I am in the same position you were. 9 months ago had a plate, 3 screws and a hook inserted to stabilize the clavicle while it healed. The hook has always bothered me but in October got to the point where I had to remove it b/c of constant pain. Tomorrow I go under the knife again to have everything removed. I'm hoping I can resume training in 6-8 weeks, but don't really know what a reasonable time line will be until I talk with the surgeon.

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Barry Dmitruk
2017: Florida 70.3 (done); Mont Tremblant 70.3 & Ironman

I had the hook plate and had it removed after 5 months. It's nothing like having it put in. I took no pain killers after the surgery. The incision stung a little and that was about it. There was more discomfort from that thick bandage they gave me than anything else. The arm was kind of weak for only a day or two but nothing like before. After a day or two it felt normal. Bandage and stitches came out 10 days later and I started running and biking immediately. I could have probably done it sooner but didn't want sweat under the bandage. Started swimming about 5-6 weeks after surgery.

That's encouraging, thanks. Of course I presently have to wait before I start training for another reason as well. I had a second brain surgery Dec 16 and have to remain sedentary until January 28 at minimum. The second surgery seems to be working so I am hoping to resume training early in February.

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Barry Dmitruk
2017: Florida 70.3 (done); Mont Tremblant 70.3 & Ironman

Great news on the second surgery Barry!!

I don't have the hook but have a regular plate, put in July last year. Mostly OK, but there is some discomfort as the plate is right at skin level with no fat over it (as you guys know), so seat belts etc irritate it. Also if I sleep on that side in certain positions it can hurt a bit. I also find it a little painful swimming during the (not sure what you call it), arm recovery phase during flip turns and during backstroke. Also, generally if I try to bring my arm across my chest/body too far, the compression hurts a bit

I'd consider having it removed but going to give it more time to see if those issues resolve.

Thanks!!!!

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Barry Dmitruk
2017: Florida 70.3 (done); Mont Tremblant 70.3 & Ironman

Having the hardware removed from my shoulder was pretty simple. I basically had to wait until the skin closed (two weeks) to swim, but was able to run and ride in a few days. It felt like a punch in the shoulder rather than the excruciating pain of the original surgery. It wasn't too big a deal for me once I got over the surgery drugs and so on. Good luck!

Thanks hopefully mine goes as smooth as yours.

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Barry Dmitruk
2017: Florida 70.3 (done); Mont Tremblant 70.3 & Ironman

Barry, I missed what happened to you mid-summer, but that's a lot of surgeries. Very good to hear that you're working through them.

I still have my hardware from May (mine wasn't so major, I guess!) and it doesn't bug me beyond being a bit of a barometer, which I'm a-okay with. Hope your process is (nearly) painless and you're back to it quick.

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The question of who is right and who is wrong has seemed to me always too small to be worth a moment's thought, while the question of what is right and what is wrong has seemed all-important.

-Albert J. Nock

Pins, plates, screws and hooks. Things sure have changed since I broke my clavicle playing sand lot football way back in 1961. They cut me open and inserted a silver rod through the marrow. After it healed the doc removed that rod. Never had any problems whatsoever soon after or since. Just a faint scar to remember the operation. I don't recall much discomfort after the bone had healed either. I do remember the excruciating pain when it broke, though.

Thanks Derf appreciate it. Barry

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Barry Dmitruk
2017: Florida 70.3 (done); Mont Tremblant 70.3 & Ironman

Two years ago I broke off the tip of my left clavicle and had a plate and screws put in. Four months ago I started to have pain in that shoulder, the sensation that a tendon or muscle was catching on something. I could not raise my arm above my head to blow out my hair, reach into the fridge, or lift anything remotely heavy with that arm without considerable pain. I saw my fracture surgeon and he injected my AC joint with cortisone with no improvement. He sent me to a sports medicine orthopedist who prescribed a guided cortisone injection into my bicep sheath as the pain had since migrated to my bicep muscle although I still had pain in my AC joint as well. After an MRI that showed nothing significant and 6 weeks of PT--during which I got better, and then worse--I returned to my fracture surgeon who said he thinks the plate should come out, although he can't say for sure that my symptoms will be alleviated. (The end of the plate also sticks out rather gruesomely at the end of my shoulder because I'm skinny--I thought it was the end of my bone!)

