Broken collar bone, now what..??

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  • Broken collar bone, now what..??
  • Premier Icon H1ghland3r
    Subscriber

    So I managed to come off on a night ride last night and after an extended walk off the hill to where my wife could get to me and a trip to a&e for an X-ray I was sent home in a triangular bandage sling with a box of ibuprofen and told I’d get s call from the fracture clinic today to go see them and, to quote the a&e doc ‘they’ll almost certainly plate it’….
    Come this afternoon, still no call so the wife calls to see what’s what only to be told ‘there was a virtual appt. this morning and the consultant has decided to see how it heals on its own, you have an appointment to see us in a month.!!!’

    Is this SOP.? I’ve been given no advice as to how long to immobilise it, or what, if anything to do to ensure it knits correctly, the fling u have is highly temporary and is basically serving no purpose st the moment and I’m in quite a lot of pain..

    I know there are a few docs on here so thought I’d ask if I need to be kicking up a bit of a fuss rather than just taking what I’m told at face value.. The last thing I want is to wait and then be told that it’s healing badly and I’ll have restricted movement or worse…

    Putting it out to the STW hive mind for advice…

    Premier Icon H1ghland3r
    Subscriber

    Wife and I have already discussed that option, I don’t have private insurance so would have to pay for it, no idea what the costs are but I’m assuming it won’t be cheap.!
    Also need a referral from GP to do that I believe so could talk it through with him when I can get an appt.

    To be be honest though I’m more concerned about the potential gap in care that seems to have happened, I left the hospital last very much with the impression that I would be seeing someone today and that therefore what was done last night was all very temporary, just to get me through the night..

    fasthaggis
    Member

    I let mine heal on it’s own,so I am now rocking the Quasimodo look.

    Premier Icon H1ghland3r
    Subscriber

    That’s very reassuring thanks…

    Edit: missing smiley.! 😯

    Premier Icon 40mpg
    Subscriber

    That does sound like a bit of a fob off, but TBH there’s not a whole lot they can do for a collar bone, either plate it or not.

    I broke mine twice in 2 years a while back. They explained that plating it can cause problems with the nerves (there’s a lot that run past your collar bone) leading to tingling/loss of use in fingers / hand so they tend to avoid that if possible.

    If not plating, its important to get physio advice. The bone forms a soft joint with ‘tendrils’ first, then a hard lump around the join which eventually gets absorbed back a bit (I’ve still got a small lump 6 years later).

    First time was really painful so I over-used the sling to stabilise it, which lead to frozen shoulder and elbow. Now that IS painful! Try to keep your elbow moving whenever you can to start, then when the soft joint forms (usually after 2-6 weeks i think depending on how good your blood flow to the area is – mine was crap!) I was told to gently swing my arm (like when walking) to move the shoulder and promote blood flow. This hurt and I didnt do it enough!

    Get down your local pharmacy and buy a better padded sling first – the foam straps they provide are crap and tug at your neck. After a few weeks I started using the European ones which is like a cross-your-heart bra backwards – basically pulls your shoulder back and up to support. This gives much more mobility and I found it much more comfortable.

    So basically pester the fracture clinic / your doc to get some physio advice pronto, and good luck healing – I feel your pain!

    Premier Icon Del
    Subscriber

    i’d expect they’d want you back in a week for another xray and a visit with the doc to see how it’s settled. if not, ask for that to happen. also explain that you’re a cyclist and you want to carry on, so you’d like to see a physio. they won’t be able to do much initially but they can look at your xrays and answer daft questions that you’re bound to have about how much you can move it and all that.
    squeaky wheel gets the grease, so don’t be afraid to ask.
    try not to keep it in the sling all the time or your shoulder will have problems later. if you’re sat down for a bit pop it out the sling and rest your arm somewhere you can be comfortable.
    i’d imagine your GP can get access to your xrays so go there for a chat as well if you want. if you can’t get an appointment you can always just turn up and see them after appointments have finished – they have a duty of care.
    IANAD, but I have broken both my collarbones. 😀
    good luck. you’ll be in for some more pain now and then, but likely you’ll be fine. 3 million years of evolution and all that.
    good luck.

