Lateral clavicle fracture - any advice, from X-ray

[Johno]

Classic cyclists injury and I live in cyclings favorite country, the Netherlands.

Long story short, it got snapped on Thursday evening. A&E, sling and come back in a week to see what’s happening.

It’s a lateral break with chip. The danger of the internet is that trying to diagnose whether something will need surgery or not is difficult. My friends Dutch wife who is a doctor here told me that the Netherlands are quite conservative in surgery for clavicles anyway, but as this is a lateral break, it’s seems there’s a higher percentage chance of surgery.

So, thought I’d stick up the pics and see if any orthopedic surgeon sauntered by and had a view, or any else from the clavicle club and any one else with an opinion.

I really want to get back the range, strength and endurance as I ride 8-12hrs most weeks and although my work doesn’t place a higher demand on shoulders, my riding does.

In some ways I think I’d prefer surgery as the recovery time is often quoted as being quicker....

[ocd]

Lateral clavicle fractures like this are associated with a risk of not healing (non-union) whether or not they are left alone or treated surgically. Surgical treatment is with a plate and screws but they can pull out due to the forces acting across the shoulder, and the small amount of bone available for screw fixation. An experienced shoulder surgeon will be able to advise you. In the U.K. you would be seen in a fracture clinic by a trauma surgeon who would discuss the options with you. I’m sure it’s the same in NL. Hope it works out for you.

[R1gtr]

Here's my thread on my break which I received some helpful advice.
https://www.pistonheads.com/gassing/topic.asp?h=0&...

Mine took longer than I thought to recover, here is what it looked like yesterday at my final X-Ray


Physio starts properly today although since having the sling off I have been getting the arm moving as much as I can. I have really bad frozen shoulder and mobility is really poor, shocked at how bad it is in fact after 6-7 weeks in a sling.
I wasn't given the choice of an operation but kind of wish I was.

Try and find a way to sleep with it that works for you, ask what exercises you are allowed to do and do them often, minimise the arm freezing as much as you can but don't over do it.
Good luck with the recovery.

[Johno]

ocd said:

Lateral clavicle fractures like this are associated with a risk of not healing (non-union) whether or not they are left alone or treated surgically. Surgical treatment is with a plate and screws but they can pull out due to the forces acting across the shoulder, and the small amount of bone available for screw fixation. An experienced shoulder surgeon will be able to advise you. In the U.K. you would be seen in a fracture clinic by a trauma surgeon who would discuss the options with you. I’m sure it’s the same in NL. Hope it works out for you.

Thanks, confirms what’s happening and what I’ve read.

Edited by Johno on Friday 24th April 10:01

[Johno]

R1gtr said:

Here's my thread on my break which I received some helpful advice.
https://www.pistonheads.com/gassing/topic.asp?h=0&...

Mine took longer than I thought to recover, here is what it looked like yesterday at my final X-Ray


Physio starts properly today although since having the sling off I have been getting the arm moving as much as I can. I have really bad frozen shoulder and mobility is really poor, shocked at how bad it is in fact after 6-7 weeks in a sling.
I wasn't given the choice of an operation but kind of wish I was.

Try and find a way to sleep with it that works for you, ask what exercises you are allowed to do and do them often, minimise the arm freezing as much as you can but don't over do it.
Good luck with the recovery.

Thanks for the link.

How’s your shoulder feeling now? Range of movement and pain etc?

I’m sleeping OK currently, but that’s with Naproxen and oxycodone, pillows etc. Yesterday I managed with just the naproxen, but just had to take the oxycodone today.

Will book the consultation today, hopefully for next week.

[R1gtr]

My impact was pretty hard so and the bone broke downwards so I found the pain really bad to be honest, struggled the first few days but I am a poor sleeper at the best of times.

Showering and getting dressed was difficult, I ordered some larger size t shirts that were easier to get on and off and found a method that worked for me.
I got off the pills after a few days and stuck to paracetamol as the codeine based ones just bunged me up.
My healing seemed to take a while and it felt like I was in the sling for ages. Due to the CVirus a scheduled check up got cancelled so I was left treading water, unsure if it had healed and if I could start working it.

Thankfully got the all clear yesterday to really start physio which is much needed as my mobility is really bad, worryingly so if I am honest, can't lift my arm up to 90° to the front or side.
It will get better though and the pain went after 2 weeks apart from muscle pain.
When I did it I initially I thought I would be back on the go within a month but it's been a lot longer.
I hope yours heals quicker and successfully.
When you see someone maybe ask what mobility exercises you can do safely, obviously it's a balancing act as you don't want to overdo it and then affect the healing.

Today I am going to get the bike on the Turbo Trainer for a blast.

Best of luck to you.

[Johno]

Thanks, good to see you’re getting there now.

Just been out walking and will start to do more to get some exercise in.

I’m hoping to start easy rides on the turbo quickly, just to get the blood flowing a bit, but can’t see it happening for a while yet.

Take care!

I’ll update after Thursday’s consultation and X-rays.

[The_Doc]

ocd said:

Lateral clavicle fractures like this are associated with a risk of not healing (non-union) whether or not they are left alone or treated surgically. Surgical treatment is with a plate and screws but they can pull out due to the forces acting across the shoulder, and the small amount of bone available for screw fixation. An experienced shoulder surgeon will be able to advise you. In the U.K. you would be seen in a fracture clinic by a trauma surgeon who would discuss the options with you. I’m sure it’s the same in NL. Hope it works out for you.

+1
Lateral clavicle fractures are often actually a type of acromioclavicular joint injury and tricky to repair, if you need to. The lateral clavicle should be tightly connected to the coracoid, and if you refix it, just on the other side is the brachial plexus. Which powers the entire upper limb.

Very different from middle 1/3 fractures

see a shoulder surgeon

Edited by The_Doc on Friday 24th April 22:35

[Johno]

The_Doc said:

+1
Lateral clavicle fractures are often actually a type of acromioclavicular joint injury and tricky to repair, if you need to. The lateral clavicle should be tightly connected to the coracoid, and if you refix it, just on the other side is the brachial plexus. Which powers the entire upper limb.

Very different from middle 1/3 fractures

see a shoulder surgeon

Edited by The_Doc on Friday 24th April 22:35

Thanks, this again supports what I’ve learnt so far. Let’s see how it’s progressed on Thursday, fingers crossed.

[Johno]

Saw consultant today and the only surgical option is a hook plate, due to how the clavicle is broken. In my research before the appt, most things I’d read said to avoid this unless absolutely necessary. The consultant also advised to try and get it sorted without surgery, saying whilst he loved surgery he felt compelled this wasn’t the best route for me.

So, rather frustratingly I’m now stuck in this sling for another 3-4wks with limited range of motion exercises. Return in 5wks to check up.

I am allowed to ride indoors though, so starting again Saturday.