Collarbone snapage.

[ianpnw]

Long oblique fracture (plus scapula and first rib) from slow speed over the bars to rock. Carl Basamania invented this technique - cerclage wires and an IM nail. 7 weeks post-op today - off to Cham mountain biking in 2+ weeks. Or maybe road biking or hiking....I figure if I can't have fun doing something in Cham I'm doing it wrong!

[buttahflake]

Why all the hardware people? Mine was almost compound, right in the middle. Hit a tree, brutal wreck. Yes I have a funny, pointy lump. But no pain from hardware. I'm ten years out and it feels great. Let it knit itself. You are being played by overzealous hacks.

[reckless toboggan]

Why all the hardware people? Mine was almost compound, right in the middle. Hit a tree, brutal wreck. Yes I have a funny, pointy lump. But no pain from hardware. I'm ten years out and it feels great. Let it knit itself. You are being played by overzealous hacks.

Great. Now go put a 40 pound backpack on your funny pointy lump and go hiking and climbing for 10 days.

Let us know how it feels when you get back.

[buttahflake]

Feels fine
How's yer 'gina?

[reckless toboggan]

Feels fine
How's yer 'gina?

That was a quick 10 days. I guess lumpy collar bones don't affect you couch potatoes hiding in your mom's basement.

My 'gina (AKA your mom) is fine, I'll send her home soon.

[Dantheman]

7 weeks post-op today - off to Cham mountain biking in 2+ weeks. Or maybe road biking or hiking....I figure if I can't have fun doing something in Cham I'm doing it wrong!

You'd be a fool to do any serious mountain biking 9 weeks out. My PT gave me dirty looks when I told him that I went riding 10 weeks out, on easy trails in Fruita, behind my 5 y.o. The bone is "healed" but at this stage it is weak woven bone. It takes a year for the woven bone to fully remodel into strong lamellar bone. At 9 weeks the probability of a re-break if you were to crash is high.

http://boneandspine.com/woven-bone-and-lamellar-bone/

Why all the hardware people? Mine was almost compound, right in the middle. Hit a tree, brutal wreck. Yes I have a funny, pointy lump. But no pain from hardware. I'm ten years out and it feels great. Let it knit itself. You are being played by overzealous hacks.

Without surgery my prognosis was no use of my right (dominant) arm for 20 weeks, 30+ weeks for full recovery, possible non-union, months of "frozen shoulder" rehab, high probability of permanent shoulder dysfunction, and permanent disfigurement. With surgery I stopped using the sling completely in less than a week, had full ROM in 8 weeks, MTBing in 12 weeks, deadlifting 300 lbs for reps in 6 months.

For completely displaced and/or comminuted breaks, outcomes are consistently better with operative treatment. Non-union rates for bad breaks are ~25%. No way I'd risk that. From the other collar bone thread:

An operated clavicle should be good for skiing in six weeks provided a bridge plating is perfomed, and the butterfly fragments are bypassed, rather than dissected out and anatomically repaired, but that's my opinion.

Considerable disagreement exists amongst docs regarding treatment of the fracture clavicle. I was taught a generation and one half ago, that they all did fine. It has now been proven that many folks with high energy injuries actually do poorly. 25% don't heal, 40% don't like how their shoulder feels in sports, and 45% don't like the look of it.

Here is a landmark article from the June 2007 Journal of Bone and Joint Surgery. Unfortunately, like everything else, it will take two generations before the information is absorbed into general medical knowledge.

The weight of medical evidence today favors restoration of normal anatomy, because 24% of bad clavicle fractures never heal, and 40% of patients have symptoms referable to imgingement of the crookedly healed bone on the brachial plexus (nerves to the arm) and/or weakness of the shoulder.

Here is the Abstract from the Journal of Bone and Joint Surgery (American, 2007)

Nonoperative Treatment Compared with Plate Fixation of Displaced Midshaft Clavicular Fractures
A Multicenter, Randomized Clinical Trial
Canadian Orthopaedic Trauma Society

Disclosure: In support of their research for or preparation of this manuscript, one or more of the authors received grants or outside funding from the Orthopaedic Trauma Association and Zimmer Inc. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (Zimmer Inc.) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

NOTE: The authors acknowledge the advice and knowledge of Lynn A. Crosby and Carl J. Basamania.

