Page 1 of 1

Broken Collar bone (possible surgery)

Posted: Wed May 25, 2011 4:11 pm
by Darragh
Hi all,

I know theres a few surgeons/docs on this forum, and have read some old posts relating to kayakers with broken clavicles; so opinion/story time?
Last Tues(17th) I broke my clavicle in two places mtb'ing, I've seen a consultant in Leeds who has given me the two options of having surgery (fixing a temporary plate and screws to the bone) or leaving it be to heal on it's own accord and having another review X-ray in 5 weeks (the more common).

I'm seeing a Surgeon tomorrow to ask his opinion about the matter, but again if it's left soley up to my judgement I'd like to hear some info from kayakers who have previously received surgery/no surgery about how it has affected if at all your paddling and shoulder dexterity, and from any surgeons/docs who would recommend either option.

Cheers for your help in advance,
Here's some Xray photos for the carnage hungry :D

Image
Image

Re: Broken Collar bone (possible surgery)

Posted: Wed May 25, 2011 5:00 pm
by Adrian Cooper
No experience, no idea but it looks like an engineering job to me.

Re: Broken Collar bone (possible surgery)

Posted: Wed May 25, 2011 5:11 pm
by Mark Steel
Three years ago I broke mine in 3 places it took over a month to go back into place and another 3-4 months to mend, it is a bit out of shape but have no movement problems, I had no surgery but it was on the cards, I took the advice of the consultant as I thought he may Know a bit more about it than me, he did say there was a risk of nerve damage if I had opted for the surgery, but then every injury is different.

Re: Broken Collar bone (possible surgery)

Posted: Wed May 25, 2011 5:27 pm
by Steve B
Adrian Cooper wrote:No experience, no idea but it looks like an engineering job to me.
You took the words right out of my mouth.

Or, "+1" as they say on t'internet.

Re: Broken Collar bone (possible surgery)

Posted: Wed May 25, 2011 6:37 pm
by hoolabloom
I managed to break mine for a 3rd time snowboarding 5 yrs ago and it healed on its own to the extent that I was paddling the nevis 3 weeks later. Swam due to the fact i couldnt paddle backwards but was all good other than that. It healed fully within 6 weeks.

conversly my mate broke his last year biking( hit wall at good rate of knots) resulting in a few months waiting for it to heal due to the bones having pulled apart and not setting. He finally opted for sugery after about 4 months of no healing and is now fully recovered with no side effects or mobility issues.

I know that the op is the prefered method of treatment in France which was what i was told when i broke mine but being tight i elected to go for the strap it up and hope for the best method.

If i was in your situation i would give it a couple of weeks to ee if it is knitting together and if not then consider the op not worrying so much as the success rate is very high with little if any side effects. If it does heal on its own then the recovery time will be less. However it is of course the chance you take as the op will still take the extra time on top of the natural healing if it doesnt knit.

Good luck and hope your sorted soon
Dan

Re: Broken Collar bone (possible surgery)

Posted: Wed May 25, 2011 9:09 pm
by GrumpyPumpy
I busted my right clavicle into three pieces about 3 years ago along with multiple fractures to 7 ribs doing a poor Superman impression off my motorcycle.

After being told nothing could be done and it would have to heal on it's own I wrote to the Trust Chief Executive to complain I eventually had it plated with 5 or 6 screws after two weeks, two nights in hospital with no sleep whatsover due to the two senile geriatrics shouting all night.
Fully healed wound after 10 days and able to pretty much do everything after a month.

The area below the entry wound gives me discomfort if anything is tight on the flesh like a car seat belt pulling on it all the time due to the nerve damage but other than that it's fine.

I laid of my competition shooting for a year as a precaution as I can go through 150 to 200 12g shells in a comp so thought it best to give it a chance to fully heal.
The bone knitting took a long time for me mainly because I am an old git and I discovered I have Osteoporosis (which I found out after it healed when I had a bone scan) none of the Doctors suggested having a bone scan even though it was taking a long time to heal it was a friend who suggested it!

The ribs hurt like hell but I really got little pain from the collar bone once it was screwed back together, I don't recommend breaking ribs, coughing and sneezing were things to dread until they healed.

Whatever you do I hope it all works out for you

GP

Re: Broken Collar bone (possible surgery)

Posted: Wed May 25, 2011 11:14 pm
by LucyLou19
I was about 11 when I broke mine, but fairly dramatic break (although only 1 place, the bone was nearly through the skin, as in poking right against it).

