The Collar Bone Thread.

[Mo1959]

My experience of three months of non-union says that if I ever break a collar bone again I will insist on plating while everything is fresh and while I'm recovering from the original crash.

My surgeon left it up to me, but his assistant who I also spoke to said if it was his collar bone he would definitely want it plated. Glad I did now.

 

[Chappy]

The surgeon has to persuade the bone to re-start the healing process, which, as far as I understand, means getting it to bleed again and form a clot, which slowly transforms into a callus and thence to new bone. This means roughing up the bone ends, chopping up some of the inside of the bone and packing that and synthetic bone chips into and around the repair. My experience of three months of non-union says that if I ever break a collar bone again I will insist on plating while everything is fresh and while I'm recovering from the original crash.

So far I've had 3 months recovery with non-union, 4 months of recovery with a plate and from 8 April I'm facing another 3 months of recovery from the capsule release for the frozen shoulder. This might have been reduced to just 3 months if it had been plated immediately.

Cheers for the info, the specialist does not want to operate at all. If it continues for longer he did talk about a CT scan which may lead to surgery. And if happens again and the bone breaks I will insist on a plate.

I am worried that it will be weaker because it may not have knitted.

 

[Globalti]

As I've explained, surgeons are rightfully reluctant to operate as there's a good chance it will heal naturally but I think an assessment needs to be made within a month:

1 - Will this heal at all without plating?

2 - If it heals overlapping, will the patient be left with a narrower shoulder and permanent squashed armpit and muscle pain and imbalance?

 

[Colin_P]

1986, day one of what was the last six week summer school holiday, the next summer I left school.

Came off the bike, a twelve speed Peugeot racer, at speed. Thankfully knocked out but skinned parts of my head, shoulder and snapped my collar bone clean in half.

Back then, they seemingly had no interest in re-setting it into a straight line or as near to what it should look like. Instead I was packed off home and spent a miserable few weeks of the school summer hols whilst it was really raw. After a few weeks it had started to stabilise / knit so I could do a few things but it was horrible. I vividly recall the bones jarring and grinding against each other even with something as benign as gentle breathing.

It mended with the step in it and as a result my right shoulder is about 15mm closer to my neck than the left, but is apparently stronger than a bog standard collar bone.

Do they set or wire them these days?

 

[Colin_P]

I've liked a lot of post on this thread.

I don't actually like them but feel the pain!

 

[Sharky]

I've liked a lot of post on this thread.

I don't actually like them but feel the pain!

snap

 

[Globalti]

1986, day one of what was the last six week summer school holiday, the next summer I left school.

Came off the bike, a twelve speed Peugeot racer, at speed. Thankfully knocked out but skinned parts of my head, shoulder and snapped my collar bone clean in half.

Back then, they seemingly had no interest in re-setting it into a straight line or as near to what it should look like. Instead I was packed off home and spent a miserable few weeks of the school summer hols whilst it was really raw. After a few weeks it had started to stabilise / knit so I could do a few things but it was horrible. I vividly recall the bones jarring and grinding against each other even with something as benign as gentle breathing.

It mended with the step in it and as a result my right shoulder is about 15mm closer to my neck than the left, but is apparently stronger than a bog standard collar bone.

Do they set or wire them these days?

They use plates and sometimes internal pins and sometimes wire, from what I've seen on YouTube. Because the bone is under compression it has to be stabilised.

 

[Mo1959]

Do they set or wire them these days?

I've got a plate and 8 screws in mine. Was a bad break and was actually in 3 bits with a jagged bit in the middle.

 

[Globalti]

The collar bone fulfils a role very similar to that of a suspension strut on a car, it holds the shoulder blade in the correct position and the humerus hangs off the end of the shoulder blade. Normally the shoulder joint allows a very wide range of movement but beyond a certain point and for whole-shoulder movements the shoulder blade actually floats around between layers of muscle on the back. It's a much more complex and interesting joint than the hip. If the collar bone breaks muscle tension pulls the shoulder inwards causing the ends to overlap, but they can't be plastered like a limb so you have to wear a sling and hope the ends will find each other and stick together.

 

[Globalti]

Well I saw the physio this morning and he measured my grip strength with a dial gauge. The average for a bloke aged 50 is 73 lbs pressure and I'm almost 63 so I'm pleased to see that I'm squeezing 102 lbs with the uninjured side (left) and my right has doubled from 32 lbs a month ago to 64 lbs today, so there's progress.

My shoulder feels better but arm lift is still limited to shoulder height. I'm not looking forward to the capsule release op on 8 April.

 

[glasgowcyclist]

Do they set or wire them these days?

In my case they have used a clavicular hook plate like the one in this diagram, because the break was so close to the end of the shaft. (Mine is for my left side, diagram shows right)

In x-ray it loks like this. This isn't my own x-ray but is close enough.




They'll be removing it in just over two months.

 

[ColinJ]

Well I saw the physio this morning and he measured my grip strength with a dial gauge. The average for a bloke aged 50 is 73 lbs pressure and I'm almost 63 so I'm pleased to see that I'm squeezing 102 lbs with the uninjured side (left) and my right has doubled from 32 lbs a month ago to 64 lbs today, so there's progress.

My shoulder feels better but arm lift is still limited to shoulder height. I'm not looking forward to the capsule release op on 8 April.

That sounds impressive! Is that a hangover from your rock climbing days?

My upper body is pretty weedy for a man of my size. I don't want to bulk up but I think I need to do more upper body exercise. My upper body gets more tired on long rides than my legs do ...

 

[Globalti]

GC, that's pretty cool, cooler than my plate and six screws. I can see how it has the potential to hurt a lot more because the outboard end is just floating, bearing on the underneath of the acromium.

 

[benborp]

In my case they have used a clavicular hook plate like the one in this diagram, because the break was so close to the end of the shaft. (Mine is for my left side, diagram shows right)

View attachment 459617

In x-ray it loks like this. This isn't my own x-ray but is close enough.


View attachment 459618

They'll be removing it in just over two months.

Ah, that's what I should have had. Apparently it severely limits movement while it's in place and takes quite a while to rehabilitate afterwards. I can't recommend the eventual alternative of having the acromion and broken collarbone removed. Although with new materials that are now used, the rehabilitation should be complete before the artificial ligaments are due for replacement unlike in my case.

 

[Globalti]

25 sunny miles yesterday and the biggest annoyance was the weakness of the muscles that support me on the bike: the shoulders and the triceps were feeling pretty tired by the time I'd done 15 miles.

Got the shoulder capsule release op tomorrow, following which rehabilitation has to start properly.