This manuscript was prepared by the Canadian Orthopaedic Trauma Society, c/o Michael D. McKee, MD, FRCS©, 55 Queen Street East, Suite 800, Toronto, ON M5C 1R6, Canada. E-mail address: mckeem@smh.toronto.on.ca

Principal Investigator: Michael D. McKee

Lead Investigators (Site): Michael D. McKee (St. Michael's Hospital), Hans J. Kreder (Sunny-brook and Women's Health Science Center), Scott Mandel (McMaster University), Robert Mc-Cormack (Royal Columbian Hospital), Rudolph Reindl (Montreal General Hospital), David M.W. Pugh (Brantford Hospital), David Sanders (London Health Science Center), and Richard Buckley (Foothills Hospital). Study Design: Michael D. McKee, Emil H. Schemitsch, Lisa M. Wild, Hans J. Kreder, Robert McCormack, Scott Mandel, Rudolph Reindl, and Edward Harvey. Data Analysis: Jeremy A. Hall, Lisa M. Wild, Milena V. Santos, Michael D. McKee, Christian J. Veillette, and Daniel B. Whelan. Radiographic Analysis: Lisa M. Wild, Milena V. Santos, and Michael D. McKee. Manuscript Preparation: Michael D. McKee, Jeremy A. Hall, Lisa M. Wild, Emil H. Schemitsch, Rudolph Reindl, Robert McCormack, David Sanders, and Christian J. Veillette. Patient Enrollment and Assessment: Michael D. McKee, Emil H. Schemitsch, James P. Waddell, Lisa M. Wild, Milena V. Santos, Hans J. Kreder, David J.G. Stephen, Terrence A. Axelrod, Edward Harvey, Rudolph Reindl, Gregory Berry, Bertrand Perey, Kostas Panagiotopolous, Robert McCormack, Beverly Bulmer, Mauri Zomar, Karyn Moon, Elizabeth Kimmel, Carla Erho, Elena Lakoub, Patricia Leclair, Christian J. Veillette, Bonnie Sobchak, David M.W. Pugh, Richard Buckley, Scott Mandel, David Sanders, and Trevor B. Stone.



--------------------------------------------------------------------------------
Background: Recent studies have shown a high prevalence of symptomatic malunion and nonunion after nonoperative treatment of displaced midshaft clavicular fractures. We sought to compare patient-oriented outcome and complication rates following nonoperative treatment and those after plate fixation of displaced midshaft clavicular fractures.
Methods: In a multicenter, prospective clinical trial, 132 patients with a displaced midshaft fracture of the clavicle were randomized (by sealed envelope) to either operative treatment with plate fixation (sixty-seven patients) or nonoperative treatment with a sling (sixty-five patients). Outcome analysis included standard clinical follow-up and the Constant shoulder score, the Disability of the Arm, Shoulder and Hand (DASH) score, and plain radiographs. One hundred and eleven patients (sixty-two managed operatively and forty-nine managed nonoperatively) completed one year of follow-up. There were no differences between the two groups with respect to patient demographics, mechanism of injury, associated injuries, Injury Severity Score, or fracture pattern.

Results: Constant shoulder scores and DASH scores were significantly improved in the operative fixation group at all time-points (p = 0.001 and p < 0.01, respectively). The mean time to radiographic union was 28.4 weeks in the non-operative group compared with 16.4 weeks in the operative group (p = 0.001). There were two nonunions in the operative group compared with seven in the nonoperative group (p = 0.042). Symptomatic malunion developed in nine patients in the nonoperative group and in none in the operative group (p = 0.001). Most complications in the operative group were hardware-related (five patients had local irritation and/or prominence of the hardware, three had a wound infection, and one had mechanical failure). At one year after the injury, the patients in the operative group were more likely to be satisfied with the appearance of the shoulder (p = 0.001) and with the shoulder in general (p = 0.002) than were those in the nonoperative group.

Conclusions: Operative fixation of a displaced fracture of the clavicular shaft results in improved functional outcome and a lower rate of malunion and nonunion compared with nonoperative treatment at one year of follow-up. Hardware removal remains the most common reason for repeat intervention in the operative group. This study supports primary plate fixation of completely displaced midshaft clavicular fractures in active adult patients.

Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence

[MagnificentUnicorn]

Why all the hardware people? Mine was almost compound, right in the middle. Hit a tree, brutal wreck. Yes I have a funny, pointy lump. But no pain from hardware. I'm ten years out and it feels great. Let it knit itself. You are being played by overzealous hacks.