    Premier Icon 40mpg
    Subscriber

    Oh, I did go private with mine (via work scheme) and saw teh same specialist as at the initial fracture clinic. I dont think there was any advantage to private.

    Steve77
    Member

    These mostly heal on their own ok, and even if they don’t you don’t risk much (other than time) by waiting and seeing. That said I’ve broken both sides and had them both plated and would encourage anyone who isn’t a big risk for surgery to do the same. You getter a better end result, and you get it faster. Look online for a surgeon who does a lot of these ops and go and take your x-ray to him for a second opinion. It will help if you can say you need it to heal exactly as it was for your job or that you play sport at a high level etc.

    pdw
    Member

    Sounds odd to me. When I did mine, I got given a less temporary, adjustable sling, and also some advice on what I should and shouldn’t do with it, when I could expect to be driving, etc.

    Although it was basically “you’re unlikely to do yourself any harm by trying to do to much with it, book an appointment for 6 weeks time, but unless there’s problems, cancel it.”

    fasthaggis
    Member

    I was told at the time that bolting it would not make it heal any stronger,so just left it.I did the other side 2 years later so I kinda balanced it up.That was 20 years ago and I don’t notice too much restricted movement and it never bothers me.

    Rob Hilton
    Member

    Is this SOP.?

    Yes. It’s just what you don’t want happening as you want someone to make you fit and well again.

    I’ve had it twice, it lingered on for ever before they plated it, the 2nd didn’t need it and they wouldn’t even though I wanted it done (I understand why they don’t want to slice people open).

    Had I known about these guys the 2nd time I’d have given it a go – will defnly if it happens again. It might be black magic, but if it works it works regardless of whether you believe in it, no?

    Home

    crispycross
    Member

    40 mpg has it spot on. I’ve broken both of mine, one at age 20 and the other one at 40. Both healed naturally. I remember most about the recent one. I kept my elbow mobile, slept on my back and felt the movement stop after about 10-12 days. I used a figure-8 bandage which kept the shoulder pulled back gently – that can help to keep the bone aligned. Mine knitted with a bit of a chicane in it but it’s about the right length, so now I have no symptoms or weakness.
    I was back on the turbo, still with a sing, in 7 days just to relieve the boredom. Luckily, the consultant I had a 4 week follow up with was a shoulder specialist and cyclist, so I was confident in the advice I was given. First road ride at 4 weeks, then at 6 weeks I went on a 6-day training camp (Tenerife – highly recommended) and at the start of week 8 I was racing cyclocross again. Crashed into a tree at week 12, bruised shoulder but solid collarbone.

    Good luck!

    Premier Icon H1ghland3r
    Subscriber

    Any kind of sling would be better than the ‘Boy Scout special’ I have got on now, can’t really put any weight on it as it presses down in the break when I do ..
    Am willing to be persuaded either way in plate or not as there seems to be pluses and minuses with potential nerve problems but I can’t be immobile/unable to drive for 6+ weeks so if that’s the alternative then I’ll have to look at getting it plated…
    Wife has already ordered a better sling as u can’t see this healing at all the way it is now, I can feel the bone moving whenever I move at all.. 😥
    Will push to see the GP asap and get hold of X-rays so I can get to a physio and take it from there…

    Thanks for the advice it’s helping take my mind off the pain…

    Premier Icon weeksy
    Subscriber

    The collar bones seems to heal quite well, you can get a reasonably large gap ‘filled’ in the process. Mine was about 3mm apart but has healed up sweetly, I have a big bumpy bit there… but it’s been fine and dandy since… it’s all good IMO.

    Premier Icon Pawsy_Bear
    Subscriber

    decided to let mine heal on its own. Who wants intrusive surgery. Their right to consider it.

    taxi25
    Member

    This is my right collar bone I’ve broken it 4 times. They’ve never plated it and I never pushed, it always heals up on its own sooner or later.

