Chain dropped during a sprint, body slammed myself at 28.7mph, shoulder took most of impact. Distal fracture pretty obvious in xray below. I’m in a lot of pain and you can see where bone is trying to push into skin of shoulder creating a bump. Very hard to get comfortable without pain. have a sling now for my arm.
I would like opinions about whether or not this should be fixed surgically with a plate or whether there is a chance it would heal better left alone — I am aware that non-union healing is a high probability giving the displacement, but is that a big deal? Your thoughts anybody!?
The orthos I saw wan to operate and fix it with a plate----anybody else have good sucess with this or not?
How about anyone who has let it heal on it’s own when broken/displaced this bad?
Rub some dirt on it and so some sprints up hills tomorrow morning and quit being a baby! Slings are for infants.
Seriously though get the surgery. I watched my cousin go the sling route and it was apparently pretty hellish. It will heal faster with a plate holdig it
In place.
Mine was dislocated - not broken - so not sure if any of this applies - 38 years ago - sports med doc who looked at it said leave it and you can play again within 30 days - he said it happens to hockey players all the time.
Hit the dirt again 10 days ago - and I’m not sure if the dislocation helped or hurt - landed on the same shoulder - same pain - same huge bump swelling - just started to swim again - shoulder mobility was non existent for the first five days.
I still wonder if I should have had it fixed the first time - second medical opinion from a sports med guy might help.
I’ve got IMMT on sunday and will think again about getting it fixed - but that iwll probably take me away form serious training for 2-3 months …
FWIW, I broke mine in a MTB crash five years ago, got it plated, and was happy with that decision. A friend - one 20 years older than me - broke his, opted not to plate it, and it never healed properly leaving him stiff and sore to this day.
I’ve had quite the collection of broken collarbones, never had surgery, a sling was sufficient each time. My brother wrecked once and broke his and got it plated- was out for a while but I think recovered just fine in fairly quick time after.
This one was my most recent break, obviously in a different location than yours, but mine healed just being in a sling- I’ve got a pretty significant lump in my skin from where it’s still out of place, but it has completely fused and I have zero pain or issues with it. That being said, had they recommended surgery, I would have done it.
My Training Partner shattered his collarbone with a nasty spill on April 15. 2 weeks later he had surgery with a plate inserted. 6 weeks later he was back on the road on the bike and running. At 8 weeks he was swimming and on July the 20th he was back racing in a sprint. On August 25th he will be in Louisville doing the Ironman. Get the Surgery.
I did something similar about nine years ago. Doc recommended against surgery claiming (correctly I guess) that 95% of the time the bone ends fuse. I’m one of the 5%. I’d recommend the surgery with plate. I won’t do any mass start racing anymore due to the risk but time trials are OK and relatively pain free from the shoulder. I actually may be slightly more aero as the right side collarbone is ~ 2 inches shorter. But the bike keeps wanting to steer to the left. (
This. Broke mine twice in the same spot and it fused but your whole alignment is thrown off leading to muscle imbalances, cervical issues, shoulder flexibility issues…you get the point.
broke mine 20+ years ago and hospital just put it in a sling and sent me home. Was told at time they don’t operate unless compound due to risk of infection…should have got further opinions, just listened to dude in emergency. It was very close to piercing skin and in follow up consult I was asked if it was compound due to how it looked on xray, + a couple of floating bits.
it took an age to just start knitting and I have ended up with the ends of the bone sitting on top of each other and a large lump. If it happened again I would probably go the surgery.
Broke mine last year in a bike tumble also, and did not have surgery per the doc’s recommendation. It was displaced more to the front and lined up a little better. They explained to me that, provided they fuse, the ends will get pulled together as the new bone forms. Mine healed up fine.
I’d be inclined to go with what the doctor says. OTOH, it couldn’t hurt to get a 2nd opinion from someone other than an anonymous internet poster…
GL with the recovery; you should be able to get on a recumbent stationary bike pretty soon, at least! Be sure to do the exercises they give you as soon as you can (which was pretty much right away for me). Will hurt like heck but will pay off with restoration of your range of motion.
February 2012 I went down hard in a solo nighttime crash, shoulder took the brunt of the impact. Xray revealed left clavicle broken into 3 pieces (free butterfly fragment ~1.25" long in the middle).
Saw the ortho the next day, and we decided to give it a week to see if things would naturally re-align. They didn’t. In my case, the butterfly fragment migrated downward and the body tried to close the two end pieces together - minus the 1.25" which would have left me with a visibly less broad shoulder on one side. Not only will the surgery help you recover much much faster, it will also help ensure that you look more normal when it’s all said and done.
9 days later I had the surgery and got it plated (1 screw to hold the fragments together, 3 on either side to bridge for a total of 7).
The longer you wait for the surgery the more difficult it is to perform as the bones start to knit back together… the doc will have to re-break it to re-set it.
