Clavicle fracture, not healing, surgery?

[nonunioninnj]

Hi!

I am not a cyclist (although I enjoy riding my bike around town and the tow path in my area) but have been trying to find good information on the topic of a broken collarbone and opinions/experiences with surgery- especially from women (haven't found much in the way of equestrian forums). So, if any of you would be willing to give me your opinions, I'd really appreciate it!

I am a 25 year old girl and was thrown from a horse onto my head September 20th- breaking my collarbone. I've been a jock my whole life- played softball in college, fly fish, surf, yoga, hike… all that stuff. I hate being still.

When I first got x-rayed it was a clean fracture in the middle section, by the next day is shifted and displaced, so the two bone ends were overlapping. Ortho put me in a figure of eight brace and kept taking followup x-rays. An xray at a little over 2 months showed although the bones haven't crisscrossed anymore, I have no signs of bone growth. Ortho now suggests bone stim, if bone stim doesn't work, surgery.

My issues are 1) although its not the horrible pain it was initially, i still wake up when I roll onto that side when I sleep, have a lessened range of motion, can't lift things, general pain to the giant lump on my bone, shoulder/back gets sore/tired when I'm too active. 2) hours at my job just got cut, and i'm not entirely sure the company will be in existence for too much longer, having me fearing loss of insurance in the next few months.

I got a second opinion today who said it would be entirely valid, at 2.5ish months out with no growth to opt for surgery.

My issues with bone stim route are mainly- cost of continued followup appts associated, the time span (cant start bone stim til Dec 21st, then i think its at least a month process), and also if the bone stim doesn't work- then I'm just at the surgery option anyway. Also, if my insurance is gone by then- I don't think I can pay for it out of pocket. I also know there are draw backs to the surgery, and have read some horror stories.

Has anyone had an experience with surgery? Do you think it was the wisest move? Issues with pins/plates etc? Or has anyone left a nonunion alone, and what are the drawbacks there?

Thanks a lot for taking the time to read this!

[abejita]

I can't help with your broken bone situation, but I just wanted to welcome you to the forum. I know the fine ladies here will have some good opinions for you!

[Kiwi Stoker]

I can see your issues and having broken a collarbone (clean and healed) and a shoulder (pinned and plated) feel your pain.

Talk to your doctor explaining the insurance thing. Getting a bone pinned is not a big issue and if done OK, can be left in for the rest of your life (most doctors won't take metal out unless it's causing issues or for religious reasons).

No, you don't set metal detectors off in an airport- there is not enough metal.

No you most often cannot feel plates or pins through your skin or muscles.

Yes, pinning does work, however of course it is surgery so there is risk.

In NZ I don't think bone stim is available, so it's always surgery. Sometimes I wonder if doctors often push new things too much. Get a third opinion if you feel you need to, but make sure you explain your situation about the insurance. Doctors should take into account people's financials as well in a treatment program.

[jessmarimba]

My back is screwed together I would like to thank your equestrian world for most of the information I found on the internet after my surgery!

Just a few more answers - I think the metal they use now is usually titanium and that doesn't set off airport metal detectors. You can feel mine through the skin, but it's at a very bony part of my back right on the backbone. They don't feel like screws, just a little extra bumpy.

Follow-up appointments for the first 90 days for me were covered under the same cost as the initial surgery. No copays, no anything. I don't know if that was my insurance or the policy of the surgical center, but it made my life a lot easier.

And I'd say at this point surgery and/or bone stim are definitely valid options. Do you know why it isn't re-growing (just placement issues or something else)? I ask because they can pin you back together, but if there is an issue with bone growth it may still not fuse. Are you around people who smoke often? What are you taking for pain? For some people, anything other than Tylenol can slow bone re-growth.

Good luck! And be careful, or we'll talk you into giving up horses and switching to bikes

[Chicken Little]

"To cut is to heal"

[NbyNW]

If it were me, I think it would probably be a good idea to start treatment with the insurance you have now, than risk a new insurance plan deciding not to pay at all if they classify your injury as a pre-existing condition. (I honestly have no idea what they would do, but just throwing that out there as a possibility).

This is a good time to educate yourself as to whether you will have the possibility of extending your insurance when/if your job goes away, what that will cost, or whether there is an affordable option to purchase your own health insurance. Get the information you need in order to plan ahead.

www.healthinsurance.com is a good place to look for insurance quotes.

