Hi, first person to break this in my cycling group of friends. Broken it in to 3 pieces. Have broken quite a few things in the past but this is the most uncomfortable thing I’ve done. Constant pain even on the pain killers.
How long can I expect this to continue?
Thanks for any advice.

Go back, insist on surgical repair. That’s what I did. Sooner the better.

I had an op, and it was 3 months to heal, but relatively pain free post op.

To add substance; all current evidence suggests that early ORIF (open reduction, internal fixation) has a much better prognosis in the young fit and healthy adult than conservative treatment, leading to lower instances of non union and malunion. My own experience and opinion is that the NHS is relatively keen on conservative treatment due to lower overall risk (to them!) as they seem to view a slow, painful malunion as an acceptable outcome.

My experience; horrendous and nauseating pain for three days up to op, instant improvement after op, no analgesia required in about 1-2 weeks post op, normal day to day use of arm possible task to three weeks after op, fully healed in three months and a referral to physio that I didn’t need as a result.

I’d agree with v8ninety. I’m four weeks out from surgery repair which was 4 weeks after the break and in the word of the surgeon, 4 weeks makes it spicy! But now I’m driving, arm nearly as mobile as before and able to be back on the road bike (with extreme care). The level of numbness is minor and I was off the pain meds in less than a week and using the arm for some things within two weeks. Honestly getting it plated was the best decision possible

I put my foot down with the (reluctant) consultant from day one and had surgery three days after the injury. Best decision I ever made. My decision making journey was aided by a my thread on here somewhere;

http://singletrackworld.com/forum/topic/ouchy-ouchy-ouch-first-mtb-related-fracture

I’d add that I did have to insist on the op and the fact I was getting a lot of muscle pain from a totally misshapen shoulder didn’t concern the docs too much- basically had to tell them the current shape would massively impact my sports

What pinch flat said; you may have to fight for it, but it’s a winnable fight. Helps if your fracture is overlapped, comutated, generally nasty. Point out that it is very important to you that you want to be the same structural shape as before, and aren’t particularly fussed about a bit of superficial scarring/numbness.

The point that won it for me was that I could never wear body armour with the shape and shortness it was in, that and the fact that it moved and shortened by over an inch in the space of a weekend.

Yep. Basically you need to impress upon the docs that ‘malunion’ ie; the healing of the bones in a non ideal shape, is NOT an acceptable outcome for you. Because in the UK, it is seen as such. This is because (IMHO) malunion does not prevent most people from doing most things. Not an acceptable compromise for me, but other people’s MMV.

I’ll offer a counter to view to most of the above. I’ve broken collar bones 3 times over the years. Both sides have had one significant break in to 3 or 4 pieces. Both were given conservative treatment by the NHS but healed well and cause me no problems. For the second surgery was an option but I declined and feel it was the right choice.
The first major break had no additional treatment and I was riding again after 6 weeks with minimal discomfort.
The second major break had additional treatment from physioclinic.net guys in Ipswich. Using lasers and magnets they do treatments on lots of sports people (world cup dh racers, moto gp and mx champions etc) and specialise in sports injuries. I was very skeptical when I went but have no doubt the treatment helped. I was back riding on the road after 2.5 weeks and after 5 weeks was riding in Scotland for a week with no trouble.
I know a number of other people who have had breaks without surgery and none have significant issues from the malformed union. Those who had treatment with the guys in Ipswich had very good outcomes and quick healing.

Fair enough; good to hear an alternative viewpoint.

Yeah true enough, it will depend upon the break, for me I was ok with conservative initially but when my shoulder moved and shortened I decided it needed intervention as a malunion in that state wouldn’t have been acceptable- the docs weren’t overly concerned about the shoulder being 40mm shorter than the other and having no shape or form.

I broke mine twice a couple of years back. Not clean through and only one break each time, around 4 weeks both times. Never had physio or any follow up stuff, which I’m paying for now, stiff shoulder, can’t lift much weight on the left side. Need to get to a physio really

Yeah the physio can be key, mine has just started and the shoulder was in a terrible state, being really diligent and it’s already improving a lot.

I wouldnt be too quick to assume that surgery is the best option. Me personally, unless it was really obviously not going to heal conservatively, i’d be at least trying the non-operative route first.

Broke mine on 25 April. Break at shoulder end and a floating shard, plus partial detachment from sternum. I was advised that plating was the best option and they did it the next day. I take regular high doses of painkillers due to osteoarthritis and to be fair barely felt more than a bit of discomfort.
A consultant back home criticised the decision to plate it, but another said there was little choice.
Plated I’ve had more or less full movement after a couple of weeks. However, the bone growth is slow, and I’ve just had a Ct scan to see what’s going on.

Broke mine 24 May. Lots of pieces (because i’m fat)
Had a hook plate. Spent the time since like a fellow from Trainspotting but with a arm I cannot put a shirt on or wipe me botty with. Think walking about with the claw. But in a months time I will have it removed and for the rest of my natural I will have full mobility and the best possible outcome, (Presuming my fat ass dosen’t fall off on that side again)
And you lot complain about the weather this summer!

i’d be at least trying the non-operative route first.

