June 30, 2015
Just under two weeks ago I was leisurely riding my bike along the tranquil routes on the island of Guernsey when I find myself staggering upright grasping hold of my arm. Initially in denial that I had done anything serious I managed to walk back to the campsite only later to discover I had broken my collar bone.
The collar bone is also known as the clavicle. The Latin translation of which means little key – so named because of the rotation movement that occurs when lifting the arm sideways. The clavicle is a very common site of fractures partially due to its long slender S shape positioned horizontally that connects the shoulder to the axial skeleton. There are 2 options for treatment. One to allow the fracture to heal naturally and rest the area for 6-8 weeks. The second option is surgery whereby they fix the fracture together with a plate and screws.
I was seen in fracture clinic and informed that I was borderline for an operation due to the amount of overlap between the two ends of bone. Given the risks associated with an operation I decided to conservatively manage the fracture and be reviewed in 6 weeks. I was keen to start to move my shoulder to prevent secondary complications affecting the shoulder. So, despite being only 2 weeks since fracture I have been squeezing my shoulder blades together and allowing my arm to rotate outwards. I am placing more caution with lifting the arm upwards as I feel this may displace the healing fracture as I am only at the stage of bony healing where the scaffold is being laid down but it remains very soft.
My other concern with the decision to manage the fracture conservatively is the occurrence of non-union which is where the fracture fails to heal. A recent study looking into this gave an 18% non-union rate for this type of fracture : http://www.bjjprocs.boneandjoint.org.uk/content/94-B/SUPP_XXXIII/16.abstract. Hopefully as I am fairly healthy mine will heal but I’ll post an update in 6 weeks. In the meantime it’s the dreaded accounts for me!