Fortunatley I was in France, so was treated with the collar bone brace pictured on this website: http://tullyseniors.wikispaces.com/Clavicle , doctors in England were horrified, but I dont have that tell tale lump around my collar bone which people who have breaks and get put in slings seem to suggest... I don't know if I was just lucky or what...

However... I remained in and out of Physio from age 8-Present day (20) because of my accident prone nature, some serious underlying muscular-skeletal issues, a habit of not cross training...

Id go with whatever you surgeon reccomends, but I *imagine* surgery will be the speedier recovery with less mobility issues. Then find a shit hot physio- 12 years of physio it seems could have been boiled down to the right training programme and the right pain management, and, to begin with, some medical tape for support while retraining. Fight tooth and nail to get a sports physio on the NHS, they do exist, and will actually treat you rather than just give you ultrasound and send you on your way.

Re: Broken Collar bone (possible surgery)

Posted: Thu May 26, 2011 10:09 am
by Simon
One thing to think about/discuss with surgeon is the likely amount of distortion and difference from the original geometry of the shoulder joint once it has healed.

If it is likely to heal by itself with the collar bone close to it's original shape, and so the shoulder joint remains in the correct alingment, then a slow self repair might be sensible, avoiding the known risks of surgery.

But if it is likely to leave you with some residual distortion then that might indicate surgery to put it back in it's correct shape. Residual distortion will increase the wear on the shoulder joint and increase the stress on the ligaments and joint structures, and make you more prone to problems decades down the line.

I had a shouder injury 25 years ago which was left to heal, and it has been fine for tweny years, but I am now beginning to get twinges aches and pains, which I was warned would happen by the consultant surgeon 25 years ago.

Good luck.

Simon

Re: Broken Collar bone (possible surgery)

Posted: Thu May 26, 2011 2:06 pm
by Performance Kayaks
Having broken both of mine (on separate occasions) and having left then to set 'Naturally' I'd suggest having the elective surgery!

Through Nature, they are uncomfortable before and after they knit together, and then there is the times that you move or knock your elbow and it breaks the knit apart again!

Have the surgery, unless you can guarantee not moving for 3 weeks (and try not to take pain killers)!

Re: Broken Collar bone (possible surgery)

Posted: Fri May 27, 2011 1:05 pm
by tomcrow99
I did mine very badly mountain biking a couple of years ago, I got the op but only through a coin toss as part of a research study (Mr Robinson, Edinburgh Royal Infirmary...) which was looking at the differences in healing between the 2 options. If they hadn't had offered the surgery I'd have gone private, I wanted to be certain it would heal as well as possible in a short a possible time as I had a baby coming!!
Like the poster above, my wound healed in a couple of weeks and I was back in a boat doing flatwater paddling after 4 weeks and back on my bike off road after 6 weeks. Two years on, there is still some slight atrophy in the muscle and I get a tightness in one of the tendons every now and again. The plate is not nearly as intrusive as I thought it would be though and I only notice it after carrying a backpack for a while, carrying boats and wearing BA's are fine. The scar also is pretty neat, though I suspect this depends more on the surgeon.

BEFORE:
Image

After:
Image

In the most recent x-ray I had the bone fragment had been pulled in and no gaps remained.

Your break looks quite similar to mine, I would push for the op if you could. MTBR is full of horror stories of non unions which need re-breaking to get them to set in anyway close to a normal position.

Any other questions just ask

Hope this helps

Tom

Re: Broken Collar bone (possible surgery)

Posted: Fri May 27, 2011 7:23 pm
by Darragh
Thanks everyone for sharing your experience and advice, yesterday I decided to go for the surgical option as it's generally viewed as the quickest way to get back work/play/good strength.

Decided yesterday, getting in done next wednesday...boom... as soon as that!
hoolabloom wrote: ...conversly my mate broke his last year biking( hit wall at good rate of knots) resulting in a few months waiting for it to heal due to the bones having pulled apart and not setting. He finally opted for sugery after about 4 months of no healing....
Performance Kayaks wrote: Have the surgery, unless you can guarantee not moving for 3 weeks (and try not to take pain killers)!
Sounds like my worst nightmare, hence my decision now rather than later... I couldn't stand the TV in the 3 hours A+E waiting room, never mind 4 months of Jezza Kyle ;-)
tomcrow99 wrote: Your break looks quite similar to mine...
Really? I think I got off a bit lighter than yourself :P


Thanks again for everyone's posts, I'll try to remember to update this a month or so down the line for anyone who wants to read this in future...

