It wasn’t the jump wot done it, it was the awful landing!

So many questions I don’t know where to start!
I just don’t know what to expect. How long off work (I’m self employed) how long must it be immobile etc etc. a clean snap at the top end by my shoulder. My arms in a sling and they said (at Dumfries hospital) it’ll heal on its own and to present myself at my local A&E (Macclesfield) on Monday to get on their books. Can I ask for it to be plated/pinned or do I have no say in such things?

(I’m 49 and should know better!)

Thanks in advance
Chris

I think you do have a say. I went to Stepping Hill, they were trying to set it back into place. They thought that had, then my shoulder just slunked and it fell right back out of place again, when I went in I said that I wanted it plated. After trying to get it back in again they gave in, admitted me and gave me a plate the next day.

HTH

don’t keep your arm completely immobilised or your shoulder and/or elbow will be fecked. when you’re sat down let your arm out and move it to different positions.
guess you’ve just done it?
you’ll get another xray so they can see that it’s all migrating back to ( sort of ) where it should be. the bone is in a sheath so it ‘should’ figure itself out.
ask to see physio.
find out what you can/can’t do, having seen the physio.
it’s a scary old business so don’t be afraid to take someone along who can help ask questions.
ask to see the physio.
make it clear that you’re in to sport and need to get back to full strength and range of movement.
my local hospital is good, and the physios are right outside the doctor’s offices, but even so, it’s a bit of a sausage factory. don’t be afraid to ask questions and take their time – it’s what they’re there for.
ask to see the physios at week 4, as well as your contact on monday.
any contact that is offered, take it. now is not the time to be modest/unassuming/not wanting to make any trouble.
take the pain killers.
i’ve done both mine. the second one was a worse break, and my shoulder on that side is closer to my neck than it used to be, but range of movement is better, and the shoulder on that side doesn’t click or graunch. just because i knew what to do and how to treat it.
i had a week off work for both, and walked to work after that. probably fully mobile and able to use it at 6 weeks ( standard bone healing time ), back riding gently at 8, fully confident on it at 10.
if you go the plate route ( i wouldn’t personally ) remember that if you suffer a similar impact later you will have an increased risk of shoulder or neck damage – effectively the collar bone is sacrificial.
good luck, but you’ll be ok. 3 million years of evolution and all that. chin up. 😀

Sound advice from Del
Having broken my right collarbone 2 1/2 times, I will offer the following, but bear in mind that eveyone is different.

I was a couple or so years younger than you when I broke it for the first time, good clean break, reasonably aligned and towards the neck end of the clavicle.. I had four weeks off work as the school I was working in was petrified I’d get barged into by a student in the corridor or workshop and make it worse. Went back when I could drive. Plating was not mentioned at all, just got on with it. The limiting factor in the driving was wearing a seatbelt as it was my right shoulder.

The second time was four years later and it was much closer to the shoulder joint and was more displaced. I had about five weeks off work as it partly coincided with a holiday, I was told it was healed but after 12 months or so it started becoming very uncomfortable again so had it x-rayed at 18 months on and was told I had a complete non-union so after a discussion, had it plated.

I sincerely wish I had had it plated when it broke as it was another period off work and another recuperation. As you could possibly imagine I was not popular.

Having said that, I have known others who have had uncomplicated healing and have been back at (desk) work the same week. The problem for others has been the time before being recomended to start driving again. this seems to vary depending on the individual. One guy I know was told not to drive for 8 weeks, another was OK after two. Itbis actually the responsibility of the driver to make that choice, but bear in mind your insurance company may not be impressed if you go against the advice of your consultant and are involved in an accident.

I had a clean break like yours, but regard an op the decision to plate was taken right from the start, there was no consultation over it.
I had no particular pain whilst waiting for the op (5 days later), but kept it in a sling and was careful, caught the train to work. might be worth asking for a decent sling right from the start rather than the first aid triangle I started with, after a few days it was really cutting into my neck.
Had the op on a Friday morning and for two days and nights it was unpleasant (clock watching for the next painkiller), but at about Sunday I was fine and stopped the painkillers, flew to Spain for a few days on the Wed. I think they ask you to keep using the sling even tho you feel you don’t really need it. I felt happy driving maybe 8-10 days after the op but was right hand side break so less used arm for driving, left side break would probably make it really difficult for gear changing.
Presumably the advantage with an op is that it is effectively fixed as long as you remain sensible and sedentary for a while and can pretty much get on with life. Didn’t take any time off work apart from the 1 week holiday I’d already booked (was a week immediately after the op). I wasn’t in any hurry to get back on the bike. I started a bit of physio after about 8 weeks for some muscle pain.
as said above, every case is different

Get a proper clavicle sling, figure of 8 style, Amazon sell them but there must be other sources available.

