Anyone have a broken clavicle repaired?

[AlterWhiner]

Posting under an alter, since I don’t really want all my health information associated with my main account.

But I would love some advice from people who have had broken clavicles repaired with ORIF procedures. I broke my clavicle last year, after falling off a horse. And it’s turned out to be a non-union, which means it never healed. I’ve come a long way in my recovery, but not having a fully-attached collarbone has caused me to have some recurring shoulder bursitis and some other limitations that my doc things could be ameliorated by surgery. I feel great riding, but I can’t pick up a tack trunk without making my shoulder hurt for a few weeks.

But I am so not looking forward to the disability and recovery! All of the guidance I’ve gotten from the doc about what to expect has been sort of vague, though it sounds like it’ll be 2-6 weeks in a sling and 10 weeks before I’ll be allowed to ride again (ugh!).

Anyway, if there’s anyone who has been through this and would be willing to share experiences, I would be grateful. I’m wondering if there’s anyone like me who had a nonunion and decided to take the plunge. Was it worth it? And I’d also welcome guidance from people who had surgery, even immediately after an initial fracture, about how painful it was, how the recovery went, etc. People who managed to stay in shape post-surgery, how did you do it?

I’d really like to be able to go back in time and just have the fracture fixed surgically the first time! But it is a bit of a different decision to sign up for the whole experience the second time, on purpose. I’m trying to get my mind around the tradeoffs. Thanks!

[Bluey]

Could you get a second opinion, if you want to be double sure that is the best way to manage this situation?

That is what I did when the orthopedic surgeon suggested cutting one perfectly fine bone in my forearm in half and shorten it.
Then using that piece to rebuild other little bones in the wrist that were being destroyed over the years by that one too long bone.

Barbaric!

Got a second opinion, found out that was standard, went thru and all has been perfectly fine since.

When I broke my clavicle all healed just fine.
If not, surgery would have been done shortly after that.
I was off a horse over two months, tried to ride before that and no way.
Getting on and off was very hard, trotting too painful yet.
It was closer to three months before I could ride without serious pain.
I knew one trainer that broke it and was jumping the next day at a show.
He then took off several weeks to let it heal.

Hope yours resolve soon.

[AlterWhiner]

@Bluey

Could you get a second opinion, if you want to be double sure that is the best way to manage this situation?

Thanks for your kind words. I should have mentioned that i have gotten a few opinions on this. Two shoulder specialists, and a personal friend who is a foot and ankle specialist, but fixed some clavicles in residency.

They all basically say it’s up to me, but that fixing it should help with the problems I am having. They all recommend the exact same procedure, down to the number of screws. So I feel like the prescription is right. Just more a judgement call about whether the benefits are worth the considerable downsides.

I’ve worked really hard on PT and lifting, etc., to see how far I could get on strength alone. I feel like I know the answer. There are some things I still can’t do without setting off shoulder pain that I’d like to be able to do. Riding isn’t on the list, though, which is part of what makes it a tough call!

I always worry that orthopods don’t dwell on the rehab fine print, since their job is basically done one they’ve fixed the bones. (The information sheet with recovery instructions was literally one-page long.)

[Bluey]

That is a tough call, surgery should be a last resort, but some times, the quality of life we want will take us there.

Will be interesting to read what others here have to offer you.

[Magicboy]

How old are You? Will the surgery have an impact on future arthritis? I’m sorry you have to go through this.

[touchstone]

Kleth, thanks for this helpful update. Here’s my xray, just for fun. You can see where it tried (and failed) to heal. It is helpful to know that the surgical pain is less than the fracture pain. I had a brutal few weeks after my initial fall that I am hoping not to relive.

I’m really struggling to psych myself up for this. But I’m hoping it’ll get me a better long-term outcome.

I don’t think there’s much arthritis risk either way, or at least not that was disclosed to me. I was basically told that if i don’t fix it, it won’t get better, but it won’t get worse either.

A few dumb questions. Could you wear a bra after the surgery? How long before you were comfortable enough to get on an exercise bike or go for a real walk? I was in so much pain after the first fracture that I got really deconditioned. My hope is that I’ll be able to do more lower-body exercise through this recovery. But I’m not totally sure what’s realistic.