You'd be a fool to do any serious mountain biking 9 weeks out. My PT gave me dirty looks when I told him that I went riding 10 weeks out, on easy trails in Fruita, behind my 5 y.o. The bone is "healed" but at this stage it is weak woven bone. It takes a year for the woven bone to fully remodel into strong lamellar bone. At 9 weeks the probability of a re-break if you were to crash is high.

http://boneandspine.com/woven-bone-and-lamellar-bone/



Without surgery my prognosis was no use of my right (dominant) arm for 20 weeks, 30+ weeks for full recovery, possible non-union, months of "frozen shoulder" rehab, high probability of permanent shoulder dysfunction, and permanent disfigurement. With surgery I stopped using the sling completely in less than a week, had full ROM in 8 weeks, MTBing in 12 weeks, deadlifting 300 lbs for reps in 6 months.

For completely displaced and/or comminuted breaks, outcomes are consistently better with operative treatment. Non-union rates for bad breaks are ~25%. No way I'd risk that. From the other collar bone thread:

Like Dan, my orthopedist and others I work and recreate with all recommended surgery. Mine was comminuted, and I had separated both the SC and AC joints and had a fragment that was augered into my brachio-plexus, which could have caused pneumothorax and limb paralysis if left untreated. Conservative treatment would have been immobilization for 6 months and would have likely resulted in a non union requiring a more difficult and risky surgery. I chose surgery. Stick to talking about things you know about buttah, like Dead shows and acid.

[buttahflake]

Okay, so let me get this straight, you know assholes And collarbones?
Look at you!
Take a lap, big dummy.

[MagnificentUnicorn]

Okay, so let me get this straight, you know assholes And collarbones?
Look at you!
Take a lap, big dummy.

I do know assholes, I recognized you right away. I've helped fix more collarbones than you can imagine.

[buttahflake]

I do know assholes..

Yes, we know.
You're our in house expert, Aaron.

[alfajores]

Joined the club



12-15’ drop in on the mountain bike. Cleared the landing. Went over the bars at speed on the run out.

[thefortrees]

Well, I’m in the club now too. Over the handlebars in a high speed berm to a small tabletop exit. Rode this thing a hundred times...


Left clavicle Broken and a Bennett fracture in the right thumb. Thumb will require surgery.

Curious to see how wiping my ass plays out with only four functional fingers! Only 15 hours in - last night wasn’t awful, edibles ice and ibuprofen helped out.

[yeahman]

Well, that sucks. Good luck mending.

[klauss]

Foook. They told you you’d shoot your eye out.

Vibes

[shroom]

shiiit, vibes

[grinch]

Damn! Heal up T. That sucks

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[::: :::]

Well, yer gonna become a southpaw now in your healing downtime

#furiousmasturbation

Oh wait, left shoulder?

Maybe need the wife to do some extra innings for you in the meantime...

Heal up, man ...sorry to hear!

[thefortrees]

Well, yer gonna become a southpaw now in your healing downtime

#furiousmasturbation

Oh wait, left shoulder?

Maybe need the wife to do some extra innings for you in the meantime...

Heal up, man ...sorry to hear!

Haha! I asked for some help in that arena and she was not amused.

[ddraver]

Fair play though, if you're gonna do do it, do it proper!

Heal fast

Sent from my Pixel 3a using Tapatalk

[Dantheman]

R hand/L shoulder is a rough combo. I've had a Bennett fx with surgical repair before. Other than the inconvenience of surgery and 6 weeks in a cast recovery wasn't bad. There is some, albeit mixed, evidence that NSAIDs impair bone healing. The safe bet is to use acetaminophen as your primary pain control med and add small amounts of ibuprofen on top of that as needed.

[thefortrees]

Just had a follow up re: left clavicle, and the doc says it’s not bad, no surgery or sling required (sling only for comfort). Wednesday appt for hand.

Ass wiping was successful today but took 3x longer than usual with limited ROM in left and cast on right. Bidet is now ordered and arriving later this week.

Doc made the same claim about NSAIDs impairing bone healing. All Tylenol and edibles for me here on out for pain control.

[SkiLyft]

Fuckkk — vibes my dude!! Heal up quick!


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[rockcreek]

Joined the clavicle club yesterday. First day, first run, first turn. Surgery Monday.

Thank you to those that have come before me, hoping your pearls of wisdom will get me through this time of gimp

[yeahman]

That sucks man. Hope you heal up quickly and can get back out there this season!

[thefortrees]

Bummer dude, You’ll be back at it soon though. Just get on the aggressive rehab plan and keep it moving!


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