Internal fixation of fractured clavicle.

[CaveatLector]

Does anyone know if there is a "guru" in this area?

I have a fractured clavicle from an accident a couple years ago. The sports med ortho Dr. took a very conservative approach saying it would heal on its own since most do. Even 1 and 2 months subsequent to the accident when I requested surgery he said it wasn't a good idea. Well, it never healed and the 3 other docs I have consulted with since then don't want to touch it saying even surgical intervention may not get it to heal. One said I would probably need grafting from my hip and said the negatives may outweigh any chance of positive outcome.

The fracture is not mid-shaft. It is distal and from everything I have read the fractures closer to the shoulder have higher chances of non-union so unfortunately I fall into that category.

If anyone knows of a specialist in this area please advise. Also, if you can tell me about the latest and least invasive (least scarring) procedures I would appreciate it. Thank you!

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[asdf123]

How much pain do you have? Is it a functional problem for you? How distal is the fracture?

Clavicle fx's are treated nonoperatively. The only indications for surgery are open fractures and nonunions (ones that don't heal that continue to be symptomatic). Now distal clavicle fractures are bit more tricky but most of these are also treated without surgery.

If the fracture is very distal, a Mumford procedure (resect the end of clavicle) is usually helpful.

As far as a specialist, I would either see a orthopaedic trauma surgeon or a shoulder specialist. The thing about clavicle fractures is that surgery is so rarely done that most orthopods don't have a significant amount of experience with this type of surgery. What region of the country are you in?

If you continue to have pain and if it is affecting your life you should see a traumatologist or shoulder surgeon...surgery is certainly reasonable for a symptomatic nonunion.

 

[strory]

Consult your doctor first. There is a simple "piano key test" to locate the area of the fracture. Are you sure it is the fracture and not a dislocation? The ligaments at the distal part can take a while to heal producing the same collarbone pain as you felt before. Check out this resource for anything concerning the collarbone pain. They also have stuff like basic diagnosis, symptoms and some rehabilitation techniques that you can try.

Best,

Strory.

 

[skiz knot]

Clavicle fx's are treated nonoperatively.

Not always.

The only indications for surgery are open fractures and nonunions (ones that don't heal that continue to be symptomatic).

Wrong. Also consider nerve injury/exploration, poly trauma patient, significantly displaced/shortened, (dominant extremity in) a laborer/athlete...

If the fracture is very distal, a Mumford procedure (resect the end of clavicle) is usually helpful.

Wow. It would have to be a VERY distal fracture, sparing the conoid and trapezoid ligaments in a skeletally mature individual in order to consider that move. Mumford is usually considered for chronic AC joint injuries and/or arthritis.

 

[skiz knot]

Consult your doctor first. There is a simple "piano key test" to locate the area of the fracture. Are you sure it is the fracture and not a dislocation? The ligaments at the distal part can take a while to heal producing the same collarbone pain as you felt before. Check out this resource for anything concerning the collarbone pain. They also have stuff like basic diagnosis, symptoms and some rehabilitation techniques that you can try.

Best,

Strory.

OHHHHHHHHHHHHH...

Just realized this was a 6 year old post resurrected by a BOT to drive hits to a lame website...