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Yet another Clavicle Fracture


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After many times swinging the leg over the bike it finally happened. The below x-ray was taken of my right collarbone on 7/13/08 and the overlapping of the bones has shortened a bit.....Ortho said NOT to have surgery - "It will heal itself." Well after 5 weeks, i have 50% ROM and 50% strength. yeee-hawwww.

I am currently trying to get an appointment with Dr. Mark...in the meantime

who doesnt like to see other peoples misfourtune, it gives us something to do while we are at work!

Dr. Mark, where do you think the bone graft is going to come from?

braaapppp

IMG_2582.jpg

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By a ticket on American Airlines and go see Dr Mark. I had a dumb a$$ as my first ortho who screwed it up. After 6 months and a non union I went to Dr Mark, he fix what the dumb a$$ should have done the first time. Save yourself the trouble and time and go to Houston.

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By a ticket on American Airlines and go see Dr Mark. I had a dumb a$$ as my first ortho who screwed it up. After 6 months and a non union I went to Dr Mark, he fix what the dumb a$$ should have done the first time. Save yourself the trouble and time and go to Houston.

Ditto what Madday said....I waited 4 1/2 months for mine to heal...I did have about 85% ROM and could ride the bike and do push ups, but never felt right...always felt like my left shoulder was unconnected to my body..

Go see the Doc.....getting it done right the 1st time is the way to go....

If the doc does a bone graft....its no biggy...a bit stiff for 3 days but by 5th day you will be walking almost normally....If it was me I would have the bone graft...why not to the best thing possible to get it to heal ...

Scotty J.

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Thanks for the advice guys... I cannot wait. I consider myself pretty lucky, I was wearing a leatt. When you guys went to see Dr. Mark did you take your wife, girlfriend or a random from the bar to help get around?

Yvonne has my info and I am waiting to hear back from Norma (surgery scheduler?)

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My Dad went with me since he was newly retired....You can do it by yourself...I mean you can walk(limp around) even if you have a bone graft....Arrive on Sunday..Surgery Monday...PT with ED at the doc's office Tuesday and Wednesday...fly out Wednesday late afternoon early evening...

It is nice having someone there to help out and talk to you....My dad really wanted to see what this Doc was all about...he was impressed with Dr Mark...

Search my threads I ahve many with lots of Info......I have before and after Xray thread below

https://www.thumpertalk.com/forum/showthread.php?t=611690

Scotty J.

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Thanks for the advice guys... I cannot wait. I consider myself pretty lucky, I was wearing a leatt. When you guys went to see Dr. Mark did you take your wife, girlfriend or a random from the bar to help get around?

Yvonne has my info and I am waiting to hear back from Norma (surgery scheduler?)

You will be in good hands. I went down by myself and had no problems at all. Dr Mark and his staff will take good care of you. I stayed in the hospital after surgery because I didn't have anyone with me. Everything went very well and couldn't be happier

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Wow !! I'm not a doctor...but in my non-doctor mind i can't even fathom how that could heal. Then ends are 1 inch apart and pointing away from each other. If not sugically fixed, how would that heal? A big 1.5" ball of calcium to kinda glob it all back together? Thank god for sugeons that can fix stuff like that. I like be anatomically symetrical ?

Sounds like you are researching the correct info.

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Wow just now able to see Xray....man you need that fixed...just do not understand docs these days...

Doc Sanders will fix you up in no time...If you have any other questions feel free to PM me or just give me a call. 404 four zero three 633 one

Scotty J.

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Yeah, I had been reading the threads from Scotty and madday. as for the healing part.....The ortho said "wait and it will essentially turn into a ball o bone." I will never forget him saying that. I asked him how long it would take and he said "3 months." :worthy:

Lately my hand goes numb when I fall asleep and I have pains at the lower part of my shoulder blade. Plus my shoulder feels like it is not in a comfortable location.

After reading the other threads, you have to research and try to find an ortho you trust will fix your problem. Plus hearing the horror stories from other TTers, I am just lucky that others have gone thru this and posted their experiences. THANKS.. ?

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The fradture fragments are putting pressure on the brachial plexus which is the nerve supply to the hand.

The bone is shortened over one inch. Even if it did heal, you would be left with a painful, weakened, and deformed shoulder. This doctor should read the articles in the Journal of Bone and Joint Sugery. Pehaps he should actually take a CME course, rather than sign in and sit in the bar. Here s an abstract from the Journal January 2007. Show it to the doctor. He probably hasn't seen the inside of a book in decades.

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.

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Well if you cannot see Dr Mark...go see Dr Shelbourne...I just realized that you my friend are in Indiana...

Either way I waited 4 months and saw 4 orthos....all said to wait at least 6 months...Dr Mark was the only one who said he would have plated it from the get go....

Good luck but you will not need it in the hands the doc...

Scotty J.

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What you find, in your search for a good doc, is that many who claim to practice "sports medicine" are actually more content to replace hips and knees in the seniors for easy money, and send you home in a strap like it was 1972. Ask the guy what HE does for sport and if he would be happy with that.

If its plated right its not such a big deal, you can function normally in a few days, just don't fall on it. In fact you will be much more comfortable post op in every way than you are now all misaligned. I was riding my Ducati in a few weeks, and by 10 weeks was up to my full pre injury workout levels.

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Doc, Thanks for posting the info regarding clavicle fracture treatment. I probably won't show that to my doctor because hopefully I will have the surgery done by the time my next appointment with him! Although I should for the sake of all the other people that would see him for clavicle fractures.

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