broken clavicle

[GMP]

F5,

Did you get a hook plate? They hook over the edge of the distal clavicle, and can irritate the rotator cuff, thats why they are taken out. Then you are looking at more time while the screw holes fill in.

The longer you are immoblized, both from the injury limitations before the op and from the sling (if the doc does that) the longer and harder it is to get back to normal. I have done it twice, once the conservative sling method and next the immediate movement method. The later is much better if your doc beleives in that method. I had 90% ROM and was mock bench pressing a PVC pipe the day after surgery.

PM or email Dr. Mark Sanders who moderates the health forum on Thumpertalk and see what he says about a hook plate and when it should come out.

When you can't ride for a year and talk to docs a lot you learn too much about this stuff. Good luck!

 

[nhrider]

Good luck! Listen to Glen. He has helped me out!

My doctor said I could move my shoulder gingerly and that has been a big help. I had to wear the sling only for walking/standing around. I start OT again on Weds. I've been doing some of my old OT exercises just to stay a little loose. Nothing crazy. This nerve blocker is some strange stuff. At first I could not feel anything but now I'm starting to feel pins/needles in some of the area.

 

[(F5)]

Hi

Yes that sounds right. I did wonder about the screw holes filling in. I'll try to get movement going as soon as I can after it is taken out as I think that I was overly ginger, but I do remember it being somewhat sore to do so. Probably most of the issue was that I wasn't getting much movement before the plate, but it really hurt then & I was concerned that if I moved the break too much it would never heal the bone. I mean that makes sense I would have thought when there is no plate yeah?

The surgeon did say that it was a bit of a race between the bone healing & the plate wearing out (fracturing). Near the end there is a lot of leverage so if you rely on the plate it will wear out before the bone heals & break. That was enough to make me fairly careful until the x-ray showed that there had been some union. I was told the sling should come off after the plate as soon as I was ready, it took me a few days to work up to that. But they did say not to lift my arm up past 45 because of the leverage until bone healed. I have ~95% range just the plate limiting the rest.

 

[nhrider]

Update.

The bandages and sling are off! I'm so happy! Doc gave me a few exercises to do but have to do them on my back. No standing with weight and exercising. I can only lift about 2 lbs and nothing over my head. Oh, that wasn't nerve blocker he put in me...I thought he said that but any was. The feeling is from the nerves being pulled out of the way. They take time to come back and some may never come back around the incision. I did see the X-ray. Pretty cool. Nice work. I tried to get a copy to post but they couldn't give me one. I'll try to get one next time.

 

[GMP]

F5,

Yeah that looks like a hook plate. There is another type of Accumed Ti plate used for that as well.


Steve,

Like I thought, that will be numb for months. Everything else will come back fine.


All the docs except Mark Sanders tend to play it conservative. A lot has to do with the technique of installation. There has to be enough working length between the distal and proximal screws so the plate can flex slightly without fatiguing. Ti has a flex modulus similar to bone, where stainless is more rigid and will create stress points. If its done right, and you do no more than you are told, its fine to use full ROM with the weight of a water bottle immediately after surgery. I had special exercises to do that would not stress the area, but promote blood flow for healing. Thats the idea. Only the doctor knows what he did so you have to listen to him, and its safer to just say no than to say yes but be careful.

 

[(F5)]

Hi thanks for the input & sorry for Hijacking the thread.
My doc told me he had a collection of plates that had failed & had to redo the surgury & that was enough to make me careful. Ti is all that gets used in NZ I think, but I could easily be wrong.

That feeling of the bone actually supporting weight once the plate is in is great having had the 'unconnected' feeling for a few months. Good luck. Heal like a starfish.

 

[nhrider]

Update.

It has been 2 1/2 months since the surgery and I feel great! Much better then being in a sling! F&*@ Slings! I hate them! Any was. I have been lifting weights and have full ROM. Yes, it is a little tight feeling some times and I'm still a little numb. It doesn't seem to really bother me. I have been snowmobiling a few times and it feels fine.