I have been reading articles about Body Martin getting back in the saddle after six weeks after he plated his clavicle. I wonder if they gave him some sort of special magic surgery, or if he was just more willing to live with the risk of reinjury if he fell. The difference between six weeks and three months seems infinite!

[AlterWhiner]

Kleth, thanks for this helpful update. Here’s my xray, just for fun. You can see where it tried (and failed) to heal. It is helpful to know that the surgical pain is less than the fracture pain. I had a brutal few weeks after my initial fall that I am hoping not to relive.

I’m really struggling to psych myself up for this. But I’m hoping it’ll get me a better long-term outcome.

I don’t think there’s much arthritis risk either way, or at least not that was disclosed to me. I was basically told that if i don’t fix it, it won’t get better, but it won’t get worse either.

A few dumb questions. Could you wear a bra after the surgery? How long before you were comfortable enough to get on an exercise bike or go for a real walk? I was in so much pain after the first fracture that I got really deconditioned. My hope is that I’ll be able to do more lower-body exercise through this recovery. But I’m not totally sure what’s realistic.

I have been reading articles about Body Martin getting back in the saddle after six weeks after he plated his clavicle. I wonder if they gave him some sort of special magic surgery, or if he was just more willing to live with the risk of reinjury if he fell. The difference between six weeks and three months seems infinite!

[AlterWhiner]

Kleth, thanks for this helpful update. Here’s my xray, just for fun. You can see where it tried (and failed) to heal. It is helpful to know that the surgical pain is less than the fracture pain. I had a brutal few weeks after my initial fall that I am hoping not to relive.

I’m really struggling to psych myself up for this. But I’m hoping it’ll get me a better long-term outcome.

Magicboy, I don’t think there’s much arthritis risk either way, or at least not that was disclosed to me. I was basically told that if i don’t fix it, it won’t get better, but it won’t get worse either.

A few dumb questions. Could you wear a bra after the surgery? How long before you were comfortable enough to get on an exercise bike or go for a real walk? I was in so much pain after the first fracture that I got really deconditioned. My hope is that I’ll be able to do more lower-body exercise through this recovery. But I’m not totally sure what’s realistic.

I have been reading articles about Boyd Martin getting back in the saddle after six weeks after he plated his clavicle. I wonder if they gave him some sort of special magic surgery, or if he was just more willing to live with the risk of reinjury if he fell. The difference between six weeks and three months seems infinite!

[KarenRO]

I sustained multiple disunited fractures to my left clavicle in 2001. I departed from a galloping horse at a high rate of speed The orthopedic doctor did not recommend surgery. In fact, he was very against it. His experience and reasoning was that the clavicle is meant to rotate and the rotation increases the risk of a screw moving from the bone to the heart. He was also against slings as he said that made the arm too stiff and bone pieces need movement to reunite. I wore a lightly padded harness for 6 weeks that kept my shoulders back. Best posture ever! I actually gained a 1/2 of inch in height from standing so straight. While the clavicle healed cleanly, that type of fracture will always be susceptible to early onset of arthritis. And, in really cold weather, my clavicle can ache but it is more annoying than painful.

[darkbay]

Oh my gosh, I had no idea the pins could migrate! I found this article that seems to say they used to use smooth screws that could migrate. https://www.google.ca/amp/s/www.hippocraticpost.com/muscular-skeletal/pinning-broken-collarbone/amp/. The doctor told me that they could remove the metal later if I wanted but there would be a 2 month recovery period for the screw holes to repair themselves. So most people don’t bother.

I did buy some soft tank top bras to wear for the first while after surgery but after a while I found no problems with my regular bras.

I think the nice thing about this injury (as opposed to breaking an ankle for example) is that you can start walking really soon, I can’t remember exactly when I started exercising but I spent at least 4 weeks working out at the gym before I started riding again. I think Boyd Martin has different motivations than we do. My main concern was that it might rebreak if I had another fall and I really, really didn’t want to go back to the start of rehab again. So I gained some fitness before riding again. My first ride was fantastic, day 2 and 3 not so much after my riding muscles got sore.