    Premier Icon gummikuh
    Subscriber

    Yep same here, broke both mine, the right one 3 times, last time I shoulder charged a tree and snapped the shoulder blade too! I even tried to ride home, lasted about 3 minutes before I decided that was pretty stupid and there was nothing supporting my right arm! had to phone the wife to come and collect (she is a GP) NO sympathy.

    My clavicle has a big lump in it and looks odd but still works.
    It will heal in around 4 weeks, keep moving it and get a better sling.

    Occupational hazard for a cyclist unfortunately.

    Ro5ey
    Member

    Get yourself to Ipswich

    jamesfts
    Member

    Get one of these and try to keep moving as much as possible – a bit like ribs, there isn’t much you can do.

    Luckily mine was a straightforward break and didn’t need to get it plated, was at work the next day, driving shortly after that and back on the bike within the month.

    http://www.physioroom.com/product/ProCare_Universal_Clavicle_Support/2042/38143.html?gclid=CjwKEAiAova1BRDS15OXjcug_FMSJACWNAKZapNRa_04Qexk46E1huTBrdo1ccDXgIVJt9j0dgVAzBoC_TTw_wcB

    Premier Icon H1ghland3r
    Subscriber

    So it seems like I must have poked someone correctly.. Just had a phone call from the orthopaedic consultant to talk me through what is going to happen. Apparently I would have been contacted this morning if their was anything to be done treatmentwise, it’s a midpoint break, fairly clean and he reckons it should heal quite nicely on its own in 3-6 months.!!

    Will need to see how much I can bring that forward, they did point out that I wouldnt be covered by car insurance if I drive before my appt. in 4 weeks to get the all clear to drive again. He said I should be trying very light passive movement of the elbow and shoulder to ensure they don’t seize up but mostly just keep it immobile and rest it for the first week or two. Am going to see a sports physio next week just to talk through what I should be doing and when to ensure it heals fast and fully… I’m in Peebles so there is no shortage of cyclist specialist physio’s….

    Think I am just having trouble coming to terms with basically having to sit and wait for 2-3 months while it heals without me being able to do much to speed things along..
    Doesn’t help of course that I had a big list of events I was doing this year starting with Vallelujah which I don’t think is going to be feasible. I’m currently keeping my hopes up for the l’etape Loch Ness which I’m signed up for in 10 weeks… So that’s my current target…

    Premier Icon gummikuh
    Subscriber

    You should be able to set the bike up on a static and spin away, sit up a bit upright and not lean on the bars.
    All helps?
    I was able to ride like this after around 2 weeks.

    Given the state of the countryside, might be a better idea anyway.

    Just think how this would feel in the middle of summer!

    Premier Icon H1ghland3r
    Subscriber

    How does that clavicle support work jamesfts.?? It looks from the picture like the strap would go right over the break.?!?
    The wife has a couple of more traditional slings coming tomorrow but it looks like that would give much better freedom of movement.?!
    Did you start wearing that straight away? Or after a week or two.??

    Premier Icon jairaj
    Subscriber

    Sounds like you’re getting poor service from the NHS. I’d at least expect a bit more information from them about how to take care of it to help it heal well. any yes the boy scout sling is as good as it gets in my experience with NHS.

    I’ve broken a few bones and had really good service from NHS apart from when I broken my clavicle in June 2012.

    First fracture clinic appointment the doctor said it was a bad break and quite a bit of separation but thought it might heel ok without any intervention, lets wait and see in till the next appointment.

    A couple weeks later had second appointment at the fracture clinic and the doctor said there was a little sign of progress but no where near as much as would be expected and then left the decision up to me about whether to operate or not. I told him I wasn’t qualified to make the decision as I had no idea of the pros and cons. He wasn’t much help in the conversation after that. So I left saying i’ll need to get more information before I can make a decision.

    Contacted two doctors in related fields through friends and family connections to get other opinions and more info. Both said for the severity of the break and the fact I was a active person it would be better to operate and get a plate on it.

