mppsu2003

Finally saw my ortho today 5 days after breaking collarbone. The fracture was displaced 3 CM. He basically said there are two options: surgery or let it heal on it’s own. Surgery would heal quicker, while it could take a couple of months on its own and leave me with a lump. Doc said in both cases functionality should return, though there’s a small risk of not healing if I let it go on it’s own.

Does anyone have experience with this? I’m okay skipping surgery as long as functionality eventually returns.

Maelochs

Two recent threads examining this issue ... I assume the same people will post he same stuff in this thread.

https://www.bikeforums.net/general-c...xperience.html
https://www.bikeforums.net/fifty-plu...g-recover.html

Dean V

I had a similar break about 30 yrs ago. Wasn't given the option of surgery.
I would take the surgery as I would rather not have the lump and it also makes your shoulder a bit narrower on that side.
The original symmetry would be preferable to me.

Dominae

If I had it to do all over again I would have chosen surgery. No question. 4 years later have a big bump and still painful if I sleep on it wrong. Plus, it took 10 weeks to heal naturally and that 10 weeks was no picnic.

popeye

The SO's was in three pieces with the center piece acting as a doubler. No surgery, on the trainer in 2 weeks and the road in 4. No problems other than a bump she is fine with now 6mo later. It is a non weight bearing injury so riding is fine if you don't crash again. Fancy Newport Beach surgeon did not recommend surgery nor did the trauma surgeon that used to frequent here.

canklecat

It's different for everyone. See three different ortho docs, you'll get three somewhat but not radically different opinions.

Surgery wasn't an option after my shoulder break and Grade 4 dislocation last year (I couldn't be intubated for anesthesia). By the time the trachea problem was corrected the shoulder had pretty much healed.

I spent most of last summer on the indoor trainer and finally got back on the bike after about three months, at first on an upright hybrid, then gradually more rides on the road bike.

At age 61, mine took much longer than I'd expected to not only heal but to stop hurting so much. It was darned near impossible to sleep or do anything for months. But I've been in physical therapy for six weeks and it's gotten significantly better. Less chronic pain, better strength and mobility.

There's still that distinctive ACV joint knot that almost everyone gets with shoulder injuries. That's permanent. But if I can avoid surgery or joint replacement I'll be satisfied.

In contrast a friend who's in her early 40s has had two serious shoulder injuries in the past two or three years and was back on her bike and riding faster than I can go in only a couple of weeks.

Ferrarif2002

Broke mine April 12th, it was a “Z” fracture so surgery was the only way to go. Had surgery on the 16th and the only pain I had was slight discomfort, like I couldn’t move it to get it to go away and that was only the day after surgery. The next day I was pain free and actually stopped using the sling after day 3. I didn’t lift anything over a pound for the first week then I started my own ROM work and started increasing basic use of the arm. I broke the other one a few years ago, no surgery needed as it was lined up perfectly and it healed straight and you can’t even tell it was broken but it took a good 4/5 weeks before I could move it as much as I could after one week on the recent one. I was on the trainer 6 days after surgery and honestly could have been back outside riding 3 weeks later but was in no hurry.

mppsu2003

Thanks.. mine was the “z” fracture too, but the doc stated pretty much equally the options for surgery and non-surgery. It’s just a tough choice to make. Either way pros and cons

Ferrarif2002

I didn’t “need” to have surgery but the way it was poking up it really was the only option to fully recover and the quickest way. I’ve had a number of bike related surgeries and if that’s what your apprehensive about, the surgery itself, I wouldn’t worry, it’s a quick routine surgery and if it happened again I’d make the same choice.

Chris L

I broke mine in 2011 after a collision with a red light runner. It healed on it's own in about six weeks (along with the two broken ribs from the same collision). I didn't have a surgery, in fact, the staff at the hospital where I was taken told me that surgery wouldn't help and I should let it heal on it's own. As it was, it healed up as good as new (I was mid 30s at the time). There was some stiffness after initially healing, but yoga fixed that remarkably quickly.

motosonic

I just went the no surgery option and I'm just over a year later and I'm still having issues and rehabbing. Of course, I broke my scapula, too.. so.. slightly different scenario. I think I might have opted for surgery if I were given the option next time because it feels like the healing process is a lot longer without it. But I was told the same as some others here that they couldn't do anything with surgery and this was my only option.

linnefaulk

I broke mine last August. I skipped the surgery as I didn't want the arthritis that occurred with my ankle surgery years ago. It took a long time to fully heal though I had no pain and started riding 3 weeks later. I do have a bump but surgery would also leave a bump because of the hardware.

wphamilton

I've been there, with a 3 cm displacement - the first time with the Open Reduction surgery, which I think was botched leading to breaking it again 2 years later and trying the conservative treatment which failed. I'm not a doctor, but here it is straight, from what I've learned.


