Midshaft Clavicle non union

KernowSteve
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Midshaft Clavicle non union

Post by KernowSteve »

Long time lurker on the CUK forum and CUK member, this is my 1st post in this section asking for advice/thoughts.
3 weeks ago during my very early morning commute I had an altercation with a lamppost and as can be imagined, the lamppost won! The incident was entirely my own fault and I take full responsibility for it, however the question now turns to recovery....
Although a full licence holder I have for a number of years now lived a car free life. This has suited me and my family well, my workplace/commute lends itself to car free travel and my Wife does not drive. Kids at school just across the road etc etc...
The impact with the lamppost broke and displaced the right Clavicle mid shaft and follow up fracture clinic appointments/x rays are showing no signs of union or even remotely lining up. I've an appointment in 3 weeks were I hope surgery can be discussed as I lead a very active lifestyle and have a physically demanding job which requires 2 functioning arms.
Once the broken bits are aligned and mending I am interested in anyone's experiences returning to cycling after this type of injury, bearing in mind that cycling is my only form of transport and is an essential part of my journey to and from work. I am currently on my turbo one handed in a sling everyday and walking miles just to retain as much fitness as possible as I was hoping for some 2-3 day tours around the West Country this Summer, although this is much less of a concern than the fact that my everyday transport including commuting is by bicycle!
Sorry for a bit of a rambling post I guess I have way too much time to dwell on things at the moment!
Jdsk
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Re: Midshaft Clavicle non union

Post by Jdsk »

I'm sorry to hear this.

You're doing the right thing by finding some form of exercise that's tolerable.

Start writing down everything that you want to discuss and all of the questions that you have so that you don't forget anything. It's important that the surgeon understands how important cycling is to you. They might be prepared to communicate with you by email before the next consultation. Take those notes and questions with you when you go.

When you do start cycling again it might be easier on a bike and in a position where there is less load on your arms.

Jonathan

PS: If you want any information on the possible surgical procedures and outcomes do say, but it's generally much better to get those through your practitioners.
rjb
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Re: Midshaft Clavicle non union

Post by rjb »

I broke my collar bone during an off from the bike. It was obvious that surgery would be needed following the initial x-ray. I had a support plate inserted and the 2 halfs screwed to it a couple of days later. When I discussed this with the surgeon and I told him I was a keen cyclist his advice was to keep off the bike for 6 weeks to give it a chance to knit together then booked me in for another op 6 months later to remove the support plate. He was concerned that another accident with the plate in could shatter the whole collar bone and surrounding area causing significant damage.
Hope that helps, but as Jonathan advised discuss with your surgeon for personal advice. Good luck.
Have your phone camera handy when the surgeon shows you the x ray. :wink:
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boblo
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Re: Midshaft Clavicle non union

Post by boblo »

I broke my left one mountain biking (or rather body surfing whilst trying to mountain bike) and went through the standard UK triangular bandage/hurry up and wait repair process. All seemed fine until almost exactly a year later I had a very minor lie down, again whilst mountain biking, and broke it - again.

I elected for surgery and went via BUPA. I'd planned a 4-5 month tour 4 weeks later and didn't want to miss out. I was under the knife within 24hrs and back on the bike within a week. I elected for dissolvable stitches to avoid being pulled around again and donated bone for the organic 'putty/filler' they pack around the repair to accelerate union (usually your own blood and bone fragments apparently). They 'harvest' the bone from elsewhere on your body which, apparently, can be as painful as the original injury. After this discussion, I elected for donated bone, AKA 'dead man's bones...'.

Apart from a slight hiccough with a DVT immediately post op, it repaired and recovered as expected and I took my trip as planned. I was suppose to pop into local hospitals en route to check the post DVT Warfarin dosage but that wasn't really practical where I was travelling. No other issues.

The surgery site took about 3+ years to recover full sensation as the nerves are cut during surgery. I haven't had the plate removed as it causes zero issues during my activities.

