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Bad fracture, collarbone surgery - recovery time?

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    Bad fracture, collarbone surgery - recovery time?

    Posting for a friend: He's a colt starter and horse trainer. Had a scary fall getting on a troubled youngster after 10 good rides. Suffered multiple breaks to the collarbone, and required over 20 screws and plate to put it back together. He does the lion's share of work at his farm with 1 helper. He's also one of those guys who doesn't listen to Drs, and pushes the limit physically in order to keep his business lean vs hiring more help during the busy summer training months. What is a realistic time frame for recovery? Not to where he's "back to normal", but "serviceably sound"? He's used to riding, breaking in, barn chores, stacking hay and all the stuff that Drs say you can't do for 3-4 months I know he will not sit in the house that long. Financially and psychologically he can't. What is practical for those of you who've had a surgically repaired collar bone? Thanks in advance!
    Savor those rides where you feel like a million bucks, because there will be those where you feel like a cheap date...

    #2
    Wife and mom of motocrossers here, so multiple collarbone fractures in our family.

    My understanding is that if it's plated, it's stronger than the actual collarbone. I believe some pro racers even go right back to racing once it's plated. However, with all of those screws it sounds like your friend of a friend's was fractured in multiple places, so it may be more vulnerable to re-injury. His biggest issue once the acute pain recedes will be regaining his range of motion, so sticking with the PT is a must.

    Best of luck to him. Note: I am not a medical doctor, these are just anecdotal observations.
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      #3
      Hm. I don't know, regarding a fractured and hardware repaired collarbone.

      But...

      My husband is very much going to work on the ranch if he can, regardless of what a doctor tells him about recovery from an injury.

      Also, my husband has two wonky collarbones. They did not fracture, but rather tore the stabilizing ligament . The ligament (acromioclavicular ligament) is toast, on both sides. One, going over the handlebars in a bicycle race, the other twenty years later flipping an ATV over backwards.

      There's a repair surgery that can be done, but he has been advised against it by some very good Ortho docs. It doesn't have a very high success rate, and if it is going to be successful, you have to Not Use That Arm At All for months.

      So good luck to your friend... I hope he gets in working shape sooner rather than later.

      Comment

        Original Poster

        #4
        Yes I'm looking for personal/anecdotal experiences because the orthopaedic surgeon said 3-4 months of down time. That won't happen. I was told not to ride when I broke my lower leg, but once it was casted, I did. I was doing training rides on client horses, not starting youngsters, so could ride without stirrups. If I didn't, I wouldn't have an income. That's the situation this guy is in, and he has a family to feed.
        Savor those rides where you feel like a million bucks, because there will be those where you feel like a cheap date...

        Comment


          #5
          He's going to have to give it some time. Obviously clavicles can't be immobilized like a broken arm or leg .

          All you can do for someone you know who will not give it the time required, is to try to have people available to help him out.

          Most Ortho Docs have experience with patients that won't do what is best for them. "Doctors, Nurses and Cowboys are the worst" is a quote from my old Ortho Doc.

          If someone can explain to the Doc that the patient will go back to work sooner than advised and ask what are the worst activities to do with his particular injury, then you can concentrate on trying to have someone available to keep him from doing that thing.
          Last edited by skydy; Jul. 6, 2020, 11:47 PM. Reason: clarity

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            #6
            I dislocated my shoulder badly once, another time dislocated an elbow, also a horse pawed me and barely grazed my head, but hit my collar bone full on, with shoes, have a nice hard bump along it to show for that.
            It splintered, is the way the ER doctor called it, but had not displaced.
            He said to watch it, wear a sling and not do but a minimum and keep an eye on it and it may need a permanent metal plate repair if it didn't heal right.
            The problem was, there was not enough bone left intact to screw the plate to.
            All that was there were many long splintered pieces, some broken clear thru, some still attached on both ends.
            See how much rebuilding we can gain so there is something to hold screws if that plate is needed after all.
            Every time I wore a sling for long time, but still kept feeding, cleaning stalls, grooming and handling horses.
            Just could not ride, you can't really get on and off several horses a day without hurting something while in a sling.

            I made a little basket out of baling wire and would carry 50 lb blocks of salt one handed and put them out, used a dolly or dragged bales with a hay hook, etc.
            The orthopedic surgeon said because of being sensible and keep moving and doing things, I always ended up with a good, solid repair and no need of PT, as just keep working did wonders.
            I always regained 100% use back, not all do that from those injuries.

            I expect you friend will be up and doing most everything fine with one hand.
            Don't know that he should or can ride for some time.
            That he can still do many things and get around to check that all is ok will be very helpful to his state of mind during this time.
            Help him find what he can do and how rather than trying to slow him down and protect him, which he may fight.
            Being sensible with what you do is ok, overdoing it, not smart.

