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I'll chime in on this, I broke my collarbone end of august this year. We had been riding some decently fun/gnarly stuff at Bromont but ended up going down in a berm, on a green trail... Front of the bike just decided to go left while the berm went right, shoulder ended up contacting the dirt directly at around 30 kph. I Instantly knew something was broken but it didn't hurt that much. I went to the hospital and they ended up telling me it wouldn't be too bad to see if it heals by itself or if surgery was needed. A couple days later, after seeing an orthopedist, they determined that surgery was needed (my clavicle broke in two pieces, right in the middle and the two parts ended up going on top of each other) and that my whole right shoulder was slightly sagging lower than the left one. Surgery went fine, quick and easy process but the recovery was not necessarily fun at first. 11 screws and 37 stitches later, the recovery process started. The pain was easily bearable (to be honest I've had way worse pain not stemming from broken bones) but I was mostly scared of reopening the scar (22cm scar on the right shoulder) for the first weeks or so. It was quite a quick process to regain mobility and 1.5 months later I was back to riding bikes on the trainer or on the road. I was actually mountain biking by the end of October although I took it easy. It never really hurt but I was always slightly scared of crashing. I've started riding bmx again the last few months and so far it held up great. It does feel slightly weird sometimes when it's cold outside and it kinda feels as if someone just shimmed a titanium plate in between my bone and my skin (it feels slightly more sensitive in that area). I don't think I'll have to get it removed but I have another consultation with an orthopedist in two years to see if it bothers me. All this to say, thanks for free healthcare (Canada here...), take the time to make sure it heals properly before doing action sports stuff again (sling, recovery, regaining mobility, etc...) and screw using green trails as liaisons in between gnarly trails...
the part about elderly / geriatric patients isn't entirely true. while they do represent a good portion of the patient population for internal fixation, they require fixation different parts of the anatomy and for different reasons than the population under 60. over 60 the most common fractures occur in the hips, pelvis, and humerus. There's commonly an underlying issue of bone density loss which is seen much less in non-elderly patients. nowadays there are lots of orthopedic surgeons that specialize in sports injury, skiing/snowboarding are big ones.
the most common materials used for implants are titanium and stainless steel (316L), so they are highly unlikely to trigger a metal detector. some of the grades used are actually MR safe.
I should also add that the inherent surgical risks are much higher in elderly populations (especially with ORIF), so an orthopedic specialist will be much less likely to recommend an unnecessary procedure (such as hardware removal) to an elderly patient. generally speaking they would only remove it if the risk of keeping it in place is higher than the risks associated with the surgical removal.
Had my hardware remover last week. Got it 3 years ago after crashing and fractured into 3 pieces. One year after surgery fell on my shoulder and fractured on the most outer screw-hole which was the weakest point at the time. New surgery would be sceptical cause here a larger piece of metal would be necessary and the surgeon had to operate on the most outer part of the bone where more nerves and vessels are involved. The surgeon advised to let it heal by itself.It healed very quick but in an angle. Now you can see a large bobble on my collarbone. So I definitely advice to take it out!
I have plates in my arm that had to be redone as I bent them and my arm in 2011 and wish I could've had them removed as often the muscle gets pushed in to the screw heads and causes alot of pain at times, so I recommend removing them for sure. And a screw in my hand that hurts in the cold sometimes too.
I've had a few struggles with the rod in my elbow. But removal probly wasn't much of an option outside of an emergency. The collarbone plate worries me more, in terms of a crash, but I don't like 'feel it' much outside of maybe a heavy backpack. The elbow is touchy... I guess just where it's located. My arm gets weak and I think it kinda pinched a nerve and shut my arm off during a jump line. Introduced my chest to the handlebar lol
Also losing the range sucks. I feel like I can't ride my normal size in a bike. Either having to run riser bars on a large, or just run a medium... To avoid a bunch of weight on my elbows and yanking back when it doesn't extend fully.
Nice to hear a proper pro perspective tho. Part of me wishes I sought removal but I'm unsure what that would have entailed in terms of cost. Murkaaa
I'm guessing that's a Herbert screw for a Scaphoid? I've got one of those, can you do open hand press-ups or do you have to do them on your fists?
FWIW my insurance paid for my removal after I explained to my Dr. that the hardware was causing quality-of-life issues.
I assume... There is a timeframe where they no longer recommend taking it out after long enough time? Unless it's an emergency? I've kinda settled in to it but... I've always been back and forth on like more surgery/rehab/etc and future weakness... Just for a bit more comfort, more or less. Plus I assume the range is not coming back for my elbow, rod or not. :/
No a longer screw all the way through my first metacarpal, its not bad but definitely feel it.
The arm plates I'm thinking from memory it was after 1 year they would need to come out as the bone starts growing around them, I had a hell of a time with them though bent them in my race run at Fort william 2011 and then tried to continue racing in Leogang the following week as I couldnt quite accept what had happened.
fucksaaake so was that also a bone break as well. or is the bone more or less held intact by the plating... but the plating it also keeping it permanently bent unless removed?
Crazy that it was holding and you were trying to ride on it.
And having removed it, did the arm settle in well after? Or did you kinda lose range/strength in that arm?
Removing plate from collarbone is one of the easiest and least invasive open surgeries, also healing is pretty quick, I haven't come across any patient who would won't to keep it in place for both esthetic and comfort reasons, there is almost no soft tissue covering it, in very fit person you could see it easily and even say where holes for screws are. Intramedular nails are different topic, but since the OP wanted to adress collarbone fractures only, I would absolutely say that number of active and relatively young patients will be close to 100% toward removal after 12months or so. For pro racer doing it in the off-season no issue.
Well, after 24months it's very likely that plates will be overgrown with bone and fibrous tissue, it's not impossible to remove it, but requires more fiddling with cleaning bolt heads to be able to remove them and more brute force to release the plate itself. As a result it is more painfull/ heals longer after. In some patients even after shorter time frame there is a lot of bone overgrowth so 24months is on the more liberal side of Max. Time to removal.
There are exact guidelines where surgery is required and where you can let it heal conservatively. To pitia simply, if there is only one fracture line, it's around the middle third of the clavicle and there isn't soft tissue interposition in the fracture you can let it heal naturally. Good surgeon doesn't do surgery that is not absolutely needed.
Oh yeah, mine gets sore after longer rides, and definitely functions as a cold weather detector! My stiffness has gone after nearly two years, but my range of movement is shot. Do you also have a limited range of movement in your wrist/thumb as a result?
For reference:
That's the limit for me unless I really push it with some stretches
That’s pretty good dude. I’d say you oughtta notta taken pics but the endless rug background is pretty sick
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