The sports ortho thinks I should also have a biceps tenotomy, a procedure where the long head of biceps tendon is released from its attachment in the shoulder joint, allowing it to fall down into the upper arm and out of the shoulder joint. This removes the damaged, inflamed tissue by releasing it from the joint. I'm not so convinced that this is a procedure I want to have, especially because no one is certain that the plate is not the cause of my distress.

My long-winded question is whether anyone has had a similar problem with their plate possibly rubbing on the long head of the biceps tendon, irritating it. My gut tells me to have the plate removed but I'm afraid of going through a second surgery that results in no improvement.

Any comments would be appreciated.

Have the plate removed. It is minimally invasive. Read my comment higher on this page.

And then if you don't get the mobility back look at alternatives. My situation was like yours. The plate was locking the AC joint and I wasn't able to lift the arm over my head, and I had pain especially when rolling over in bed, or getting up from a chair with a high back (pressure on the shoulder). Mobility came back in a week flat after the plate was removed, and all that pain went away. Surgeon's advice was completely wrong. He kept insisting that the symptoms were not caused by the plate. That I needed more PT. And some sort of nerve test BS. I did my own research instead and opted to remove the plate.

>The sports ortho thinks I should also have a biceps tenotomy, a procedure where the long head of biceps tendon is released from its attachment in the shoulder joint, allowing it to fall down into the upper arm and out of the shoulder joint.

If it were me I'd try everything else before attempting something like that.

Hi I know it is a hard decision between surgery and non surgery. For me the pain pre-surgery was pretty intense and I was willing to take the gamble. So January 7th I hat the plate, hook and screws all removed. I have 100 % mobility, 100 % no pain and I can do weights, swim, bike and run. For me it was the best decision I could have made.

I think this is a decision to be made between you and your doctor. I suggest doing some research, weigh the pros and cons and decide. I have absolutely no regrets, the only regret is I waited 9 months after surgery to get everything removed. Good luck and I hope things work out for you. Hope to see you at a race soon. Let us know what happens.

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Barry Dmitruk
2017: Florida 70.3 (done); Mont Tremblant 70.3 & Ironman

If you do decide on surgery, GIVE THE INJURY TIME TO HEAL. Do not rush things, I can't stress that enough. Mobility exercises at first and NO MORE.

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Barry Dmitruk
2017: Florida 70.3 (done); Mont Tremblant 70.3 & Ironman

Thanks for your replies. My gut tells me to have the hardware out. If that doesn't alleviate my biceps pain/weakness, I'll explore other solutions. I, too, wish I could go back to how I was pre-accident. My only consolation is the settlement from the accident for which I'm grateful, but money cannot make you whole.

I broke my collarbone after a particularly nasty bike crash.
Collarbone wasn't starting to heal correctly. So I had the surgery to install plate and screws to straighten it all out.
The surgery to install was the worst experience. Everything hurt, my shoulder, ribs, hip.. The nerve block was indescribable. It was a very awful couple of days.
But, 8 weeks later, I had a surgery to take the plate and screws out. This is a funny story.
My ortho says "Lou, you are a big guy" I'm like, "yeah, and ?"
He says "this surgery is going to take 15 minutes high end"
I'm like "and this is bad ?"
"No, but, the shortest amount of time I can you will be out is about an hour"
"So ?"
"Is there anything else I can do for you while I have you there ?"
"Like what ?"
So I had him remove a screw out of my ankle that occasionally hurt.
Wild story.
The rehab and PT from that was real easy and pretty much a breeze.

Is there a limit for how long you can keep a plate in?

Mine has been on for about 3 years now but I'd like to take it out at a point.