Avoid Ibruprofein related pain-killers as it slows down bone regrowth

If near Ipswich visit the Physio Center for laser and magnetic treatment to speed the healing process.

Avoid plating unless really required.

Have read that to knit broken bones together quicker is to be placed in a pressurised capsule
Pretty common for Ahletes.

I pushed for having mine plated and got my own way, having spent 48hrs reading ALL about the pros and cons. Glad I did and would recommend it to anyone suffering a similar fracture to mine, which was a displaced fracture of greater than 20mm, with two north-south fragments. In most civilised countries this would be a no brainer, as both those things make the chance of a malunion or even a non union high. I would probably reservedly recommend it for simpler fractures too mind you; as the pros (for me) far outweighed the real and potential cons.

Pros of surgery;
• Little need for splinting less than a week after the op; which meant that whilst I couldn’t do much useful with the arm, importantly I could keep it mobile, which reduced my need for physio to nil.
• immediately reduced pain (mine was goppingly painful, ymmv) and more importantly the improved sensation of actually being the correct shape again, and not feeling bits of bone grating together when you move in bed/sit funny/try to get up from seated/cough.

Cons
• Scar isn’t very pretty (but nor am I, and nor is a huge calcified lump under the skin of a misshapen shoulder, which is what I’d have likely ended up with).
• Small triangle of completely numb skin caused by the dissection of a nerve during surgery (literally not a problem).
• Risks of going under knife vs not going under knife. GA’s are serious shit.
• Potential of the metalwork being annoying or unsightly. Mines fine. Yours may not be.
• Had to book fit quicker, which was a bit of a shame, but literally had no reason to not be at work after about two weeks (obviously as you are self employed this will be on the ‘pro’ list anyway.

My thread, for reference

I broke my right one on Tuesday evening at the shoulder end, don’t think its too bad as it s not that painful at all. I can move the arm quite a lot and have been doing stupid things like playing footie with the kids, longish dog walks and only had a day off work to go to fracture clinic. Its not painful in bed but it did hurt this morning when my 5 year old threw me a balloon and I automatically raised both arms to catch it! This is all compared to the left side that I broke 4 years ago which hurt a lot and I did none of the above…….so they all vary..

Busted mine on the 1st of this month, bad landing as yourself and with a clean break.
In HK they are not keen to go the surgery route (pins)if it is a clean break, currently I am in a shoulder brace which looks similar to those underarm gun holsters 70’s detectives used to wear.
I am lucky as I work from home and could use some holiday up so the recovery has not been too bad and I have tried to limited the amount of time I spend out and about to limit the pressure i place on my left arm.
If it is affecting your work I would see if you can get it pinned, from feedback from friends it appears the best option to enable you to resume work and recover.

Busted collar bone threads on STW are the one subject where you’re guaranteed to get a lot of very well informed advice from non-medically trained people 😀

I’ve done both mine also and had both plated.

Here’s something that doesn’t usually get reported though.

Once you have the plate in, apart from it hurting like a Son of a Bitch whenever anything falls onto it (and I mean it’s excruciatingly painful and if you have small children a head flopping tiredly onto your clavicle is the classic example), you have also now made your ‘fuse’ much stronger than the bones around it.

If you crash again, bear in mind that the next most likely thing to snap will be your upper arm. That is still better than actually breaking the clavicle with a plate in it again, but still, a lot more of an issue than breakign the clavicle itself.

I am obviously speaking from experience. 🙁 Managed to shatter my upper humerus into five bits and only narrowly managed to avoid surgery on it. My right arm now aches after any prolonged period on the bike.

Thanks for taking the time for those long posts, I really appreciate it.

The massive problem I have is that I’m a tradesman (plumber) so my work is very physical. I’m sitting in my local a&e as I write this so I’ll see what they say. Anything I can do to speed things up I will!

Once you have the plate in, apart from it hurting like a Son of a Bitch whenever anything falls onto it (and I mean it’s excruciatingly painful and if you have small children a head flopping tiredly onto your clavicle is the classic example)

Not my experience. Obviously everyone is different. I was aware of mine for about 6-12 months, now don’t notice it at all (and that includes being regularly used as a climbing frame/trampoline by boisterous 4-5yo boys!)