Thanks Glenn for all the help! Without you, I would probably still be hobbling around and driving my wife crazy!

The crazy part is my friends kid broke his clavicle last Sunday. The docs told them to come back in a couple of weeks. They said they didn't want to plate it because he was young...I believe around 14. They said because he's still growing that could cause problems later down the road. They said that the plate would need to be removed. I agree with that but the other stuff sounds like a load of crap but I'm not a doc. I told her to see the doc I saw...Hope she listens...

 

[GMP]

Hey Steve,

Glad your doing well! Go easy until you get the OK, it feels good before its completely healed.

All the soft tissue around the plate takes time to come to terms with its new neighbor. You will some feel tighness and funny stuff, but it passes with time. I'm a year post op and don't notice mine at all now unless I get head butted by a kid or the dog.

The doc may be right about kids clavicles, I remember Dr. Mark telling someone the same thing. Its the last bone in your body to mature. Probably depends on the kid and age though, as well as the severity of the break. Just have your friend ask Dr. Mark. My 10 yr old son's friend tore his knee up good on a trampoline, including his ACL Much different ACL procedure for kids, All the drills are CAT guided. they had to go to a childrens hospital in Philly.

 

[nhrider]

Good info...I'll pass it along. I guess they are on the fence if it needs to be plated. Then again, she took him to the place the told me to wait another 8 weeks. The same place that had no young adults or kids there. Hip and knees are first inline. I told them to get a second opinion. Better safe then sorry.

Yes, I have been careful. I'm talking low weight with lots of repetition. I have lifted a few heavy things. I always used my good arm for about 80% the weight. Bad was just there to guide/balanced my right arm. The Doc cleared me for snow blow, little snow shoveling and snowmobiling. I have only been snowmobiling two times. Nothing crazy and slow speeds. Doc said no push up or dips. Doc also said I would feel it if I couldn't do it.

 

[(F5)]

Pah! the way kids heal, he probably already has. Little urchins. Anyone would think they were designed to last longer than us mature fellas.

My shoulder has started clicking more in the last couple of weeks. There always was a bit of a click as I went to full up or full down it would click 1/2 way as the muscles move over the plate I guess (which is at the shoulder end & under the joint). Well its been in 6 months now & I got the letter saying it has been approved to come out. Just waiting for them to say when it will be booked in. Can't wait to get it out (but is in more intrusive place than if it was in the middle).

In 2 weeks it will be a year since the break & I'm gagging to get out on the bike (or sleep on my right side). But I have taken my trials bike & road/racebikes out. I miss the EC though.

 

[GMP]

I went from a water bottle immediately after surgery, to a max of 10 lbs. for the shoulder work, then added bicep work later at a few more lbs. Shoulder rehab was always the same though, no movement limitations. Sounds like you have been a good boy. Worst thing that can happen before its solid is you fall on it. Keep up the good work and we should hook up for a ride next (this) season.

 

[nhrider]

Update.

It has been three months since the surgery. I'm still feel good. I had my last X-ray last week and the bone looks very good. All the spaces has grown back in. The Doc says I'm good to go. I'm still have a little tightness and numbness in the shoulder area. If I turn my head to the right, I feel some pulling over the plate and screws. Not really that bad but it is there. I have also woken up and found myself sleeping on that shoulder...seems fine. I'm doing push-ups against the wall right now. I'm hoping to move to the floor at the end of the month. I'm also lifting weights. Not a ton and not as often as I would like. I may have the plate removed in June but I'll have to see.

 

[Skidad]

That's the good news Steve

Now give em the sad news

 

[GMP]

Steve,

Give it more time to be safe before you push it or ride with it, trust me on this one. With my first plate, I was doing a full workout with weights, Gravitron, etc. and felt fine. Than it fell apart when the plate was removed at 16 weeks. Also, give it time before deciding on the plate removal. Unless there is something not right about the install your body will get used to it. It takes longer than the bone healing from my experience but it does get better. If you have it taken out, its rehab all over again, as you have 6 4mm holes in a small bone that have to fill in and calcify. I can show you a post op (plate removal) XRay that looks like Swiss cheese. Thats 6 weeks easy, so there goes summer.