Someone told me if if stays in for too long then you can't take it out, though I feel like this is incorrect.

I've had mine in for almost 4 years. I broke mine at IM 70.3 New Orleans in 2012. My only ambulance ride ever - hopefully. Thanks potholes. Anyway, my plate doesn't bother me at all. My surgeon told me that unless it bothers you there is no reason to take it out. Even though the removal procedure is supposed to be not nearly as bothersome as the original surgery, it still requires general anesthesia and probably a week or two of limited activity. So for me, I just look at it like a lifelong souvenir. Hope all goes well for you whatever you decide. Cheers,
-Doug

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It is the mind itself which builds the body.
-Joseph Pilates

I just broke mine a couple of weeks ago (a pedestrian stepped out in front of me and I went over the bars. Yeah, I know). Fractured my radial head and also shattered my clavicle into multiple pieces, mostly along the lateral side.

Being a complicated and lateral fracture, I was told that a hook plate would be needed. Basically the plate is attached to the pieces of bone of the clavicle, after being hooked under the part of the scapula at the AC joint. I think it's called an Open Reduction Internal Fixation ("ORIF") procedure to attach the plate. [Go have some fun on google, but I don't recommend watching the videos of the procedure]

Anyways, because this type of plate hooks in underneath the scapula, during movement it'll rub against ligaments, causing discomfort and potentially damage. This is why these are usually removed after 6-12 months.

I didn't particularly enjoy my surgery last week Friday (okay, the general anaesthetic was nice), but have read that many having had the same done experienced a lot of relief when the plate was eventually removed.

I hope it's a good experience for me too when I have it done.

Hi all,

Great thread, so I am contributing to the learning/database of clavicle treatment/outcomes. I am a 50 year old male.

My story is June 28th, 2017 I was ambushed by a dog causing me to high side going 25mph, landing on my head, knocked out cold, awakening to three joggers standing overhead telling me I was alright and an ambulance was on its way. My clavicle was snapped, with a break point clearly stuck up into a fair sized trapezius muscle.

The first orthopedic I saw said that despite the large separation, there was little shortening of the length of the shoulder, and therefore we should wait and see before making a decision on surgery. If there is little shortening of the shoulder, non-surgical healing is preferred route by most doctors. Well my shoulder was not shortening because the bone was jammed up into the muscle (think of a knife jammed into a meaty steak), and so my shoulder was not going anywhere. And I thought, hmmm, looks to me like this break should be realigned, I mean it was really broken, and I am really active (5X ironman finishes, and assorted other ultra activities) which seemed to make no difference to the doctor. So I sought a second opinion.

The second orthopedic said, yep, that looks like that break should be corrected with surgery, but let’s wait a few days and see if it moves. So I waited over the July 4th weekend with a bone tip knife sticking into my trap (arghhh) thinking, for sure surgery. That was until a friend shared me a picture of the plate and screws that went in to his collarbone break - and then I thought - Whoooaaa - what is that?!!! Suddenly this was a much bigger decision.

After a great holiday weekend, I went back to both doctors. I saw the second orthopedic first. We took another picture, and he said, "Yep, surgery, and I have time tomorrow morning, let’s get it done." I said "Ok" - I mean what else I am supposed to say. Then I drove myself to the other doctor, we took another picture, and he said, "Yep, you look good, and I think surgery is going to be a step back in your recovery." Truth was I was already feeling good (already using a power spray washing and leaf blower over the weekend with arm in a sling). I said "Ok, are you sure?" He said "Yep, we can always cut later." I said "Ok" and left.

Contemplating this a bit, I concluded that the bottom line was: I was going to have a great recovery either way. I was strong (a dozen pull-ups no problem, regular workouts with 70lb+ dumbbells no problem, 100 pushups no problem, etc.) But which way to go? I opted to keep my surgical appointment - I figured over the long haul - I wanted that bone aligned properly, and I did not want to risk a non-union (that is when the bone does not grow back together) as I knew that in order to heal back together naturally, then bone would somehow have to connect through the trapezius, and that looked wrong. And if I had the surgery later after a non-union, this would be a much more drawn out thing - and I am anxious to return to full power.