    Tried to contact NHS to get another appointment to tell fracture clinic doctor I would like to operate but had to wait 2 weeks for the next slot.

    I had BUPA health care through work so decided to use it. I saw a BUPA doc who was also a cyclist and keen outdoor person who also said a plate was the best option for me and within a few days he operated and had me fixed up.

    The private physio sessions after that were also much better than what I’ve had with NHS in the past. I felt I recovered quicker and have very little lasting effects from this injury.

    *** edit just seen your recent post. Looks like you’ve got the info you need in the end.

    Premier Icon jairaj
    Subscriber

    I got give one of these slings by BUPA and found it very comfortable.

    http://www.physioroom.com/product/Donjoy_Ultra_Sling_II/2042/38240.html

    taxi25
    Member

    I’ve always managed to get out on the road bike after 4wks and the mtb at about 6wks. Just riding around stuff nothing to hard, just remind yourself you don’t want to be falling of onto your shoulder.
    L’etape loch ness, 106k pretty flat in 10wks, You’ll have no problem.

    Premier Icon onewheelgood
    Subscriber

    Broke mine, the ends were nearly an inch apart. They said it would heal on its own, but after 3 months there was no sign of new bone formation. I asked for a second opinion, and the consultant said that 90% of collar bones heal on their own but mine wasn’t in the 90%. Said he could plate it in 6 weeks time. Or on Tuesday if I went private. I had it done on Tuesday.

    Premier Icon H1ghland3r
    Subscriber

    Thanks again for all the info and encouragement, I knew STW wouldn’t let me down.

    Taxi25, that’s what I was hoping to hear, never having done this before (believe it or not I’m 43 and this is the first bone I’ve broken!!), I wasn’t sure what was possible, it’s reassuring to know that I’m not being unrealistic.. The next step after that of course is that I’m supposed to be riding GT7 in a pair..!? Will use Loch Ness as an indicator I guess and just be careful not to overestimate my recovery..

    I guess the first step after a few days of resting it is to aim to get on the turbo gently in around 2-3 weeks or so

    Van Halen
    Member

    i went to the pub alot when i broke mine.

    mainly as i lived on my own and couldnt open tins so a pub dinner was the way forward.

    once i could hold a tin chelsea were well on their way to euro glory and i could miss that so still in the pub.

    i was back in work after a week as i was soooo bored (desk job so i could rest elbow on table and i could get train)

    i remember walking being agony to start with. had an almost seperated collarbone (about 2mm overlap). i too had a crap sling.

    no special exercises or any of that shizzle. i seem to remember being back on the bike in 2 months at the same jumps (minus a bit of confidence)

    crispycross
    Member

    Yes, it will move and be crunchy and painful and you’ll get sad and angry, but with a clean mid-point break and little displacement you’ll be fine. One morning you’ll wake up and realise you can’t feel movement any more – that’s the sticky bone ends actually sticking together – and it feels such a relief.
    My consultant said that bone growth and consolidation goes on for months, but 90% of the final strength can be reached in 6 to 8 weeks.

    Premier Icon steveh
    Subscriber

    The last two times I’ve broken mine I’ve been to see the guys at physioclinic.net, it’s a big trip from Sheffield but worth it. I was sceptical but the results for me on comparison to the first break I had and didn’t visit and the second very similar break where I did make me sure it’s worth it. Lots of pro mtb, mx, jockeys etc visit with injurys.

    jamesfts
    Member

    how does that clavicle support work jamesfts.?? It looks from the picture like the strap would go right over the break.?!?
    The wife has a couple of more traditional slings coming tomorrow but it looks like that would give much better freedom of movement.?!
    Did you start wearing that straight away? Or after a week or two.??

    I only started wearing it after getting nerve pain from using a more traditional sling. If/when I do it again I’ll be wearing it from the off as it gives much more support and freedom of movement. It wraps around your shoulder joints and supports from there, keeping you more upright and helps prevent the usual dropped you get with a broken collar bone.

