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OH broke her collarbone 6 weeks ago. This shows how well it's healed in those weeks. Doc wanted to leave it longer but consultant fortunately agreed that no amount of time would fix it. Trauma surgery in 2 weeks.
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One without the necklace is after 6 weeks. Time for a t-shirt i think
That truly sucks and is so typical of the wait and see approach the NHS takes with collar bones.
I had both fixed with open reductions (two separate occassions) and am glad I did. I was fortunate to have private medical insurance both times.
For another view I had two bad breaks, into 3 and 4 bits, with si!olar displacement, was offered surgery and turned it down both time with very good results.
Nasty.
When I broke mine I was lucky to be seen under the NHS so didn't have any unnecessary surgery and it healed fine.
Two images six weeks apart. Not much healing happening.
Yup so now surgery as in her case it didn't heal.
Aye, Steveh, that ain't healing tho. Agree drac worry was doc who wanted to gi've it six more weeks. OH is copper so tough to do her job with that shoulder.
All that would have been into consideration for surgery, rather than just doing it to make cash, least she's on the road to healing now.
As both the consultants I saw told me, the case for surgery is not just to ensure a first time heal, but also to help mitigate problems in later life with bad posture, back ache and other issues caused by shortened collar bones pulling things out of alignment.
That looks familiar!
Luckily did mine in South Wales and went to Abergavenny hospital where the consultant suggested either surgery or waiting to see if it healed. When pressed he said if it was him he'd have surgery. Got it fixed back in Devon where it turned out that the break was worse than first x-rays suggested and it would never have fixed itself and I'd have needed a bone graft to fix it!
The plate is pretty visible though and if I do it right you can see the screw heads!
Oosh! That looks nasty, hope she gets well soon!
How about my mates leg though, spot the missing parts. (bin done before on here)
[url= https://farm9.staticflickr.com/8465/8094655948_a45f774243.jp g" target="_blank">https://farm9.staticflickr.com/8465/8094655948_a45f774243.jp g"/> [/img][/url][url= https://flic.kr/p/dkiecA ]Stu's leg 3[/url] by [url= https://www.flickr.com/people/7904024@N08/ ]jimmyg352[/url], on Flickr
Don't think you'd expect much radiological evidence of healing at 6 weeks (I'm not an orthopod but when I did my collar bone there was no difference at 6 weeks).
I adopted the wait and see approach- mine was less displaced than the op. At 6 months there was visible callus and it felt stable. However another month down the line it's still not fully united. Had an off in the snow last weekend and landed on the same side and it's really tender at the fracture site. Wish I had pushed for fixation now.
Back to fracture clinic on Monday...
As both the consultants I saw told me, the case for surgery is not just to ensure a first time heal, but also to help mitigate problems in later life with bad posture, back ache and other issues caused by shortened collar bones pulling things out of alignment.
Let me shorten that story for you.
Kerrrrchiiiiing!
Apart from the sad indictment that places on anyone involved in private medicine (you really believe that doctors are that imoral?), you could also just as easily make the same argument for the NHS in reverse; the only reason they don't take the best course of action is because they might save money in the long run.
For the record, the first consultant I saw was also associated with the British Olympic team and was an expert in treating atheletes. I trusted him. You don't have to.
FWIW I had semi emergency surgery, on mine, part of which involved plating by the French NHS. The African surgeon who carried out the operation was insistent that the plate and screws be removed 18 months after the operation, not least because it is uncomfortable, but can also vastly complicate any future break.Kip - Member
The plate is pretty visible though and if I do it right you can see the screw heads!
UK NHS does not seem to do this as a matter of course (it's cheaper) but will remove the plate if you push them to.
not least because it is uncomfortable
I know what you mean. My two year old flopping his head down onto either of my plates is enough to make me drop like a sack of spuds (it doesn't do him much good either).
Here's mine.
[img][url= https://farm9.staticflickr.com/8537/8973337694_4ce0b9e252_z.jp g" target="_blank">https://farm9.staticflickr.com/8537/8973337694_4ce0b9e252_z.jp g"/> [/img][/url][url= https://flic.kr/p/eEWGES ]IMAG0130[/url] by [url= https://www.flickr.com/people/26994719@N07/ ]edayeaye[/url], on Flickr[/img]
[img][url= https://farm6.staticflickr.com/5445/8973338074_d6602cf189_z.jp g" target="_blank">https://farm6.staticflickr.com/5445/8973338074_d6602cf189_z.jp g"/> [/img][/url][url= https://flic.kr/p/eEWGMq ]IMAG0128[/url] by [url= https://www.flickr.com/people/26994719@N07/ ]edayeaye[/url], on Flickr[/img]
The whip i did milliseconds beforehand was almost worth it 😀
Snapped mine into 3...
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NHS made me wait and wait for it to heal, even did a weeks holiday in the alps with it separated still, that was painful riding at times.
Finally they said it wouldn't fix so they plated it.
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Was off the bike for around 6 months in total 🙁 Plate is still in now and doesn't really cause a problem, slightly restricted movement but not really noticeable, I just get a little scared at the thought of coming off and snapping the plate..
The delay in fixing clavicle fractures may just be due to surgeons following current evidence...
J Orthop Trauma. 2014 Mar;28(3):119-23. doi: 10.1097/BOT.0b013e3182a2968e.
Early versus delayed operative intervention in displaced clavicle fractures.
Abstract
OBJECTIVES:
Recent evidence to suggest that fixation of clavicle fractures yields better outcomes than conservative treatments has led to an increasing trend toward operative management. There is no evidence, however, to compare early fixation with delayed fixation for symptomatic patients before union.
DESIGN:
Prospective comparative case series.
PATIENTS:
Displaced clavicle fractures treated operatively in our institution during a 4-year period. Ninety-seven patients were included: 68 with early fixation and 29 delayed. Radiographic and clinical outcomes were available for all patients and scores were available for 62.
INTERVENTION:
Early plate fixation (within 3 weeks) of displaced clavicle fractures compared with delayed (3-12 weeks) fixation of displaced clavicle fractures.
OUTCOMES:
Radiographic union, Oxford Shoulder Score, QuickDASH, EQ5D, and a patient interview. Mean follow-up was to 30 months.
RESULTS:
There were no statistically significant differences in age (P > 0.05), sex (P > 0.05), and energy of injury (P > 0.05) between the 2 groups. The mean QuickDASH was 8.9 early and 9.1 delayed (P < 0.05) and the Oxford Shoulder Score was 44.2 early and 43.9 delayed (P < 0.05). In the early fixation group, there were 5 wound healing complications, and 8 went on subsequently to have removal of prominent metalwork. In the delayed fixation group, 2 had wound healing complications and 4 required removal of prominent metalwork. There were no statistically significant differences in the EQ5D scores.
CONCLUSION:
Our series supports delayed fixation of symptomatic clavicle fractures as results do not differ from early fixation.
Clearly there are some cases which fit the criteria for surgery straight away, but don't assume that because a surgeon doesn't offer you an operation if is because he is trying to save the NHS cash.
(COI: Consultant Orthopaedic surgeon!)