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  • Collarbone -Last ride -tips please?
  • alric
    Member

    just riding along on sunday,first thing I remember is someone said he just put my (dislocated) thumb back in. Broken a collarbone and 6 ribs.So I still dont know what happened,probably wheel slipped and a tree hit me.
    Spent the night in hospital,now I’m not sure how aligned my bone is.So…is it going to heal optimally, as it is?
    Is/was their a figure of 8 bandage to straighten it more? iirc I had one when i did it before, but over 40 years ago
    An MX site recommends a Collarbone bra, for this- is there such a thing, and where do I get one?
    I get re-assessed friday,if surgery is an option, should I go for it?
    What is best practice to get it healed straight?
    It seems(to me) a regular break, near the middle
    I dont want complications down the line, from a shortened bone,etc

    whitestone
    Member

    I did mine in January, broken about mid-shaft with 3cm displacement/overlap. Neither Norwegian (where I was at the time) nor UK protocol suggested surgery – usually only for double breaks and/or bone fragments breaking the skin. Didn’t have or was offered a figure of 8 bandage, just had a plain sling.

    General advice was to use the sling to keep the shoulder up whilst the bone knitted and set. Apparently even with a 3cm displacement the bone will sort itself out. Went back for the 6 week check-up to be told it was all going well and to avoid doing anything that might fracture it again for the next three months. “Yeah, right” I thought, “I’ll be on my bike” Little did I know …

    Ask the doctors all that I’d say.

    Did mine last Sept, no surgery, took just over 3months before i could do anything significant with the arm. Dislocation muscle damage more significant than bone break it seemed for me. 1st ride after 3.5months. Physio after 4. Back to full strength now, can’t quite straighten above head as much as before, but physio is sorting it.

    Premier Icon tjagain
    Subscriber

    Treatment of fractured collarbones is something where the evidence base for different treatments is not strong and different countries sometimes do different things. I had a figure of eight when I did mine 40 years ago but this seems to be rarely used in the UK now. I guess thats what they mean by a collarbone bra!. Simple sling or even collar and cuff support is now the favoured UK treatment. surgery heals quicker and obviously you get better alignment but then you have all the risks of surgery and a lump of metal on top of your shoulder which can cause issues of its own.

    I think the figure of 8 gives better alignment / results but I am no orthopedic surgeon. Read up on the options and discuss on friday.

    alric
    Member

    reading more about this,there was an operating technique where a screw was put in that pulled the 2 parts together(rather than a plate) bit this isnt mentioned in the later articles I found

    Presumably a lag screw?

    In my limited knowledge that’s sort of orthopaedics 101 but it relies on you having the right shaped bone ends to screw together.

    The problem is, there’s no one-size-fits all answer to fractures. They’re too different to each other. To use a clichéed analogy, a carpenter could use whatever technique he wanted to fix a broken table depending on how the break looks and what techniques he knows will work. You can’t do a randomised trial of plate vs screw vs sling only since each pattern of injury is different. That’s why there’s no consensus on which treatment is ‘best’.

    Hip fractures are much more easily categorised so there is a bit of an evidence base.

    So my advice: get the opinion of someone who knows what they are doing (probably any NHS consultant with a few years’ experience). Talk it through with them, make sure they know that you’ll expect to ride your bike often when it’s mended and see what they say.

    Premier Icon ginkster
    Subscriber

    I broke mine in 3 places last summer while on holiday in France. French doc referred me for surgery but Brit doc from my insurance company was advising to leave it in line with normal UK practice. I opted for the surgery and was fixed up less than 24 hours after the crash. The surgeon was excellent – lots of practice I assume as it was in the Alps! Very glad I went that route as the shoulder recovered very rapidly, good enough to MTB across Iceland 5 weeks later. My ribs however took 3 months to stop hurting and there was little I could do to ease the pain. Thankfully they were surprisingly ok on the bike but not good sleeping.

    The shoulder is all good with no pain, full range of movement, a tidy scar (war wound!) and all symmetrical with the other side. I do have a very small lump under the skin on the edge of the plate but it does not bother me in any way. My doc and physio were very impressed with the surgery and how it speeded up my recovery. I would therefore recommend surgery but it is obviously not for everyone and there are risks. Your doc will be able to advise. Good luck.

    Premier Icon tjagain
    Subscriber

    I was in russia 30 years ago on a motorbike tour. One of the people crashed and broke a collarbone. The local hospital put him in a full shoulder spica! Yes that is a full rigid plaster of paris contraption like this

    [url=https://flic.kr/p/24k3s1]shoulder spica cast[/url] by quashercore05, on Flickr

    I think that would give you really good bone alignment but also serious muscle wastage and joint stiffness. Part of the issue with collarbone breaks – you are playing one factor off against another.

    Premier Icon steveh
    Subscriber

    figure 8 brace is common abroad but not in uk. I have used them on breaks before and find them much better, better movement and healing was good. I generally suggest physioclinic.net in ipswich at this point for some laser and magnet treatment which sounds like whichcraft but really works but it’s not really an option at the moment.

    Premier Icon asbrooks
    Subscriber

    I broke mine over 3 years ago. It never fused as the break was too far apart. It still is for all intense and purposes still broken.
    As soon as I was able I doing the physio as directed, then after I was discharged started doing some weights to build up the muscles in my shoulders. It doesn’t cause me any issues.