    With regards to car insurance I called them up when I felt I was safe to drive and explained the situation, they didn’t ask for any confirmation from gp/hospital etc.

    Premier Icon H1ghland3r
    Subscriber

    Bit of an update 7 weeks on.

    Was back at fracture clinic yesterday and had a long discussion with the head of orthopaedics (mostly because the locus on-call consultant was awful and scared my wife and I to death)
    It’s not going well to be honest, I was told 3 weeks ago that I had a partial union of the bone with initial signs of new bone formation. Seems that was somewhere between highly optomistic reading of the X-ray and flat out wrong, dept. head yesterday says there is no visible signs on the X-ray of any union or healing at all between the 3 sets of X-rays I’ve had now.
    I have approx 1cm of overlap at the break so there is quite slump and I can feel the broken end of the bone through the skin.
    I’ve been seeing a sports physio since week 2 and due to progress with her I was in quite high spirits until yesterday as I was mostly out of the sling, only using it to support the shoulder when the weakened muscles got tired, with the exercises I have been doing I have greater than 90 degrees of movement out to the front and side, I can lean on the arm a little, not enough to push-up but leaning on a counter top is pain free.
    Anyway, head of orthopaedics yesterday tells me that it looks like I have what is called a ‘fibrous non Union’ which basically seems to mean that rather than bone forming to heal the break there is something akin to cartilage/ligament holding the bone together and that it may never heal over as bone..!!! She seemed to be fairly upbeat about that as she was able to apply good pressure on the break without pain and in addition to me having a little over 90 degree movement to the side that restriction is muscle based, she was able to lift my arm almost vertical to the side before it started to hurt.

    Needless to say this came as a bit of a shock and I’m pretty down about the whole thing now. The main issue I have is there seems to be little to nothing I can do to help the situation, I’m downing supplements and high protein meals like nothing else, trying to stay active and as I said seeing a physio weekly but apparently it’s making no difference…

    Not really sure what this long rambling post is meant to achieve, just helps to put it all down on ‘paper’ I guess…

    jimw
    Member

    Spoiler alert- this may not be what you want to hear but here goes:

    Anyhow, I had a fibrous non-union that was fine and mostly pain free for 18 months. I had been told that it had healed properly just like you.
    Unfortunately it started to break down and I was getting a lot of pain. I saw my GP who referred me to a shoulder specialist (not a general orthopaedic surgeon). It did take a while to see him but the upshot was that I had a plate put in. He assessed the original x-rays and basically said that it was never going to heal and this should have been picked up by the first consultant-who is a knee specialist.
    It was a longer healing process than if I had had the plate put in at the time of the initial break but three years down the line all is well.

    All of the above was on the NHS.

    jimw
    Member

    I meant to add that I would recommend trying to see a shoulder specialist if possible. It may be that your fibrous union may eventually calcify-I sincerely hope so. If you do consider plating be aware that it will extend your recovery time and any operation has it’s risks. I for one don’t regret pushing for the surgical option.

    jet26
    Member

    H1ighland3r – goal of treatment is return to function – ideally this is via fracture union.

    If you do get a fibrous non-union which allows PAINLESS RETURN TO NORMAL FUNCTION which is a distinct possibility then worrying x-rays is to some extent treating the X-ray and not you.

    I have seen people 15 years down the line from a non union who are fine (and have been throughout!).

    If you can’t get back to normal then clearly this is a different matter, but in short don’t sweat too much about x-rays – they are a guide based on how you are, not the be all and end all. Sounds like you got some good and sensible advice/opinion.

    fallsoffalot
    Member

    I Dont understand the get it moving and get physio idea, Its a broken bone.Keep the bloody thing still till its mended, THEN start rehab,
    Not a doctor but i have broken both ankles, heel,wrist, arm, collar bone,ribs, fingers,knee ligaments and now rockin a titanium knee.

    psycorp
    Member

    ^^^^^^^^^^^

    Your username not a joke then?

    fallsoffalot
    Member

    To be honest thats not all of em. but just saying let it at least make a union before moving it about. also all physio’s arent equal

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