On a side note, I watched a round of MotoGP whilst on that trip. One of the Japanese contenders fell, broke his, had it plated and won 7 days later... So cycling shouldn't be an issue - probably.
Last edited by boblo on 15 Mar 2024, 2:15pm, edited 1 time in total.
briansnail
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Re: Midshaft Clavicle non union

Post by briansnail »

Just to cheer you up.You are not alone.3 months ago I cycled under a sign and forgot I was wearing a hat and took a tumble.
You might want to consider a recumbent or a e bike for back up.If it rains heavily or snows - just take a bus.
****************************
I ride Brompton,Hetchins 531
KernowSteve
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Re: Midshaft Clavicle non union

Post by KernowSteve »

Thanks for the replies, it's nice to remember that it's a common cycling injury and many cyclists suffer Clavicle breaks and are able to carry on cycling after a suitable recovery period. I guess I'm just dwelling on things a bit with all the spare time I currently have!
On a positive note I've been considering a saddlebag instead of my backpack for the daily commute and this injury has forced me to make my mind up. Concerned about future issues with the shoulder straps I've now purchased a Super C saddle bag with a quick release bagman support to help reduce the loading on my upper torso once I'm back on the bike.
I will definitely be writing down a list of concerns/issues for the consultant when I go back in a few weeks, thank you for that advice.
I'll update this post when I get more info on the future treatment planned.

Steve
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Audax67
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Re: Midshaft Clavicle non union

Post by Audax67 »

In 2002 I had a difference of opinion with a post growing out of our local cycle path, and the intern at emergency insisted there was only one fracture where there were in fact two. Long story short, once the damn thing had knitted it was a bit bent and a centimetre shorter. The ortho surgeon offered to break it again and plate it straight, but since I wanted to get back on the bike I said what the hell, I'll live with it.

I still get pain in the shoulder-blade because it's pulled out of line, and I can't carry a weight for long on that side; and in fact it's hurting now from over-zealous mousing. My advice these days is always accept the longer wait to get back: it's an investment.
Have we got time for another cuppa?
eileithyia
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Re: Midshaft Clavicle non union

Post by eileithyia »

Broke mine a few years ago and it was completely non-aligned requiring plating to get it into line again. A series of follow up x-rays indicated some initial signs of non-union..... however x-rays don't show the true state of healing and a MRI scan showed that it was indeed healing..... like you I rode turbo one armed for a while but could find I could easily reach the bars with two hands within a short time..... though I did have a frozen shoulder from the lack of mobility.... so had a lot of physio to get full movement back......
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KernowSteve
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Re: Midshaft Clavicle non union

Post by KernowSteve »

Update 02/04/24
Visited the Fracture Clinic today at Derriford Hospital, armed with all the information I've gathered over the past 3 weeks.
Latest X Ray showed no signs of healing as I suspected, so I put forward my case to the Consultant....
Result! The Consultant was much more engaging with me in respect of cycling and an active lifestyle and has now accepted my request for a surgical solution. Appointment booked for next Tuesday with the Surgeon to discuss what will be done and what to expect etc etc.
The Consultant made it quite clear that there is no right or wrong answer, it all depends on the individuals circumstances/expectations. For some a 12 month+ wait for a chance of a possible natural rejoining is the right choice. For others the more defined and quicker surgical route is the right choice.
Thank you for all your advice/thoughts, it was a great help to allow me to prepare for today.
I will update this posting as and when there is more info to add in the hope that a future forum user may find it useful.
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Cowsham
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Re: Midshaft Clavicle non union

Post by Cowsham »

When I had a bad fall off my mountain bike in 2021 I broke my collarbone along with seven ribs and shoulder blade. I was told that because the collarbone had a distal break it would heal no problem. ( ie at the outer edge of the clavicle where the AC joint is attached to it and in turn joins it to the acromion process -- the pointy bit that's part of the scapula ( shoulder blade ) and was also broken in my case.
Screenshot_20240402-214618_Gallery.jpg


Hearing that from the doctors I didn't give it much consideration during the recovery process because I could touch my hands above my head and do most things even when broken although it was still a bit painful so 6 or 7 weeks later when the orthopedic surgeon took more xrays and said it wasn't healing it was a big shock.

He wasn't at all comforting when he gave me the options.

1. We keep that shoulder absolutely still for the next 6 weeks returning in 8 weeks for xray and hope
2. You may have a non union ( some people live with that bit of bone floating there the rest of their days )
3. We do an op to remove that outer bit altogether which means no AC joint.
4. We try an Op to put a small plate in for a while and remove it with a second op. " he said this was unlikely because of costs to the NHS and my age ie I'd too old to spend money on so I'd have to live with it "

I was determined option 1 was going to work so I kept my shoulder ( not just my arm ) as still as I could for the next 5 weeks and started moving it gently on week 6 to prevent frozen shoulder.