…you have also now made your ‘fuse’ much stronger than the bones around it.

Also not my understanding of it (not that my understanding of it is much more positive). Doctors are at pains to explain that once the bone is healed, the metalwork (which is actually pretty flimsy) adds eff all to strength of the bone, and in fact because it is fixed through holes in the bone it is still weaker than a healthy, unbroken bone. This also means that any future fracture that involves the same clavicle has the chance of being a LOT more serious, as there’s a lot of sharp/spiky metalwork that you really don’t want floating around near important stuff like nerves, blood vessels and lungs…

Anything I can do to speed things up I will!

surgey would definitely do that, so long as it goes to plan. Mainly down to the reduction in immobilisation time meaning a reduction in the need for recovery physio.

As above, there will be lots of opinions. The bit that made me sit up and take notice was when my consultant told me that the medical profession is a bit divided on plate v leave. Traditionally he said that he was in the “leave it alone” camp, but having reviewed my x-rays his advise would be to have surgery.

I took his word and someone else came to do the op. They recommended leaving it while I was on the gurney in the anaesthetic room 😯

I carried on and his work failed a week later.

The original consultant asked lots of questions and said “we have no choice, we have to go back in, my advice is still to plate, but using a different plate. It’s more complex now and I would prefer to do it myself, can you wait 3 weeks?”. I winced (it was pretty much all I could do that the time) and waited three weeks in a drug induced haze. The morning after the 2nd op I felt a bit bruised, but 90% pain free

In summary, there are a lot of factors involved, but listen hard to the consultant, make notes, ask any questions you can think of and ask for a second opinion if you want one

Good luck

EDIT – I was late to the physic camp due to the delay about. I made things much harder, but I tried to be a model patient and made good progress. Now have full movement and most strength, but if anyone touches my shoulder in the wrong place it is a bit hurty 😕

My 2p on the subject is speak to a doctor. Having broken a few bones before (including my clavicle and having it plated) my experience is all broken bones are not same. Small differences in the position of the break or how the bones are situated post break etc etc can all lead to different treatment and rehabilitation.

It can be a bit frustrating with the NHS having to wait to see a doctor at the fracture clinic for real advice rather than getting it from A&E doctor. But when you do get an appointment with the specialist they are usually more knowledgeable and able to advise you a lot better on your situation.

Make sure they know you are active / sporty person and would like to resume these activities one healed. I was borderline needing a plate but because I was an active person the doctor felt putting a plate in was worth the risk.

Good luck hope you heal quickly and back to normal soon.

Mine was going to be operated on but the senior consultant over-ruled that decision (the cynic in me thinks this was for budgetary reasons). I didn’t ride for 3 months because I’d heard horror stories from fellow club cyclists who tried to ride too soon. Moreover, it was during November/December and raining a lot, so not the worse months to miss out on.

It wasn’t as painful as others have experienced and I could sleep more-or-less OK. I have a desk job and can also work from home so overall it didn’t affect me that badly.

Absolutely agree with physio and keeping it mobile once the physio/consultant says it’s OK to.

Flossie,

Firstly I’ll declare some subject matter expertise – I’m a senior medic. Many of the comments above are well meaning but incorrect or based upon assumptions.

Secondly – the management of clavicle fractures has changed dramatically in the past few years as techniques have evolved, but what treatment is correct for you depends on multiple factors such as the nature of the break, your level of activity and expectations etc etc. You can’t and shouldn’t go into this level of detail in this forum.

If you report to your local hospital ED, you will enter the orthopaedic surgery system via the “fracture clinic” in all probability. You may then end up on the books of a specialist knee surgeon, or back surgeon or hip surgeon. It all depends on who is the duty orthopaedic consultant on that day. Get my drift?

You need to consult a specialist upper limb surgeon. He or she will be best placed to advise you whether operative repair will suit you best, or whether yours is a relatively straightforward fracture that will heal easily with conservative treatment (i.e. in “collar and cuff”).

So what to do? Easiest approach is that when you are being booked into fracture clinic, be politely assertive and ask to be given an appointment for a team led by a specialist upper limb surgeon. That shouldn’t be difficult and may not incur any delay at all in you being seen. They may even do this as routine anyway. If they don’t – then you have other alternatives. One is to make such a request when you get to the fracture clinic; the other is to seek a private opinion.

I hope you get this sorted with as little fuss as possible. If you want to discuss this further – send me a PM.

Pete