The difference in pain post surgery was night and day. Kept in the sling and on the pain meds for ~2 days after. Though some people keep on the drugs long term I wasn’t happy with the side effects (severe constipation… just a warning…)
I took a very aggressive (too aggressive) return to riding because the crash happened right at the start of road season. I was on the trainer in a week, gentle rides outside in 2 and back racing in less than six. This turned out to not be a great idea as jumping back in after a long break really messed up my knee and I ended up taking some additional time off for inflammation to go down.
In retrospect I would have had the surgery ASAP after the break. My only other regret is not doing PT afterwards. I had good (near normal) pain-free range of motion after a few weeks, but there are still certain movements where I can feel the plate and it can cause a little pain lifting heavy objects. My emaciated cycling upper body type doesn’t help. If you have more muscle going on to support things the better.
Though I can see the plate/screws through the skin I have had very few issues with pain from seatbelts, backpacks, etc. After 18 months the scar is nearly gone. Word of warning - the incision does cut nerves for surface sensation on your skin immediately below the surgery site - which will leave a small patch of permanently numb skin. It’s a little weird but I’m used to it by now.
I had a similar break in the same location though it was slightly less displaced than yours.20 % was still overlapping. I just let it heal on it’s own. Don’t have any problems now, except for a slight bulge there.No pain
1st 3 days were tough though as I couldn’t do anything myself.
I recently did he same sort of thing but had about 10mph on you and at least 6 more pieces of clavicle floating around that they kept and screwed together.
For those of you playing along at home and who haven’t yet tried this, take it off your list of things to do. Bikes aren’t meant to ride on you. Sure you can get a cool scar, a plate and some screws & chicks dig scars but on the whole it’s over rated.
Your break is similar to mine of April 2012. Virtually the same location (though on the left side). I knew my season was gone so was in no hurry for union so surgery wasn’t entertained. It did take a long time to mend and at two months and four months delayed union and fear of non union was possible (x-rays best described as cloudy around the site). Kept waiting, used Exogen stimulator. Eventually it got together enough to do light exercise and at 10 months I did a half marathon. At 12 months I was 100% and the only thing holding me back was my fitness. I’ve heard many success stories with and without surgery. My choice was to go without and see. There was nothing to lose (but time) since I had decided to chuck the season anyway. Every person and every case is different. I’m not a patient person and waiting for the healing process to run it’s course sucked, but ultimately I completely recovered. I hope you’re as fortunate, regardless of the course of action.
I broke mine snowboarding - completely snapped it into two pieces. My break was right in the middle of the collar bone, while yours looks to be nearer the shoulder.
I chose not to have the surgery - the doc gave me the choice of surgery or not (surgery = heal quicker, have scar; no surgery = heal a bit slower, but fine, no scar) but he was confident the bone would heal fine without surgery. I wore a figure-8 shoulder strap to keep my shoulders pulled back that was incredibly painful and I had to sleep sitting up for 2 weeks, also v unpleasant. I was also a little skeptical that it would heal well, considering the 1/2 inch gap between the two ends of bones at the break. But after 10 weeks I could even manage to waterski (albeit mostly holding on with the good arm) and I have not regretted the decision not to have surgery 12 years later. No pain, and even though there is a lump there now, it is not really noticeable. It is certainly less noticeable than a scar would have been if I had had the surgery.
But like I said, mine was a bit lower than yours, so not sure if that matters.
Surgery was a toss up. Because I didn’t get the option of operating day of the break, I had to wait 2 or 3 weeks for swelling to go down. During that time I did tons of research and got a second opinion and discussed a great deal with my family which includes several more Docs.
I went for surgery. Because I was in peak fitness, recovery and rehab was very quick and easy (according to Doc and PT at least).
I had three pieces in there. One plate plus 9 screws and all was back together. Honestly, I could have ridden the trainer the next day. I think I was told to wait a week though (biggest issue was sweating into would IIRC). I was on the trainer in a week or so, running a few weeks after that, swimming a few weeks after that and then back on the road on the bike probably in 6 weeks or so. All of that was very conservative. I was told by my doc that he worked on an NFL receiver with a very similar break who got the exact same model and size plate. That guy played three weeks after the surgery.
Of course he makes his living on his body, so I can see why he would be so aggressive. The way mine fell into the schedule, there was very little difference between 4 weeks off and 8 weeks off.
I was operated on 4/5/2012 and I raced on OLY first week of June (PR’d).
Lasting side effects: a slight scar, nothing too bad really, some numbness around the area. It was a large area the day after surgery, now it is a hardly noticeable area and I am told it will likely continue to shrink over the course of my life. You can see the plate and the screws (granted I am pretty lean). I guess if I ever stop all this TRI stuff and add a few healthy pounds back on, it won’t be so obvious, but right now, it is pretty darn clear all the time. If you catch it in the right light, you can really see the details of the plate.
Mine was a break with a floating piece, but far closer to the middle of the bone than yours.
Thanks so much to everyone so far—this is why slowtwitch is so amazing—this is honestly as useful or more useful than any of the published clinical reviews I’ve been able to find.
Anybody else?
At this point I’m leaning towards getting the surgery to plate it ASAP.
