Out on the road yesterday and my mate managed to send my flying off the bike resulting in a 'Displaced Midshaft Clavicle Fracture'

Anyone out there had one?

Seems like they are unclear on whether or not pinning is the right option. 😕 What route did you go down and what were the results

How long before you were exercising again? How long until full (whatever that is) recovery

Thanks

If it will heal without surgery then IMO that is the best option. My prefered treatment is a figure of eight bandage – for some reason out of fashion in the UK now.

http://www.calortho.net/shoulder_ac.php#fracture

The figure of eight holds alignment better I believe – its what I had when I broke my collar bone.

4 wks until the bone is knitted – at least – 12 till its as strong as it was

Broken my left one 10 times!

Agree with TJ, when I was a kid the treatment was a sling for 4? weeks then fig 8. More recently sling only, I'm sure that mine healed better, and was painless quicker with the fig 8.

Do as much other exercise as possible, just walking as much as possible will keep your fitness up, and you get less pissed off with being injured. A week after I broke it last time I did an 18 mile walk, used a bumbag to carry essentials, was not a day without pain, but I felt sooo much better for it.

Good luck, and hope you get more sleep tonight 'cos sleeping for the first night is not easy….

Thanks TJ.

Was yours a displaced or non displaced. It seems that is the critical factor in determining the benefit of surgery.

I agree a non operative route would be my preference if it makes sense.

10 times – wow???

I'm gong for a walk today but will be 'slightly less than 18 miles 🙂

Also may give the recumbant bike at the gym a pop!

Healing vibes dude,

Collar bones usually heal well without surgery even if they are displaced.

Did mine last year. Used one of those figure of eight bandages that TJ mentions.

I was back on the turbo after three weeks, back riding one day short of six weeks, and back racing two weeks later.

I posted this on a collar bone thread a while back…

Even with a fairly bad collar bone break it'll heal well and be as good as new if you treat it right.

The crucial stage is from day one to around ten to fourteen days. During the later part of this period you'll get what's known as a 'fibrous union'. After that it's just a hardening off process.

So, for the first couple of weeks do very little, rest and give it a chance. After that, assuming no complications, you can start turbo sessions. Pretty soon after, around the three week mark, that you can go for gentle rides (think, roadie towpath style). But, if you fall of and land on it you'll **** it good so be careful.

By six weeks you'll be back riding normal – but be careful, make it progressive. After two months, it's fixed, and it'll never break in the same place again.

All the above assumes that you are normal healthy sort of geezer.

There are those that say that you aren't a proper cyclist until you've broken a collar bone.

SB
BTW……
I ain't no doctor
ain't no doctors son

Thanks Strato.

May look into thes figure of 8 slings

I would also recommend a figure 8 sling. I was given (Ok I had to pay 40 euros!) one when I broke my collarbone in the Alps this summer. It was much more comfortable than the sling I used the previous time. I had a fracture further out towards the shoulder joint and it took me 12 weeks before I felt secure enough to go off road with it. I had an X-ray after 8 weeks and it had only just started to form bone along the fiberous material ( Oh that was a very serious fracture said the radiologist- was it? said I – I hadn't realised). My collarbone still aches after physio 16 weeks later but it is OK on the bike. I was strongly advised by the consutant not to have surgery unless absolutely necessary as there is a complex set of nerves and bood vessels in that area and provided you have no nerve impingement it is safer to leave it.

bad luck. **** painful, and that's after time has healed the memory! sure you know all about it now. LISTEN TO THE PHYSIO. if they give you an option for another appointment with them after 3 weeks, take it, if they don't, ask for one. worth their weight, even if it's only for a pshycological boost.
wrt the figure 8, there seems to be some discussion. in some cases they are worthwhile, but in some they're detrimental. probably worth asking the question though.
a LOT of them go back together without intervention, so don't panic ( that's why they don't operate as a matter of course ). try and keep it a little mobile, and don't mope. it WILL be ok. trust me. they call me an engineer at work. 😉
all the best, and keep your chin up.

whilst recovering form a badly broken collar bone i did a of walkng and swimming alongside physio…when i evntually got back onto the bikes (mellow road riding to being with) i found altering my riding position very helpful, (higher & more back swpet / supportive)
Using Jones H-Bars worked well for me.

Thanks all.

Your comments / inputs have helped a lot! 🙂

Broke my collar bone into 4 bits a few years ago. First A&E hardly told ne a thing about it, second A&E visit at least got me a view of the x-ray and a chat with a consultant who said unless I wanted to wear an off the shoulder dress it would be best to leave it to fix by itself. I now have a left collar bone with a great big lump in it and several other bends and bumps, but its probably twice as strong as the one on the right. Fortunately the big bump is just about high enough up to avoid a ruck sack strap but its not ideal. So I guess if its roughly together then it should be fine, mine took a regulation 6 weeks before I was swimming OK again.

TandemJeremy are you an orthopedic surgeon specializing in shoulder injuries?

If not I'm surprised at the speed with which you dish out clinical recommendations.