Conservative - letting it heal on its own - is the preferred initial choice of *most* orthopedists, based on the principle that you generally avoid surgery if it's not *necessary* and the fact that most collarbone fractures *will* heal on their own. The drawback is the chance of "non-union" where the body doesn't actually join the ends together and you're left with the broken bone there, forever, but your shoulder is functional. 3 cm displacement is pretty big, with a good chance of a non-union.


That's what happened to me. The first break I had the plate installed right away and a few days later I'm back in action. But it was a very large plate, and my collarbone was twisted up at a strange angle, causing a pretty much permanent discomfort (some would say "pain") and I had it removed a year and a half later.


The first lesson I learned the hard way: ask for a LOW PROFILE plate especially if you have low body fat. The second lesson, perhaps vet the surgeon somehow or at least don't go the "lowest bidder" route.


Some time later I fell, a very minor fall, and it broke again. The orthopedist insisted that we try conservative treatment and I gave it a shot. What they might not tell you is that it will be months before they'll determine that it isn't going to work, and they may discourage surgery after that point, since you are probably functional at that point. In my case there was no calcification at all going on, I lost confidence with the sports clinic for other reasons I won't go into, and I sought a second and third opinion at a local hospital. I had the OR performed, and I think he had me under for an hour and a half cleaning out the massive scar tissue. I wound up using an ultrasonic bone growth stimulator because my body was balking at joining the bones. Perhaps because of the scar tissue, misaligned bones for so long, and delay from conservative treatment, but I don't know for sure why.


The low profile plate has caused no problems and is still there.


I now have a "fracture" on the other side, which didn't even show up on X-rays and has no displacement. That's ideal for conservative treatment, in a few weeks there will be little pain to deal with and I'll have mostly full function.


The other advantage of Open Reduction, in addition to better chances of a full union, is that you practically do it and you're done. Yeah it still takes the same time for the bones to heal, but you're back in business almost immediately. The drawback, it's surgery. It's trauma for your body, there's always a chance that you won't wake up from the anesthesia, and of course it's expensive.

mppsu2003

thanks for the responses. I’m about 11 days since the injury now... still sore and I can’t put any weight on it, not that I’ve tried much. I took the ortho’s advice and ditched the sling... he said it wasn’t doing anything to help keep the collarbone together, and wearing it could hinder other muscles and lead to frozen shoulder. Still taking it very easy though. Pain isn’t as mad, unless of course I move it. Right now I’d say it’s more uncomfortable than painful, with occassional bursts of pain a few times a day. Also have some stiffness in neck, arm, and back.

I know 3CM is pretty big. The doc said 80% chance it ***ons, albeit with a bump and all. I hope that’s accurate. It sounds like neither scenario for me is ideal. I’m doing the best I can with it, it’s just hard with a displacement that big. I just hope the doc was right, and I hope ditching the sling is the way to go like he said... It makes sense but I don’t see many other stories online if not wearing it.

Thanks again, any advice is appreciated.

canklecat

After my shoulder break and dislocation last year the first doc who was set to do the surgery wanted me to wear a sling to stabilize the joint for a few days before surgery. As it turned out I couldn't be intubated for surgery, so that didn't work out.

I switched to another clinic and got two opinions. The senior ortho doc said I could wear the sling occasionally if it felt better. The younger resident said to skip the sling. I wore it occasionally on long walks when the joint would ache and feel crunchy after a mile or so. Otherwise I didn't wear it at home.

wphamilton

Wear the sling in public because it keeps people from bumping into you. I'm wearing one now, but because I also have broken ribs I want to limited movement as much as I could, but I'm seldom actually using it. If you stay just three days in that sling, without ever moving your arm, you'll already be feeling atrophy in your muscles, really stiff painful joints. It's not worth the BS rehab that you'll go into IMO. On the other hand, with 3 cm separation wouldn't the bones need to stay relatively still in order to knit? I don't know about that, 3 cm is at the edge of "conservative treatment".

I have a separate sling that I use just for walking and running, where I added a strap at the elbow that reaches around my waist. It keeps the elbow fixed as a pivot point while allowing some movement of my arm, so far so good.

mppsu2003

thanks... I know that 3cm is highly displaced, but the dr said that natural healing and surgery would have similar recovery outcomes for me. I guess I’m in a Catch 22, which is frustrating.