            Hoping all is well and he won't catch COVID while in the hospital, the way things are going.

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              #7
              I think I was riding again after 8 weeks? The surgeon wanted me to wait until 12 but wasn't very clear about that, so when I was allowed to take the sling off at 8 weeks, I thought I was ok to start riding again. Woops! I wasn't riding colts though - my adult amateur hunter who had been kept in work the entire time.

              I had mine in three pieces (with the middle piece floating around in there unattached), and they fixed it with a plate and 6 screws.

              Comment


                #8
                Hmm. I had a very different experience. I broke my clavicle in multiple places in 2000 after departing my horse and hitting the ground at a high rate of speed. ;-) I went to the ER, where the breaks were confirmed by x-ray, given a sling and told to make an appointment with an orthopedic doctor. When I saw the doctor 48 hours later, he told me that pinning and plating the clavicle was not necessary and, in his experience, actually dangerous. The clavicle is meant to rotate and this can loosen the screws, which can travel into the heart. He also did not recommend a sling as he said it prevented the body's ability to heal the bone, which requires movement of the fractured pieces to stimulate regrowth. Instead, he gave me a padded harness to wear during the daytime that kept my shoulders back - best posture ever - and a series of exercises to do almost immediately, to maintain mobility and encourage healing. I was riding again in about 2 weeks but needed help with tacking up. I wore the harness for about 4 weeks. The clavicle healed fine.

                Comment

                  Original Poster

                  #9
                  Thanks for everyone's input. I guess collar bone breaks are all different, along with their pain thresholds and outcome, and Drs orders. From what I've heard, plating can make you feel better because the bone is stabilized and this relieves some of the pain. Although with his looong incision and 20+ screws, there is also pain from that! Luckily it's his left side, so he can use his stronger side. But lifting (saddling) and 2 handed work is out of the picture for a while. I'm just praying he gives it a chance to heal right - he's not the type to ask for help or set back. Ortho doc said it was the worst clavicle fracture he's seen
                  Savor those rides where you feel like a million bucks, because there will be those where you feel like a cheap date...

                  Comment


                    #10
                    Originally posted by Lusoluv View Post
                    Thanks for everyone's input. I guess collar bone breaks are all different, along with their pain thresholds and outcome, and Drs orders. From what I've heard, plating can make you feel better because the bone is stabilized and this relieves some of the pain. Although with his looong incision and 20+ screws, there is also pain from that! Luckily it's his left side, so he can use his stronger side. But lifting (saddling) and 2 handed work is out of the picture for a while. I'm just praying he gives it a chance to heal right - he's not the type to ask for help or set back. Ortho doc said it was the worst clavicle fracture he's seen
                    Too bad it was such a terrible break, that must be painful.

                    Do tell your friend, wearing a sling will have many people wanting to help you, he should let them.
                    It makes others feel good to be able to help and it helps you heal quicker if you can take your time here and there and let it rest.
                    Going to the feed store, hardware store, even customers there will offer to help you, is nice to see people care.

                    Comment


                      #11
                      Originally posted by KarenRO View Post
                      When I saw the doctor 48 hours later, he told me that pinning and plating the clavicle was not necessary and, in his experience, actually dangerous. The clavicle is meant to rotate and this can loosen the screws, which can travel into the heart.
                      Screws loosening and traveling to the heart??? This is ridiculous. I can't imagine how a doctor like that made it through med school. Pretty much every dude in motocross has had their clavicle plated at least once. I'm sitting here with my son who had his plated two years ago. He's still alive and ticking with no screws in his heart.

                      That's the nuttiest thing I've heard come from a doctor in a while. Glad you healed well, KarenRO.
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                        #12
                        downen, the orthopedic doctor, now retired, was considered one of the best in the state. Obviously, he made the right call for my situation. I did some quick research and loosening screws from bone and/or plates with clavicle repair is more common than you think. There are multiple medical papers on this issue as well as several on whether or not plates and the accompanying screws need to be removed after bone have healed. Also, just happened to see this post on a motorcross webiste: https://thumpertalk.com/forums/topic...rew-migration/

                        Comment


                          #13
                          Surgical vs non-surgical is still quite controversial as far as clavicle repairs go. There are certain cases where one approach makes more sense, other cases can go either way. I think it's something like 10-15% of people end up having the plate removed later on if possible as it can be irritating since it's so close to the surface/skin. And of course any surgery increases risk of infection.