It is now eight weeks post surgery - and did I make the right decision? Well, like I say, I know I will make a strong recovery - but - I cannot wait to get the plate and screws out - and that is why I am on this thread. The stiffness and inflexibility the plate and screws impart right now is really something. I can best describe it as feeling like a big stiff metal bug attached to my shoulder (it looks like that too). And until I get that metal bug off me, I am not going to feel right - how could I? So this thread was helpful to me, hearing others experience, and giving me some confidence that getting that metal bug off my shoulder will return me to feeling more like myself. Of course its still early, but that is what I am feeling today. As of right now, I am finally getting some range of movement going working with super light weights and breast stroke swimming to get things moving again.

Tomorrow, I will meet with the doctor again, take a picture, at which time I intend to ask him for an appointment to remove the metal bug at the earliest date possible. With that on the calendar, I will continue to rehab and move forward, but I want to meet that day soon, expecting that there will not be a material change in the way I feel about the stiff metal bug on my shoulder. And I am not going to wait a year, in fact I think we get the bug out as soon as we see the fracture is well healed. In my mind, I don't see any reason for the bone and tissue connect at, or around, the plate and screws. Get that bug out! I will be taking it relatively easy as I can, although I am now back on my daily bike commute to work, and activity just has a way of creeping into my life. But once the metal bug is out, I intend to wrap it in some strength and muscle for further protection and be as careful as I can on the bike.

I will report back if/when/after I get the metal bug removed. For those new to researching this injury and recovery, I have found there is no easy answer with this one. The good news is, it’s a collar bone. And if you broke it, you can finally count yourself among "real"cyclists because it’s apparently a rite of passage. If you want more information on recovery, I intend to post a more detailed story that tracks my specific exercises I do (as it looks like people really need and learn from others and I cannot find good instruction of recovery exercises) at http://www.jonsabes.com. Good luck!

The ROM exercises are the key; one thing that helped me was drills in the pool once I was cleared (Doug Stern's sewing machine drill in the archives here was a godsend) and yoga. I still have my hardware in almost 11 years later and it hasn't restricted me from anything. Good luck in your recovery!

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

I had a hook plate. Clavicle fractured just a few mm from the distal end. That wasn't enough bone left to screw a normal plate into. Plate was removed after 5 months. While the plate was in I was not able to touch my back, or raise that arm overhead. Also the plate hook must have impinged on nerves because I was getting pretty bad nerve pain especially when rolling over in bed. After plate removal the range of motion returned within 7-10 days and the pain stopped.

As for training, swimming was completely out. Running was okay up to 30 minutes then the discomfort would become too much. So I rode. The trainer at first and then the road. Rode every day that summer until the plate came out in the fall.

This gives me hope!! Thanks Dilbert!
It's now been nearly 3 months since surgery. I've mobility problems much like your own as well as similar nerve pain. I can't pull my arm across my body very far if I'm trying to for e.g. touch the opposite shoulder, not can I lift it straight into the air. Pain is worse at night and particularly for those first few minutes in the morning.
I'm seeing the orthopaedic in about 6 weeks where he said we'll be booking the removal surgery. I'm not sure how long after this date it'll be.
Did you also have muscle atrophy, and if you did, how was your experience with remedying it? Small weights?
Thanks again for giving me hope.

How long was your hardware in before you had it removed? I have hardware and bone grafting, it was done 7 weeks ago, and the pain is still awful.

I've had mine in for 9 months and change. 7 weeks, yeah it's gonna still be awful. When I spoke with my surgeon and afterwards on follow ups. Only 1/3 of plates ever get removed. So most people live with that piece of titanium for the rest of their life. Now there's tenderness at the collarbone because there's really nothing in between the plate and skin.

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Washed up footy player turned Triathlete.