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Midshaft Clavicle Fractures

Posted: August 16th, 2015, 3:24 am
by cpcnw
Hi all,

My guess is that there a lot of C2 owners / users who are also keen cyclists. And, that clavicle injuries in cyclists are likely pretty common?

However I had reached the grand old age of 52 without breaking a bone in my body.That is, until a week last Friday. I was coming back from a quick morning spin on my folder, and just round the corner from my house, ran over an 1.5" wood screw. The screw lodged itself in the back tyre, rotated round and hit the back of the mudguard. The mudguard shattered, and a section of it rotated around underneath the tyre. So, in a single rotation of the wheels I had a shiny piece of pvc mudguard lodged under my back tyre at which point the frictionless nature off the contact with the road, coupled with the existing forward momentum and the downward force of gravity of my 13 stone body, caused the bike to 'pop-out' completely from underneath me, resulting in a left hand superman dive into the tarmac. Unfortunately(?) due to the instantaneous nature of the above, I did not have time to get my arm down and the entire force of impact was taken by my left shoulder.

The rest of Friday was a blur. I had passed out several times with pain, was taken to hospital in an ambulance, given morphine and xrayed.

Result: midshaft clavicle fracture with 2cm displacement!

http://www.custompc.plus.com/downloads/gbclavlores.jpg

After reading a lot of reports, forums and opinion online, as well as getting email back from a US Sports Ortho I took the decision to get this plated.

https://en.wikipedia.org/wiki/Clavicle_ ... e#Surgical

This was done 2 days ago and I am now off the pain killers.

Additionally a UK Ortho, also a cyclist, contacted me and reassuringly confirmed my decision given the extent of the displacement.

It would be great to hear from anyone who has had this operation, to hear what their recovery was like etc and also if their NHS consultant was encouraging, took a neutral stance or even played down the seriousness of this injury? Where you told you could buy a diagnostic copy of your xrays and get a second opinion? Or that you had a week to decide?

Also welcome would be advice on use of my C2 as rehab aid. Currently I am just walking round the block a few times a day and have been told to keep shoulder very still for two weeks [also date of next fracture clinic / xray / consultation] - I've read the general rule is not to lift anything heavier than a pint for 6-8 weeks and no driving for at least six.

Re: Midshaft Clavicle Fractures

Posted: August 17th, 2015, 7:27 am
by heroesfitness
cpcnw wrote:Hi all,

My guess is that there a lot of C2 owners / users who are also keen cyclists. And, that clavicle injuries in cyclists are likely pretty common?

However I had reached the grand old age of 52 without breaking a bone in my body.That is, until a week last Friday. I was coming back from a quick morning spin on my folder, and just round the corner from my house, ran over an 1.5" wood screw. The screw lodged itself in the back tyre, rotated round and hit the back of the mudguard. The mudguard shattered, and a section of it rotated around underneath the tyre. So, in a single rotation of the wheels I had a shiny piece of pvc mudguard lodged under my back tyre at which point the frictionless nature off the contact with the road, coupled with the existing forward momentum and the downward force of gravity of my 13 stone body, caused the bike to 'pop-out' completely from underneath me, resulting in a left hand superman dive into the tarmac. Unfortunately(?) due to the instantaneous nature of the above, I did not have time to get my arm down and the entire force of impact was taken by my left shoulder.

The rest of Friday was a blur. I had passed out several times with pain, was taken to hospital in an ambulance, given morphine and xrayed.

Result: midshaft clavicle fracture with 2cm displacement!

http://www.custompc.plus.com/downloads/gbclavlores.jpg

After reading a lot of reports, forums and opinion online, as well as getting email back from a US Sports Ortho I took the decision to get this plated.

https://en.wikipedia.org/wiki/Clavicle_ ... e#Surgical

This was done 2 days ago and I am now off the pain killers.

Additionally a UK Ortho, also a cyclist, contacted me and reassuringly confirmed my decision given the extent of the displacement.

It would be great to hear from anyone who has had this operation, to hear what their recovery was like etc and also if their NHS consultant was encouraging, took a neutral stance or even played down the seriousness of this injury? Where you told you could buy a diagnostic copy of your xrays and get a second opinion? Or that you had a week to decide?

Also welcome would be advice on use of my C2 as rehab aid. Currently I am just walking round the block a few times a day and have been told to keep shoulder very still for two weeks [also date of next fracture clinic / xray / consultation] - I've read the general rule is not to lift anything heavier than a pint for 6-8 weeks and no driving for at least six.
Try and find a local PT who is versed on injury rehabilitation in sport, this would be my advice for you, don't try using a normal PT as they won't have a clue, try going to a local athletics club and see if they have a decent conditioniing coach who will have rehb training experience

Re: Midshaft Clavicle Fractures

Posted: August 17th, 2015, 12:10 pm
by cpcnw
Good tip. Currently its early stages anyway as I think the 'union window' is at around 14-20 days. The next xray should evidence that.

Coming back to clavs for a while...

One of the probs I have discovered with clav injuries is that there is such a large variance in severity of the injury. And, that there is a very long history of 'conservative' treatment.

The reason for this appears to be that on very low impact it only takes 7ft llbs [think I have that right] to crack a clav. And this type of injury is by far the 'most popular' - we are talking about 80% from what I can figure. This means by far the most common response to a clav injury is to keep your arm in a sling for 6-8 weeks and it will be fine. And of course, in those 80% of cases it is. I have seen several NHS sources suggesting this is all the treatment that is required and this just re-enforces the problem.

Now looking at a minority group, those that cycle / ski etc in that group by far the most common injury is a proper good fracture where the clav is badly broken into 2 or 3 pieces and the force enough to displace those pieces. In some cases its 'shattered' along its length [more common in front fall ski accidents] Essentially the bits dont stand much chance [if any] of coming back together, but even if they do they are badly aligned.

So, you have a minority group with a minority [but complex] injury type - its my opinion that this is why the response to this group is totally wrong.

In short, for way too long, clav injuries have been looked on as slightly worse than a cracked rib yet in the 20% of cases its much much worse and a lot more serious.

Bearing in mind that plating a clav [ORIF] involves drilling bone close to major blood vessels and nerves then the correct response is a pretty damn serious operation with high degree of potential risk.

What made me laugh was my next door neighbour who told me to 'Man Up' - totally and utterly clueless, I couldn't even be bothered explaining anything to her.

There is certainly a lot of ignorance / closed minds in the world.