Broke my left clavicle 2 years ago. Only used a normaly sling since the figure of 8 is out of fashion for some reason. My bones still haven't healed and are now a fibrous non-union. Was going to get it fixed surgically but decided against it for now since it doesn't affect me at all, and the surgical option didn't sound like a bed of roses. I know they have to tell you all the possible problems, but all the talk about needing a local as well as a general anaesthetic, possible punctured lung if the drill slips, the skin scare tissue sticking to the plate giving you orange peel skin, a possible numb patch etc. etc. made me think I'll wait to see if I start getting any pain, and then consider surgery.
Anyway hope you feel better soon.

geetee – nope- registerd nurse – I did forget my usual caveat about internet medicine and I have not posted anything contentious
Any argument with what I said? apart from I should have qualified my opinion by stating my level of knowledge

I had a displaced mid-clavicle thingy… in 2006. Whoop! It F'ing, F'ing hurt!! A LOT. I really surpirsed no one has mentioned that – in passing? Am I just a BIG wuss or something? I'll phuct if I'd 've been on an internet forum TYPING at the time! Owch! I remember at one point, being on the phone crying to my Mum 😯

…it didn't seem that great spending your entire existence, 24 hrs a day, with two ends of bone knocking about happily together day and night. Makes me feel sick now just thinking about it.

…anyway, I ended up waiting about 2 1/2 months with the arm in a sling, before the bone specialist – after many X-rays – finally decided the bone hadn't fused and was never going to (perhaps I'd turned over in my sleep at the critical moment?). Then I'm on a waiting list for an operation to get the bone plated together – another 2 months. Then recovery from that – about 3 weeks. And finally – I find can use my body again!

The result – a perfectly fused and strong collarbone! With a bit of pimpy Ti plate under the skin that occasionally bangs into seatbelts etc., but you get used to that. A friend of mine didn't get his clavicle break operated on and it didn't ever heal – so he just got a 'fiborous fusion' thingy. His shoulder drops as a result and I'm sure he hasn't got full movement in it. Best to go for the surgery if it is needed.

I think I was out of action for about 6 months in total. I really got into Radio 4 and some seriously badass painkillers for about the first 2 weeks. …A perfect combination! Looking back now I have a feeling the 'delay' in the offical clavicle non-fusion diagnosis may have been due to the the need to 'delay' putting me on an NHS waiting list for surgery. I guess I'll never know though… 😉

Best treatment for broken collarbones these days is to have it fused back by lazer. 2 sessions with Brian Simpson in Ipswich will probably have you back in the saddle in under 2 weeks.

I know loads of BMX and 4X racers who have had this treatment.

Mike isn't thta the guy who fixed Boorman after he bust his in Dubai before going out to do the Dakar?

Bust both of mine, have what looks like a coat hanger now! Healed naturally, my mate has had his pinned and has issues with the screws catching his nerves. The only problem I really have is my toddler headbuts the stumps when I pick him up!

Mike

That is very interesting.

Off to google.

Thanks all – again

Genesis, probably. He's the only person I know of who does the lazer treatment.

I think it costs about £170 to fix a collarbone.

I bust mine back in 1998 and it was the most painful/frustrating injury I've had. If the lazer had been around then, I would have had it without hesitation.

Just spoken to the Brian Simpson clinic.

Very interesting indeed. All in the cost would be ~ £200 including brace. They seemed very confident that they could significantly speed things up.

Pretty sure I will go down this route. Big thanks Mike! Will keep you posted

Taz,
Before you splash the cash, have a read through this thread….. it's not all one-sided BTW.

http://forums.mxtrax.co.uk/showthread.php?t=20946

SB

The break that the guy had limited success with is pretty similar to mine 😕

I think common sense should tell people that if the 2 ends of the broken bone aren't touching, then lazer to fuse/knit them back together isn't going to be the best option.

Being involved in BMX and 4X racing, I speak to a lot of people who break collarbones and general consensus is that if the ends aren't touching, it usually needs pinning/plating.

Mike

Prior to this happening I think Iwould have agreed. I do think it is not as clear cut as that though. From a bone viewpoint that is probably the case. However potential nerve damage / infection are pretty big considerations

Being involved in BMX and 4X racing, I speak to a lot of people who break collarbones and general consensus is that if the ends aren't touching, it usually needs pinning/plating.

Err, I don't think that's the consensus amongst medical professionals. As I understand it, surgical treatment (at least for mid shaft fractures) is only indicated by rupture of the skin, or non-union after several months.

For example, I have a mid shaft clavical fracture that was about 2cm displaced 3 months ago. It's fine for riding now without any surgical intervention and associated risks (infection, damage to surrounding nerves etc).

No Taz, I agree it's not that clear cut, just summarising generally on what riders that I know who have broken collarbones have been told by their doctors.

A friend of mine broke his earlier this year and hospital just put him in a sling. 2 or 3 months later not much improvement so they changed their minds and pinned/plated it. They've advised him to have the pins/plate removed once the bone heals if he plans to carry on racing as it could cause more injury if he breaks it again with them still in there. So I guess for these reasons and the ones glenh states (infection, nerve damage, etc), and probably to cut down on theatre time/costs, this is why pinning/plating isn't the medical professions first option, even though it is the quickest and probably the best way to fix the broken bone.