Whilst I can completely understand you feeling this, it’s a gamble, as there seem to be diminishing returns as time passes delaying surgery. The most benefit from ORIF is gained from having it soon after the injury, so that no malformation has taken place and the surrounding musculature has not atrophied through mispositioning and lack of use. Seeing the people on this thread who have/will need physio, there seems to be a direct correlation between rapid intervention and subsequent time/effort to rehab to full fitness. I’m sitting typing this now, ten weeks post fracture, having originally sustained an unpleasant displaced commutated fracture. However I am now fully fit for work, shoulder full strength, discharged from physio as not needing any because my shoulder was not immobilised by the injury for more than a few days. FOR me, it was undoubtedly the best option. YMMV.

Interestingly, the Reg present (but not performing) the surgery said to me afterwards he could not see any way it could have healed successfully as there was a slab of muscle in between the broken ends. The SHO who booked me in, whilst non-comittal about whether I should have an operation, when I asked him what he’d do if it was him, he said he’d have it fixed all day long, without any hesitation. Onlt the consultant (who carries the can, risk wise) was more resistant.

Thanks for your experiences guys, got to do some thinking.

Broke mine in ,june- not as bad as yours so no surgery required and I was on the bike within 5/6 weeks. The best tip I got from STW was to buy a figure 8 sling and use that rather than the traditional NHS one. The NHS one left me with a frozen elbow and neck pain which took longer to sort out in Physio than the fracture after only 2 weeks wearing it- fortunately someone from here told me to take it off before the damage was made any worse

Another break here back in May with conservative handling. Was all for surgery after posting on here but a phone call to an ex of mine, who is now an orthopaedic surgeon, convinced me to go conservative. Was also in 3 pieces but with not huge degree of shortening and very little pain. I am guessing I took no more than 3 co-codamols in the period following the break. After 3 weeks I had my first turbo session and few days later was on the bike. After 5 weeks I was back on the mountain (gently) and at 8 weeks did a MTB orienteering event. At bang on 9 weeks after the break I did a week of DH stuff in the Alps with Trail Addiction. I won’t say that it has healed to anything like the shape of the other one and that I am unaware of it ever happening because that wopuld not be true. Now and again I feel it as a very dull ache and there is a lump there. I think if I had been in massive pain at the time I may have insisted on surgery. As it is I am happy with the outcome. It has not changed my life in any way really.

Broke mine into three pieces to and they wouldn’t plate it to start with, took them 12 weeks and a ton of xrays and they finally came to the conclusion it wasn’t going to fix, it looked pretty obvious to me it was never going to fix as there was a massive gap. Anyway they eventually plated it, no issues and it fixed up well. Not had any issues with the plate really.

Surgery always comes with risk, but I believe its more the cost that stops the NHS plating more. In the US they plate everything from I can tell.

Above goes to show quite how different everyone’s injuries and recovery is. Broke mine in May scuppering June Alps trip. Bone In a few bits but nicely aligned and I trusted the consultant I saw and went conservative. After a horrid sleepless 14 days you could feel it healing. Whilst not painful after a month or so it took 3 months before it felt anywhere near right or strong. So I kept off the bike for mtb ing until after the family hols. Amazed about stories of riding turbos after three weeks. I’ve broken loads of bones and so know how to jusdge my body but I just wasn’t ready. Then went for it in sept and just back from cyb snowdon tri last weekend feeling good again.

about 2 months before I felt it was healed. Took at least 6 months before I felt confident on it, and about a year before I felt confident enough to allow a proper dunt on that shoulder. The latter may have been more psychological though.

Mines healed naturally, was 1 clean break through the centre, no real disformation apart from a raised lump in the middle of my right shoulder. not particular noticeable and has never caused me any bother.

I bust mine last May. Pretty badly displaced. Had discussion with orthopaedic reg about fixing or not.
I opted not to basically because of being self employed and not wanting to take time off for surgery. (Timing of the break was one week before a scheduled week off work, so had a week of getting the train and doing home visits on foot, then a week off, then back to normal.) Hooray no time off work at all. Partners happy. I had had 12 weeks off when I broke my humerus really badly in 2007 which did require plating. That also affected my decision making.
This was a bad decision. Didn’t really feel confident till March/April this year ie 10-11 months after the break. I’d started riding again last October but couldn’t push it. Had an off in early Jan that really hurt and was worried I had refractured it but it was ok.
If I was in same position again I’d get it plated asap.

Edit: re comment above about NHS doesn’t plate more due to cost. Completely untrue and a slur on the surgeons. It is not a consideration in my experience. If anything the way the NHS is funded encourages more surgery through payment by results. The hospitals get paid for what they do. At the high levels there may be discussions in contract meetings between commissioners and providers about “planned levels of activity” but these are not the clinicians making the decisions on individual cases.

Broke mine June 2014, plate and 6 screws fitted and was ok to ride after 6 weeks, (on the road) didn’t give me too much trouble and after 10 weeks could ride the mtb again, had the plate removed in March and has given me no issues at all, movement all ok, strength took some time to build but all was good until 2 weeks ago, broke it again, tip of bone back to original break line (wedge shape) and now plated back together, surgeons described it as “a mighty fine mess”.

No idea when I can ride this time, hope to find out more this week when I go back, initial words from the doc are not for a long while, and at best only on the road…….bugger……..