                          Anyway, back to the OP.
                          My mom broke her clavicle falling off her horse several years ago. Single break, small displacement, so they went the non-surgical route with a sling. She spent nearly a month sleeping in a lazy boy. It was a good couple months before she was back to riding. We traded cars for quite awhile as hers was manual and it was too painful for her to shift gears.

                          Keep in mind that it isn't just the bone that has to heal. There's a lot of trauma to the surrounding muscles, ligaments, and tendons.

                          Last week my 3yo got me off. Two cats came screaming and fighting out of the barn just as I was getting on. She spun and backed up until she tripped. I landed on my right shoulder. No breaks, but likely partial tears to the long head of the triceps, teres minor and teres major. No outward bruising or swelling. Slowly improving. It's been 7 days and I still have extremely limited ROM, with the triceps still spasming if I move it the wrong way.
                          However, I too am an awful patient. I've been on said baby 3 times since then. Can't tack her up, lunge, or steer myself. But I can get on and walk around. Didn't want her associating mounting with being attacked by cats

                          Comment


                            #14
                            Originally posted by KarenRO View Post
                            downen, the orthopedic doctor, now retired, was considered one of the best in the state. Obviously, he made the right call for my situation. I did some quick research and loosening screws from bone and/or plates with clavicle repair is more common than you think. There are multiple medical papers on this issue as well as several on whether or not plates and the accompanying screws need to be removed after bone have healed. Also, just happened to see this post on a motorcross webiste: https://thumpertalk.com/forums/topic...rew-migration/
                            KarenRO, I apologize for demeaning your doctor so quickly, apparently it is a thing. However, what I gleaned from the thread you linked to is that migration might be due to the screws being placed improperly. At any rate, most motocrossers are like the eventers of old; plate 'em and patch 'em so they can get back on and race! We deal with sports medicine docs who know they aren't going to abide by the restrictions given to mere mortals.

                            Glad you healed well!
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                              #15
                              I broke my collarbone on a Monday (decently displaced, needed a plate and screws), had surgery on Thursday and went out for lunch immediately afterwards. I was wearing a sling but kept forgetting I had it on and just used my arm because it did not hurt at all once the bones were stabilized and not grinding together. I took it easy the following week and went back to showing the next Tuesday.

                              I had asked the surgeon about timeframe to get back to riding and he said if it hurts, don't do it. If it doesn't hurt, use your best judgement. That may not have been the best thing to tell someone who was spending a lot of money to have the horses in FL for the winter, but whatever 😁.

                              I needed help getting the saddle on and I couldn't put my hair in a ponytail, but everything else felt just fine. I started PT when I got home from FL and a couple weeks of that and I was back to full range of motion. It's now been two years and I still get an occasional twinge if I'm carrying a bag or something right over my scar, but I've never had any residual pain.

                              Comment


                                #16
                                I shattered my left one in July 2010. And by shattered, picture dropping a glass on cement. Went into several pieces, and a lot of fragments. It happened in Vermont at a show and I had to wait a week for someone to drive me back home to Va, and then another week for surgery since I wanted my ortho at home to do it. He did an amazing job. Plate, 6 screws and cadaver bone to put it all back together. I had 1/2 a Vicodin that night and 2 Aleve the next day and that was it. He rode and foxhunted at the time, so he "gets" riders. I was 8 weeks back riding instead of 6 because he wanted to make sure the cadaver bone really fused with the real bone. I have no issues to this day as far as the plate bugging me. I fell in January on my left side and hit the collarbone (100% pilot error). No displacement of the plate, but 15 rib fractures. He said "what did you do THIS time?" Best of luck to your friend. I know it's his livelihood, but if he overdoes it, the setbacks will be worse than the time off.
                                Last edited by Kahuna; Jul. 9, 2020, 12:25 PM.

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                                  Original Poster

                                  #17
                                  Thanks Kahuna!
                                  Savor those rides where you feel like a million bucks, because there will be those where you feel like a cheap date...

                                  Comment


                                    #18
                                    I broke mine with a good bit of displacement, didn't plate it and ended up with a non-union fracture. After a lot of rehab, I do fine, but I would do it over again differently.

                                    When I was considering surgery, the surgeon said that a lot of people feel better almost immediately, because the fracture is stabilized. But you need to wait until the bone actually fuses to really load it, or you can bend the plate. I think they can assess healing via xray, but I was told around 8 weeks was typical. The plate alone simply isn't as strong as bone.

                                    He told me a story about a guy who came in for his two-week checkup, started doing pushups in the exam room, and nearly gave the doc a heart attack. He also told me about some cases where football players or other macho folks returned to high impact activities too quickly and suffered reinjury. (I guess he could tell I was eager to get back in the saddle!)

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