8 weeks later went back for more xrays. When I saw the xrays I thought it was still broken cos there was a small gap between the outer bit and the rest of the clavicle but it looked more inline but that could've been the angle -- I was sure it was still broken and sat there thinking what do I say to HR at work cos I'd already been off 13 weeks.

I went in to see the surgeon and he brought up the pic of the broken collarbone as above. My heart sunk -- but quickly flicked up the new xray telling me it had started to heal. I was a bit puzzled and asked him why the gap. He zoomed in a bit and showed me the little white lines of new bone bridging across the gap.

What a relief but I still had to be very careful with it for the next 6 weeks. I stayed off the bike for most of that but got on as soon as I could.
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KernowSteve
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Re: Midshaft Clavicle non union

Post by KernowSteve »

Update 10/05/24
Thought I'd update this thread on my current situation as promised.
Today exactly 4 weeks post surgery I managed to get out for a ride outdoors on a carefully planned route with minimal traffic and people around. I have significant mobility problems with my shoulder as can be expected from such a long period of inactivity, and have quite intensive physio to carry out if I am to get full movement back. The ride today definitely seems to have helped from a physio/movement point of veiw, holding the handlebars and operating brakes and a bar end gear shift has freed up some more movement I believe. The incision/scar area is still sore and I find it painful to turn my head as in when glancing over a shoulder checking for traffic etc. My bib shorts were just about bearable over the affected shoulder and I'm hopeful this will improve with time.
The biggest issue was bumps! I eventually developed a technique whereby I held the affected arm just above the handlebars when I spotted an upcoming change in surface and this worked well.
Fitness level seems to have been maintained reasonably well on the turbo trainer and I have been running again albeit without much arm swing on the bad side.
There is still some way to go, but for now I'm really happy with the progress and hope if anyone finds this thread in the future it may give them some hope and lift their spirits!
Jdsk
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Re: Midshaft Clavicle non union

Post by Jdsk »

Thanks for the update. It's good to hear about the progress.

You could consider a mirror to help with traffic from behind.

Jonathan
rjb
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Re: Midshaft Clavicle non union

Post by rjb »

Biggest issue I had after mine was plated was removing jumpers and shirts over my head. It was excruciating painful. I was convinced that the surgeon hadn't rounded off the edges until I saw it after removal when it was rounded. :shock:
At the last count:- Peugeot 531 pro, Dawes Discovery Tandem, Dawes Kingpin X3, Raleigh 20 stowaway X2, 1965 Moulton deluxe, Falcon K2 MTB dropped bar tourer, Rudge Bi frame folder, Longstaff trike conversion on a Giant XTC 840 :D
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Cowsham
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Re: Midshaft Clavicle non union

Post by Cowsham »

KernowSteve wrote: 10 May 2024, 4:20pm Update 10/05/24
Thought I'd update this thread on my current situation as promised.
Today exactly 4 weeks post surgery I managed to get out for a ride outdoors on a carefully planned route with minimal traffic and people around. I have significant mobility problems with my shoulder as can be expected from such a long period of inactivity, and have quite intensive physio to carry out if I am to get full movement back. The ride today definitely seems to have helped from a physio/movement point of veiw, holding the handlebars and operating brakes and a bar end gear shift has freed up some more movement I believe. The incision/scar area is still sore and I find it painful to turn my head as in when glancing over a shoulder checking for traffic etc. My bib shorts were just about bearable over the affected shoulder and I'm hopeful this will improve with time.
The biggest issue was bumps! I eventually developed a technique whereby I held the affected arm just above the handlebars when I spotted an upcoming change in surface and this worked well.
Fitness level seems to have been maintained reasonably well on the turbo trainer and I have been running again albeit without much arm swing on the bad side.
There is still some way to go, but for now I'm really happy with the progress and hope if anyone finds this thread in the future it may give them some hope and lift their spirits!
You have to be very very careful even if plated -- breaking any of that work will result in much longer recovery so take it dead easy for a few more weeks for the fastest recovery time.

Will you be getting the plate out again ?
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KernowSteve
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Re: Midshaft Clavicle non union

Post by KernowSteve »

I'm going to wait and see regarding future removal of the plate. If the irritation/soreness calms down somewhat with the passage of time then I'll try and live with it to avoid another op. Having said that I'm aware that it can become problematic in many cases and I do often carry a backpack which may or may not be an issue in the future.
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