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Managed to crash and break my collar bone yesterday. Not seen the orthopaedic surgeon yet but the nurse suggested they don't like to pin them. Anyone got any opinions on getting it pinned or not? The break is really bad and I can't see how it would mend itself.
If it's properly separated I'd push for surgery, from mates that have done theirs the recovery time can be a lot shorter, mine broke but not separated so it didn't need surgery.
Cheers that's what I am thinking. It is properly separated. 3 or 4 bits!
Get a second opinion! I had a bad break about 13 years ago and it never knitted together. Managed to live with it for a long time and it was fine, kept it strong with postural physio and yoga, but it got worse in the last couple of years, giving me pain and numbness. Just had it pinned and plated as I don’t want it to affect my ability to do what I want as I get older. They had to do quite a job on it and I’m now half way through 3 weeks off work and it is almost as painful as breaking it was in the first place. My advice, if it isn’t likely to fix itself, get it pinned now! It is the best time of year to be off a bike, hopefully you’ll be in good shape for the spring! Hope you heal well
Cheers Ben, that's what I am going to push for. Hope you recover well too
I broke mine quite bad a couple of years ago. There was a couple of days between A&E and seeing the specialist. At first I didnt want it pinned but after a couple of days I wanted it done as I just wanted it to heal quicker. The specialist said he couldnt pin it as the break was too close to the joint and they'd have to remove the pins at a later date as it would be it weaker in the long term. It was in five bits and the doc said the empty space would just fill with new bone. I was able to use my arm to an extent after a few weeks and I was back on the bike (gently) after a month and a half. Made sure I followed the physio's regime and I've been fine since. Looking at the x rays I couldn't see how it would fix itself, but it did.
At least get it properly strapped up, (figure 8 or butterfly brace) again another thing they are not keen on in the U.K. but very keen to do in Europe. Personally I’d press for pinning. You need to convince them it’s important, ie for your work, or your riding is a key part of your life etc..
My shoulders are 1.5 inches narrower due to breaking both sides, separately. So now mended overlap joins. My shoulders have not worked properly since, angles are not quite right for the shoulder joints / sockets and now ten years later, I can’t lie on my side without significant ache or roll a kayak easily, do any where near as many press ups - due to the lack of full original movement.
In Europe they strap up the bone to reset in original position and if they feel it won’t fix, they pin it, so no overlap. I know others with overlap fixes and not with the same problems, poss not so much overlap and seems to me that it would make a difference where the bonding happens so leaving it can work out.
Still I encourage you to - Get in with a good consultant quickly and get it strapped or pinned. Usual U.K. approach is a high sling to support arm and let it reset where ever, usually an overlap. Then after a few days, week or so, can’t strap it and op becomes more difficult.
blimey! Just seen the pic, this needs a good consultant to check it out properly, don’t get fobbed off with a sling and it will sort itself ...
It does look bad in the pic but see what the consultant says and remember that the operation is not without risk in terms of loss of feeling/muscle etc around the shoulder. I've had two bad breaks, one in to 3 pieces and one 4. Neither pinned and both healed well and cause me no trouble. I'd recommend a visit to these guys if they don't want to operate - pyhsioclinc.net i was sceptical before I went but after 2 similar breaks one treated by them and one not the second was less painful and more movement after treatment which meant work driving etc was all back on after a week and i was back riding on the road at 3 weeks.
That will need a few screws! Did mine last year but not quite as bad but was in 3 bits. 1 plate and seven screws later it's more or less as good as it was. I left mine about 4/5 weeks after surgery did about 15 miles on the local canal then straight to Ard rock, sore but all good.
Push hard for surgery. I did, and got my way. Much better outcomes if you research it, (better recovery, less/no need for physio, less chance of a ‘malunion’ better pain control) but the NHS is very risk averse and would rather you lived with permanent reduced ability than risk the (small but real) chance of death under GA. It feels like they basically take the view that it’s less financially risky for them to intervene as little as possible. And I’m aN NHS employee and general fanboi for the most part.
If you are young and healthy, the risk of GA is extremely low and doesn’t really factor into the decision making process.
It all comes down to surgeon’s view on whether he/she feels there’s a surgical option and the risks/benefits in terms of healing. The operation is not without risk and you will he surprised how some bones can heal despite significant gaps.
I would just make it clear that you’re active and you want to return to sport.
Looking at the picture it looks nasty so good luck with it all.
Disclosure: Am doctor, am not bone doctor. Have got plate in my clavicle.
https://www.nhs.uk/conditions/broken-collarbone/
Sometimes best to avoid surgery, if you can.
https://www.nhs.uk/news/medical-practice/mrsa-rates-slashed-but-other-bugs-a-threat/
From what I know the evidence of what works best is not clear cut at all. for simple breaks my preference would be the figure of 8, for complex ones plating and removal of the plate later. A good consultant will talk you thru the options and the pros and cos of each
I had to push for surgery after being at home for a week. My collarbone had shattered and required ten screws and a plate. Initially I was told it "could/should" heal OK but it looked like a mountain on my shoulder. Surgery came along two weeks later due to other emergencies rightly taking precedence but glad I got it done and the hospital staff were fantastic.
Cheers folks got it screwed together yesterday. Here's hoping for a good recovery.
Good for you, I think surgery is the best option, I wish I had pushed for it many moons ago. The NHS are generally too reticent to operate
Cheers folks got it screwed together yesterday. Here’s hoping for a good recovery.
Thats great news; I’d be surprised if you regret it. Out of curiosity; did you meet much resistance to your preferred treatment? Or was yours sufficiently mashed that they came to the same conclusion?
I think you’ll be happy you did. I broke mine quite badly about 7 years ago, and they screwed it together. Today, I know it’s there, but I am so glad that I have no problems with posture or bumps or soreness.
Here’s to your own thorough, speedy recovery!
Thought I would give an update to this.
6 weeks ago I had the operation to pin my collar bone back together. When I first went to the fracture clinic I was told that collar bones heal themselves and I should just leave it. From my research and asking people on here I think that advice is fine if your break is still in alignment. Mine was about an inch out! I would have been in a sling with little movement and no driving for at least 8 weeks. I explained to the doctor that I was very sporty and needed this fixed properly and after a bit of a conversation he went to speak to his consultant. On his return he said it was bad enough that they would be willing to operate and so far I am very glad they did.
Within 3 days of the operation I had a good range of movement and really reduced my use of the sling. Within 2 weeks I was back on the road bike being very careful not to crash! Bumpy terrain was too sore. The last 2 weeks I have been able to ride my gravel bike but sharp jolts are still quite sore. I will not be on the MTB until March at the earliest, I cannot risk crashing and jolts are a bit sore too.
The physio was delighted with my level of progress and puts it down to doing the exercises and generally using my arm gently. I need to remember that the bone is not fully healed until 12 weeks so need to be careful for a while yet.
Yesterday I went to the climbing wall and did some very gentle climbing which seems to make my shoulder feel a more relaxed. So all in all I am very gland I got it pinned and if you are unfortunate enough to break yours I would push for getting it pinned.
Mine was similar but not as bad. I'm now the proud owner of 7 titanium screws and a bit of plate.