Re: Broken Collar bone (possible surgery)

Posted: Mon May 30, 2011 11:42 am
by Ian.Adey
Hi,

Having had a similar break to you, and having had the opperation to plate the bone, and the subsequent one to remove the plate I have a few thoughts about my expierences that might be usefull to you.

I am 100% glad that I had the operation, With the bone overlapping the muscels were pulling my shoulder which would have resulted in a loss of full reage of movement.

The initial opperatiuon to plate the bone was fine, Although I recieved poor advice as to what to do afterwards. I was told the stiller I kept the joint the better the end result - ( 6-8 weeks) This resulted in lots of muscel waistage, and a frozen shoulder. I now know that the only limiting factor as far as the post operation movment i should have been doing was not opening up the scar.

After the second operation (to remove the plate) I began physo withen a fortnight and was padling gently within a month.

So.. My Advice would be to see a specialist sports re-habilation Physio within 2 weeks of the initial operation, and listen to there advice. Whilst the Nhs physio was helpfull the wait to see them was too long, and there end goals were are not the same as mine.


There is a list of recomonded phsios here www.shoulderdoc.co.uk


I chose to have the plate taken out as I was advised that this reduces the likely hood of future breaks. at this time they also filed down any sharp bits of bone close to the skin.

Time scales, From initial break to paddling again - 3-4 months then a month off for the plate to be removed.

Long term, Generally good some pain/ discomfort occationally. I dislocated the same shoulder this year, 3 years after the break and I believe this was dew to the shoulder sitting further forward / muscel inbalenceafter the frozen shoulder. After intensive Physio It is now stronger an in a better position ever and as good as before the break,

If i had had as good a Physo then as I do now I believe I could well have avoided the dislocation and the recovery time after the break would have been halved.

Ian

Re: Broken Collar bone (possible surgery)

Posted: Mon Jun 06, 2011 3:31 pm
by blitz66
not a Dr or even a real med student, but i am studying to be a chiropractor, we do a fair amount of looking at x-rays and know our way around a skeleton as well as any GP will do, and i'd say leave it to heal If you weren't going to be putting large stresses through it again, but MTB and kayak have a way of putting stresses on that bone that's meant to be straight, it normally transmits the force straight down the length of the bone and into the big joints around it, however if there's a significant kink in it, and when they heal they can look like two bones one over the other (think an = sign with the two lines offset...) and it just doesnt transmit load evenly.

Not to mention the fact that one shoulder's biomechanics will be different to the other, as the collarbone will be significantly shorter on one side (think F1 suspension with 1 swing arm shorter on one side) which could lead to muscle strains on one side with the levels of exercise you'll get from MTB and kayak!

The one proviso i have regarding the surgery though, is with a plate, what happens if you exceed the tolerance of the repair again? i.e. you break the same joint... all that metal could make a right mess!

good luck with your surgery!

Re: Broken Collar bone (possible surgery)

Posted: Thu Jan 01, 2015 6:27 pm
by Wadhamite
Sorry for bringing a thread back from the dead - boyfriend has just fractured his collarbone, much much more simple than the one shown above (last inch has cracked and partially but not fully separated). If it is still healing well when he goes to see the fracture clinic next week and it's all uncomplicated, any idea how soon he can be back in a boat? I'm guessing gentle flatwater paddling will come first, and then white water later ('no impact sports' presumably also covers to bashing in to rocks, plastic blocks or other boats...)

Re: Broken Collar bone (possible surgery)

Posted: Thu Jan 01, 2015 8:26 pm
by Performance Kayaks
It depends on him really. I gave mine about 3-4 months. Basically until the start of the next winter season.

Re: Broken Collar bone (possible surgery)

Posted: Sat Jan 03, 2015 6:29 pm
by andy g
I support the previous view, it is very much down to the individual.

I was in my early 60s when an MTB accident broke my right clavicle almost exactly in the middle. Although I was whisked in A&E within minutes (the first vehicle on the scene was an off duty policeman , and the second was an ambulance. I should have bought a lottery ticket that day!) I was told to let it heal naturally with the two ends overlapping each other.

After 6 weeks I was needed 2 courses of physiotherapy to help with rotation mobility. The biomechanics of the shoulder had changed due to the shorter bone

I went back to boating after about 10 weeks, and gentle paddling was fine, but it was a fair while before I could roll without feeling a twitch from the affected area.

Andy