeper and need to wedge a pillow to be comfortable.

Got antsy and jumped on the trainer 5 days after with a sling, hit the elliptical 12 days after, and one handed kickboard a week after that. Getting back in the water felt amazing. (Actual swim & run had to wait several more weeks + rehab.)
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Re: Broken clavicle displaced 1.7cm - surgery or not? [Tritops] [ In reply to ]
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Clavical healing naturally as per latest x-rays today five weeks on. Borderline case for surgery / no surgery. Would of went for surgery only had a bunch of other injuries that will take 6 / 8 weeks to recover from and wasn’t very compos mentis for the first few days post accident. Started back with walking for exercise averaging at 9.10 per km and 80km per week just last week. BUild to marathon at 100km per week just before accident.... Not sure body knows what is going on. ..... S/B/R hopefully soon.
Last edited by: Zuckerzeit: Nov 8, 19 16:52
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Re: Broken clavicle displaced 1.7cm - surgery or not? [midgwa] [ In reply to ]
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Two points
One dont mistake slowtwitch for a medical second opinion. Use your forum or threads for a orthopedic surgeon recommendation.
Two there is no valid second opinion without review of the imaging, its like the other thread asking if he should have a L3-4 disk replacement.
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Re: Broken clavicle displaced 1.7cm - surgery or not? [midgwa] [ In reply to ]
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you made the choice i would've made. actually the choice i did make. i broke one collarbone 20yr ago, quite a bit of displacement, and did not have surgery. it did heal. i broke the other one 10yr ago, pretty similar break, this time i did have surgery. healed faster and straighter. if you don't have surgery it'll heal, but the ends won't be aligned (if the ends don't line up after the fracture).

your biggest problem is going to be swimming. you're probably riding already and you'll be running soon if you're not already. it's going to take months before you get your range of motion without pain back in the swim. as i recall it, i just had to push thru a lot of pain in the swim. i can't counsel you with any knowledge what pain (in the swim) you need to pay attention to, versus what pain you need to push thru.

Dan Empfield
aka Slowman
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Re: Broken clavicle displaced 1.7cm - surgery or not? [Slowman] [ In reply to ]
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Will just add my experience with swimming, which was slightly more positive than slowman's.

I broke my collarbone in in July this year (bike crash in Santa Rosa 70.3). Had the surgery 3 days later. I was riding on Zwift after a week, running slowly after 4 weeks on the treadmill and at normal paces outside at 6 weeks. I was cleared to swim at the beginning of week 8, and hit my weekly standard mileage (16-18k or so) by week 10. The first few sessions were more awkward than painful. Pain was there, but it was more of a mental thing being constantly worried that I was hurting it. Once I got over that, it started to come back quickly and I think that the swim has been the single biggest help in getting ROM back. At this point (3.5 months after surgery) I feel like I'm at about 99% - I still notice when I am sleeping sometimes or after super long days in the aero bars, but nothing painful. I'm extremely happy I got the surgery and would do it again if I had the choice (hopefully I don't have to).

Interestingly, the most challenging part of the return to training for me was getting back outside on the bike. I spent the 8 weeks after surgery riding exclusively on Zwift so I had a good amount of fitness, but first few rides outside were jittery and I was super cautious about going down again. Probably took 15-20 hours of outdoor riding before I felt comfy again.

Good luck! Your body will figure it all out...

-------
Anders
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