    Premier Icon Del
    Subscriber

    Whatever you do remember to move your arm about a bit. When you sit down take the arm out the sling and reposition it in order to adjust the elbow and shoulder position to avoid problems with these joints later.

    Premier Icon 40mpg
    Subscriber

    Dont get over enthusiastic on the turbo trainer with your arm in a sling and topple sideways.

    globalti
    Member

    There was a thread on collar bones within the last two weeks, why don’t you search for it? I added my bit and really don’t want to type it all out again!

    Edit: Here, I even found it for you:

    Clavicle collar bone non union – experiences

    boblo
    Member

    I’d go surgery as the first option. I’ve broken my left one twice. The first time was on a high speed descent and I came a proper cropper and it hurt like fu… errm a hurty thing. I had to finish the ride and drive back to Cambs from the Peak. The quacks gave me a 2′ square piece of cloth and 6 weeks. It healed up according to the medics.

    A year later, I had a little lie down in the grass and it went again. I elected for a plate and was back on the road bike within 7 days and off touring within 4. I did have a DVT so it wasn’t without excitement but I’d go that route again particularly if you can elect to via BUPA etc.

    Premier Icon tjagain
    Subscriber

    I would do almost anything to avoid having it plated. I certainly would not want it as first option for a simple break

    robo89
    Member

    I’m left with an ugly lump from a broken clavicle, it wasn’t healing at first and surgery was on the cards but then it started to heal, I now have limited back scratching movement, really wish I’d gone under the knife and had it set properly and plated, a scar is much better than an asymmetrical upper torso.

    Flapjack
    Member

    Over my lifetime I’ve broken my left clavicle in the same place on three different occasions – last time smashed into three places during an ‘over the bars’ moment. On this last occasion whilst in the fracture clinic the first consultant said I would need an operation and plates etc, the second (more experienced) had a look and basically said it’ll sort itself out – which it did with time. Several years later other than a lump and a bit of pain when it’s freezing, all is good 🙂

    Whilst I admit scars are cool, my plate feels weird under the skin and is uncomfortable when I wear heavy (20kg) rucksacks. Not a big deal but possibly worse than an asymmetrical torso??

    Premier Icon ticsmon
    Subscriber

    Depends how bad the break is. After being sent home in a sling and told it will heel itself the consultant saw my X-ray and phoned me straight away and recommended surgery due to a few floating bits of bone. Recovery was ok 2 months ish and physio for 3 months. it’s pretty good now but I get really sharp pain if I shot putt throw anything. I wish they’d got a joiner to put the screws in as two are wonky and I can feel them.

    boblo
    Member

    I can’t lie on my front in bed with mine but otherwise I have full movement and no nerve damage. Took 2-3 years for the nerves to get full feeling back.

    I managed to extend my Ti collection last year with another plate in the neck 🙃

    globalti
    Member

    The lesson I learned from my break is that British orthopods will do anything to avoid the risk of surgery and as 75% of collar bones do eventually heal in some way so they are right, but I would still insist on an x-ray after a month to check the likelihood of the bones joining. Mine were far apart after 3 months and the broken ends had gone to sleep and rounded off so the surgeon had to re-cut and damage them and fill the gap with synthetic bone to encourage them to regrow. Now my right shoulder is shorter than my left, which is irksome and a little uncomfortable.

    Premier Icon onewheelgood
    Subscriber

    I broke mine at Mayhem in June 2005. I was told it would heal on its own. In October of that year the ends of the bone were still an inch apart. Then I had surgery. When it had healed properly I had the plate and screws removed, because the surgeon said that if I was to break it again (and my choice of leisure pursuits made it likely that I would) it would make a real mess if the hardware was still in there. I’ve since had some pretty heavy impacts and not re-broken it (yet).
    null

    alric
    Member

    thanks for the replies, i got the xray and will see what the doc saysabout it monday
    there is ome debate about slings vs figure of 8 bandage(which seems more popular abroad), and I’ll try to get hold of the bandage unless i get convinced its a bad idea

    alexxx
    Member

    done 3.. figure of 8 is the best. one of mine has healed overlapped somewhat – got full range of motion though but its a little clicky.. probably not ideal when I’m older but no ill affects after 15 years. the others healed straight so needed no surgery.. its a good bone to break as you can literally listen to your body with how much it hurts as to how much you should do with it when recovering.

    alexxx
    Member

    I should add the overlapped one I had to go back in for emergency surgery because it came through the skin a bit later but… i blame the initial doc for not allowing it to be plated… think he was just wanting less done via NHS… I’d have got it plated if I knew better at the time and had the plate removed later

    Premier Icon Greybeard
    Subscriber

    I broke mine about 40 years ago, a skiing collision. It was put in a standard sling, not a fig 8, which I was told would help it heal faster. It did heal quickly but left a lump on the front edge, which caused me pain when carrying a rucksack for the next 20 years (don’t notice it now). Apparently the fig 8 would have helped.

    At the moment, I would certainly avoid surgery of any kind if I possible could, even at the cost of less than optimal shape. Keep away from hospital for your sake and the people who need it.

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