Anyway, I’m curious... are there signs that the bone is starting to heal? IE do you feel tightness, etc. also, how long after the injury is it reasonable to expect to feel better? I don’t mean being able to use the injured arm to lift anything, I just mean feeling less pain and discomfort. For me the stiffness in my arm and back is more annoying than the broken bone. The pain has definitely subsided and been replaced by a feeling of general discomfort, unless I move it too much.

markjenn

I broke mine motorcycling and I don't know the displacement, but there was very obvious and pronounced displacement on the x-ray. I was also given the choice and told it would heal on its own (eventually). I didn't hesitate long - surgery with a Ti plate. The surgery, while not fun, was straightforward and I loved the fact that my shoulder and arm immediately felt "whole" and in proper alignment afterwards - I was able to get on with my life much quicker. I do have a surgery scar but it has faded to almost nothing and I do have some minor numbness in the area surrounding the scar (the incision severs some nerves that runs through the area) that has mostly gone away - this is all pretty much par for the course. Seven years later, I still occasionally have some minor pain if I stress it hard in certain lifting/pulling situation, but overall it feels fine and I'm glad I opted for the surgery.

- Mark

wphamilton

I can't say what the signs are, for it healing, because mine never did. I was mid-late 50's and there was a lot of stuff around the injury maybe interfering so I don't want to imply that you won't heal up. But the pains were pretty much gone after a few weeks, and the calcification - or lack thereof - showed up on x-rays.

The "soft callus" forms fully in 2-3 weeks, which should stiffen it up. It is connective tissue, some cartilage and soft spongy bone mass. After that point it starts transforming into the solid bone joint. I don't think you can really tell by feel whether that last step is happening.

Ferrarif2002

If you have any doubts about it healing on its own...I mean even 1%, get the surgery! I’m just over 2 months post surgery and I’ve been riding for a few weeks now and lifting weights for over a month. Life has returned to normal and functionality is essentially as good as before. I think you’re wasting time, you could have been over a week post op and not worrying about it anymore.

Here is my pics from the day of the accident



And a few days after


Xray pre-op


Xray post-op


Today

canklecat

I had no sensations during the bone healing process, but my break was relatively minor -- the coracoid process, a bone about the size of the end of my thumb that supports the rest of the dangly bits of the shoulder and arm.

Because I wasn't a candidate for surgery I had to let it heal naturally. I was surprised that it healed just about perfectly within six weeks. I'm 61 with borderline osteoporosis, so I expected problems. But the bone healed fine on schedule without surgery.

The tough part was the soft tissue stuff. Oddly, the residual chronic pain hasn't been the shoulder joint area. It's the shoulder blade, between the scapula and spine. Same with a 40something friend who's had serious collarbone/shoulder injuries on both sides in the past 3 years. She says the shoulder and collarbone are fine but she gets the same aches between the scapula and spine.

I've been in PT for six weeks and it's helped significantly. But I'm going to a chiropractor soon for the muscle pain between the scapula and spine.

ridethetown

Absolutely go for the surgery. I've broken both my left clavicle and left humerus and now have a plate and a dozen screws in each (my x-ray resembles a shark jaw now...). Both healed beautifully, especially the clavicle - I was snowboarding 5 weeks after surgery (yes, and re-broke it but that was my fault). It was the most painful injury I've ever had but definitely saw the fastest recovery. You'll be back at it in no time!

mppsu2003

Followed up with ortho and he advised it’s better to stay the course for a bit rather than surgery, so I guess we will see. It’s still displaced and all but I suppose there’s some progress. And ditching the sling has helped my arm feel better. I’ve still taken it easy, not lifting anything and keeping movement minimal


i did notice something new though... on Sunday I started getting this burning sensation that comes and goes in that area. It feels very tender, and if I move it feels like something is stretching out ... so it’s a very sharp pain that lasts a few seconds and happens periodically throughout the day. Has anyone has any experience with that? I don’t think it’s nerves or an infection because I have no numbness or fever or anything, and everything feels a lot better save for when that sudden pain hits. I don’t know if that’s a sign of callus forming or the bone stitching or what. Just curious if anyone has had that in their experience.

Ferrarif2002

I had that sharp pain when I broke my right collar bone and didn’t get surgery. It does feel strange but it goes away the more it heals and you start to move it around, at lest it did for me.