When I broke mine it was a very clean mid-shaft break. When I laid in bed on my back the 2 ends met up perfectly and I couldn't even feel the break when I touched the bone. It was only when I sat up that it popped apart again. Had lazer been around back then (1998) it would have saved me 6-8 weeks of hassle in a sling.

Interesting Mike.

My bump competely disappears when I lie down also.

Booked an appointment with a specialist tomorrow. Will take it from there

if dis-placed get the figure of 8 on there asap -not just a sling, (and I know they avoid surgery, but get them to 'really seriously consider it) mine started to fuse with too much over lap, went to a figure of 8 too late, afterwards they asked if I wanted surgery to break it again reduce/remove the overlap, considered the pros and cons and stuck with it, but 2 years on hurts most days, no more press ups, hauling on the bars cab leave me smarting across my neck and shoulder – they do a really good figure of 8 velcro set up now adays- will look for a link – good luck

the phsyio give me two of these, used with a velcro sling

http://www.physioroom.com/product.php?utm_source=froogle&utm_medium=cost-per-click&pid=38143&cid=2042&affid=25&utm_campaign=ProCare_Universal_Clavicle

Gosh, sounds as though I was lucky. I broke my collarbone and "some" ribs. At hospital they ummed and ahhed about operating or not and decided not. The A&E Doctor (who had been on duty for over 48 hours but still managed to be friendly, helpful and kind) told me to lie down and whatever you do don't move it. That's what I did. It healed perfectly wtih hardly a bump now. My ribs sorted themselves out. What took the longest time (over two years) was the pain in my shoulder joint when moving my arm. Looking back I think I should maybe have tried to mobilise that joint without moving my collarbone. Anyway, all sorted now.

That laser thing sounds interesting tho, will have a look at that, ready for next time!

I completely battered my collarbone back in the end of March. Impact pretty much exploded the bone, and there was only about 20mm left attached to the shoulder side. Unfortunately, the first hopsital i went to – Stafford – didn't have a clue, and the "Doctor" there said it was all fine and a perfectly uncomplicated break. Sent me home with a couple of co-codamol and a crap sling that didn't fit.

Two days later, I went to my local A&E who immediately threw away the Stafford X-ray and took two more. The doctor there said it was one of the most severe breaks he'd ever seen, said the two bones were nowhere near each other and desperately unlikely to heal on their own. So, of course, he sent me home with a sling and told me to come back in a week.

The next week I returned, and the X-rays showed the bone (sternum side) was now trying to pierce my skin. They operated about three days later, and reassured me by saying that "they hoped it wouldn't pierce the skin in the meantime. If it does, pop in to A&E".

The really short bit left on the shoulder side meant they couldn't pin it, so they had to tie it together with some special string. It's now healed, after a fashion, but my shoulder is in a different position, so I've had alot of neck pain and muscular issues as all the muscles are now doing different jobs. I spent my first few rides struggling with right hand corners, as my new shoulder meant my weight distribution was completely different.

From what I;ve heard/read, though, pinning isn't always the best option. Sometimes the pins/metal cause other problems – with nerves/muscles as others have mentioned – and don't feel that nice. Going by your X_ray, though, those two bones need to be alot nearer together. They look about as far apart as mine were….

Did mine in September, see report here incl x-rays

http://www.singletrackworld.com/forum/topic/very-long-post-make-a-drink-pull-up-a-chair-and-enjoy-half-a-transalp

Am out on the bike now as good as ever. You must see a proper (sports) surgeon and see a (sports) physio, eg one attatched to a pro-rugby or football club – someone who will make you work hard,

You'll be back at it soon

C

I knew about figure of 8 braces from mates who played rugby, but when I asked for one at A&E instead of just a sling, I was told "we don't do that in this country".

Some of the nonsense spouted by Stafford A&E was jaw-dropping, so that doesn't surprise me.

My doctor had to burst into the X-ray room just to check that the clavicle was part of the shoulder. The radiographer looked utterly bemused, slowly responded "Yes, the clavicle will, of course, be visible in an X-ray of the shoulder", and then had to tell him off for using the patient door as he was putting himself needlessly at risk from radiation.

Jesus wept.

Had a good read about these figure of eight slings. Does seem like the benefits of them are not realy quanified vs 'normal' slings.

Lot's of confusion over what truly is the best course of action. Definitely no 'one size fits all' answer or approach

Absolutly Taz. Its all about opinions unfortunatly – no hard answers.

Get as much info as you can then when you go to fracture clinic you will have some basis to ask questions and understand the answers.

No useful advice to offer here – just hope you're back out and about soon! If it's any consolation, there are worse times of year to be on the bench. 🙂

A few years ago I was with a chap in Russia who broke his collarbone. They put him in a shoulder spica cast. Never seen that done in the west.

LOL! is that from the 'reader's fractures' section?

Thanks Ant. yes that thought had occurred to me also. Still enforced lay off vs planned or laziness feels different 🙁