What bad news?

 

[nhrider]

Bad news is the bike is gone for now. I need to take some time off for my family. I put my wife through a lot with my head injury. I'll be back I promise. My daughter is 4 and she already wants a dirt bike. A orange one she says. lol. I'm going to want to wait 2-3 years and then get something. Hopefully GasGas will have their act together.

 

[nhrider]

I'm not doing anything close to a full work out. I'm still playing it safe...I think.

 

[(F5)]

Interesting (and scary) to hear about your experiences. I have just had my surgery confirmed to remove the plate at 34 weeks (2nd Mar). they did tell me it was going to leave some holes like perforated paper until holes filed in, but the way I see it the holes are still there with the plate in.

Being that the plate is held in there by the screws I don't see it being much stronger with the plate in, there will still be holes there.

I am so looking forward to the plate coming out. It is like it is getting more clicky when I do exercise, but it is strong & I have good days. I think it is where the screws are in relation to the muscles.

I've even been out on the GasGas. . . . Just the TXT rather than the EC. here is no way I can sleep on that side, it wakes me right up, but that is because of where the plate is I think & the shoulder rolls onto the plate.

Good luck nhr

 

[GMP]

From what I was told, the hook plates irritate the rotator cuff, and should come out. They are also placed more distal (outside) where the skin tends to stretch around it more. The guy who did mine (Sanders) does not use them, and for those that have them recommends getting them out ASAP.

The total strength of the repair has a lot of factors, like plate material, position, screw placement, etc. I have fallen on mine a few times, 2 minor crashes riding and one skiing. First time scared the crap out of me, but all was OK.

 

[(F5)]

Well two weeks from tomorrow mine should be out so looking forward to that. Yeah I've road-raced but spent a lot of time thinking about trying not to crash on that side. Must get a few miles under the belt before the op while it is still summer here, both on road & Trials bike. Maybe I can get the EC out for a mid week tootle. Very tempting.

Thanks GMP for informed info.

 

[(F5)]

Well I decided to completely hijack & update this for anyone following thread.

I had the plate out today. Was a quick procedure, much easier than getting it in for sure. They did warn me that there was still risk. Being a hook plate the hook is under the shoulder bone so they have to wiggle it out. They saved it for me, more on that later. The risk is that you could get nerve damage or hit a vein or rebreak the bone. Fortunatly none of that seemed to happen. I went in 7:30, was in op at 8:30 & out & recovered enough to be picked up before lunch. The guy in the next cubicle was from the local bike shop & was in to have his plate out of clavicle. Small world.

Ring Wife, she comes picks me up, takes me home, house been burgled. Great. So ring Police, they come pretty quickly & bring dogs etc. The alarm seems to have scared them off after a quick pull back the bed & dash, but they did spot my wallet on the dresser. Ironically I'd left it at home so it wasn't at the hospital (not that I'd mistrust the nurses, they were great). Also got the camera, so as I said no picture of the plate.

One of the Police that showed up we knew from Antenatal group. Smaller world. I call the credit card call centre & speak with a girl who called me on thursday to check up on a UK purchase I made (ironically for Forcefield body armour, can't get it here, supposed to be the best, to help make sure this doesn't happen again). Tiny world. So while speaking to her she recognises the Cop who we knews (sorry I've had a general today & grammar is off) voice in the background & knows him personally. Where was this world again?

Ok so it sucks being burged but not much harm done. Must go rest up, but I seem to have good movement, no sling required, just don't lift anything & obviously it has to heal the holes from the screw before it is back to full strength. I'm pretty happy now. If tired, tired, tired.