[oz rider]

Not female, but this thread links to an excellent clavicle thread that might at least cover some of the issues for you. For context, gplama is an elite rider so keep that in mind as to his fitness level and motivation to minimise time off the bike. HTH

[jaydee]

I broke my collarbone and 6 ribs in a cycling accident 2 years ago on Christmas Eve.

The collarbone took 10 months to heal enough that I could get back on the bike again. After 5 months there was some calcification between the 2 broken bones - enough to be holding it together although a very tenuous hold. My ortho surgeon didn't want to operate and insert plate as she avoids surgery as much as possible - infection, starting again from scratch etc. [The break should have been plated straight after the accident, but that just proves that you do not go to hospital on Christmas Eve and hope for decent medical attention.] The surgeon increased physio and general exercise like walking with light arm weights. I was happy to avoid surgery - I had been so sore for months after the accident that I didn't want to go there again. Within a month the calcification had increased and the physio again increased.

I still have a lump where the bones knitted crookedly, but it will gradually realign itself I am told. But it doesn't worry me day to day.

Give the injury time to heal and unless there is no knitting at all, you will be able to avoid surgery.

[nonunioninnj]

Thanks, everyone, for all your responses! Its great to be able to hear from peoples' past experiences and different points of view.

I'm glad that anyone that has had injuries seems to have bounced back.

@jessmarimba- Percs were my friends the first week- and here and there in the next week or so to sleep. Other than that I took maybe ten Aleve since the break- I'm sort of anti-pill, to a fault. No smoking by me or anyone I was around a lot- I'm not a milk drinker- but made sure to get plenty of cheese, yogurt, ice cream, leafy greens. They have no idea why it won't grow back- the displacement isn't far enough apart to keep it from growing.

@muirenn- find another horse and horsefriend! theres honestly nothing like it- from the smell of the hay and tack to the thrill clearing a jump! i rode from 5-14 and didn't come back to it til i was 24- but it was clear my happy place was on the back of a horse a girls best friend.

@jaydee- im sorry to hear it was such a long process! at 2.5 months, there is no knitting at all. i'm curious- did the dr always have you on a physio plan- or just when it seemed as though it would be a prolonged heal? my dr has never suggested any sort of PT plan. its very frustrating… i went for a walk on saturday- maybe 6 miles all together- and halfway through my shoulder/back/and collarbone are all screaming from simply holding their own weight. its very disheartening.

thanks again for taking the time to share with me, everyone!

[jaydee]

@jaydee- im sorry to hear it was such a long process! at 2.5 months, there is no knitting at all. i'm curious- did the dr always have you on a physio plan- or just when it seemed as though it would be a prolonged heal? my dr has never suggested any sort of PT plan. its very frustrating… i went for a walk on saturday- maybe 6 miles all together- and halfway through my shoulder/back/and collarbone are all screaming from simply holding their own weight. its very disheartening.

My local GP was not keen for me to do physio. Then when I went to the ortho surgeon when it was evident the bones weren't healing, she was furious that I had not been doing any basic physio exercises. She immediately started me on strength exercises using those coloured elastic strips. She said that because I was subconsciously looking after the injured areas, even though I thought I was walking straight etc, the rest of me was getting stronger but the injured areas weren't. I still have to consciously swing both arms when I go exercise walking as I keep my left side still otherwise.

I also walked a lot - but shorter frequent distances were better than one long walk. So I might do 3 x 20 minutes. I could do this without getting too sore and without getting too tired. The evening walk was more of a stroll through the golf course after it had closed for the afternoon - I used to wave my arms around a bit and shrug shoulders etc. Thankfully the neighbours knew about my accident and so didn't think I was completely crazy.

Hope this helps.

[bcipam]

in 2003 I fractured my clavicle. Surgery was discussed but attempting the conservative approach, doctor and I decided to let it heal naturally. For two years I had alot of pain and discomfort. Finally the mend which was not really bone, but tissue, broke loose and it was time for surgery. I wish I had that done the first time around. Originally it was weeks before I felt well enough to move my arm. With surgery, even though I wasn't suppose to, I could almost immediatey move.

It's now 5 years post surgery and I have to decide if I want the plate removed. You see, the screws are starting to bother me, I feel them pinching the tissue underneath... I hate surgery though so will just have to deal with it for now...