[Equisis]

I had mine surgically repaired almost four months ago. The fracture was very displaced and my surgeon basically said there wasn’t any discussion to be had- the bone would not heal without surgery. I didn’t put up an argument, as the fracture was quite painful (I broke a collarbone years ago with less displacement and it wasn’t nearly as painful) and I just wanted it fixed.

For me, the surgery and recovery were easy- I was far more painful and limited before the surgery than after. I was in the sling for a few days, back on a horse in about a week, and had nearly full ROM at my 2-week post op visit. This is the exception, not the rule. I am a professional rider and was quite fit before surgery, and my surgeon was also a rider and was very realistic about what I could and couldn’t do (yes, I was permitted to ride as soon as I felt able, wasn’t allowed to lift things for 4wks, etc). I went back to work full-time at two weeks post op and although I had some limitations, like lifting water buckets and hay bales, I felt pretty good, and pretty much back to normal at 4-6 weeks. I made a point to push myself the first few days post op- going to the grocery store, walking my dog, etc- to get over the “hump” of wanting to be still and quiet. I did have a bit more hardware placed than most people do with this kind of repair (multiple plates and quite a few screws) so I’m not sure how that impacted my recovery.

I know a couple of other people (also horse professionals) who have followed a similar timeline to me, as well as others who have followed a more conservative timeline. It is going to depend a lot on your fitness level, your pain tolerance, and your approach to rehab. I didn’t do any formal PT but I did really work at rebuilding my strength and ROM on my own, and my job is so physical that PT wasn’t really necessary. Having healed one collarbone naturally and had the other surgically repaired, if I break one again, I will go for the surgery in a heartbeat.

ETA- I did have an issue with bra straps (I mostly wear racerback sports bras and I couldn’t get them on and off) so I got a bunch of strapless bandeau bras that were awesome. I wore those for quite a while, while the incision area was too sensitive to have bra straps pulling on it all day. Get some button up shirts too, as you won’t want to be trying to pull anything on over your head for a few days. I also got some headbands which were great for the first week or so when I didn’t have the flexibility to pull my hair back!

[kleth]

AlterWhiner- I’ve been wearing a bra just with the strap down my shoulder. It wasn’t super comfortable putting pressure on the incision/plate but that’s improved as I recovered. I was able to walk to class, be a student, etc within 2.5-3 weeks without much struggle. I’m almost a month out now and only have pain if I use my arm too much (I’m technically not to move at all but I figured just elbow/wrist movement is fine but I’m not always super careful). Nothing major, I usually don’t take anything for it. More just aware that the collar bone is there than in real pain.

[AlterWhiner]

@Equisis

I was in the sling for a few days, back on a horse in about a week, and had nearly full ROM at my 2-week post op visit. This is the exception, not the rule. I am a professional rider and was quite fit before surgery, and my surgeon was also a rider and was very realistic about what I could and couldn’t do (yes, I was permitted to ride as soon as I felt able, wasn’t allowed to lift things for 4wks, etc). I went back to work full-time at two weeks post op and although I had some limitations, like lifting water buckets and hay bales, I felt pretty good, and pretty much back to normal at 4-6 weeks. I made a point to push myself the first few days post op- going to the grocery store, walking my dog, etc- to get over the “hump” of wanting to be still and quiet. I did have a bit more hardware placed than most people do with this kind of repair (multiple plates and quite a few screws) so I’m not sure how that impacted my recovery.

I know a couple of other people (also horse professionals) who have followed a similar timeline to me, as well as others who have followed a more conservative timeline. It is going to depend a lot on your fitness level, your pain tolerance, and your approach to rehab.

This is basically my dream scenario! But the surgeon has been very clear that he does not recommend full range of motion for six weeks or any riding for 10. I can’t tell if the difference is about the kind of procedure, a better understanding of the particular stresses of the sport, or just a different risk tolerance. I’ve asked why so many high level equestrian professionals seem to get back to riding more quickly, but he replied by sending me a link to the standard of care from the AAOS

I am quite fit right now, but I know that strength will disappear quickly if I don’t move my arm for six weeks.