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Left collar bone fracture - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1776 Questions
User :   Hi Doctor,
I met with an accident few weeks ago and ended up with a fracture in my left collar bone... Doctor who treated me gave me a non surgical treatment by putting shoulder belt on me and suggesting rest. But, later some medical practioner who saw my XRAY was threatening me that this should have been surgical treatment... please help.. My one is complete fracture in the middle and the pieces got one on to another...
Doctor :   Hi
Doctor :   I am
User :   Hello Sir
Doctor :   What is your age ?
User :   please suggest on what i should do...
User :   29
Doctor :   Ok do not worry
Doctor :   80% of the clavicle fracture happen in the middle 1/3
User :   ok
Doctor :   Usually the figure of 8 ( a way of putting the plaster) is used traditionally
Doctor :   This splint is applied after closed reduction of the fracture, which is accomplished by pulling the shoulders up and back.
Doctor :   It all depends on how difficult it is to maintain it
Doctor :   and follow up
Doctor :   Healing should take place in 6 weeks
Doctor :   hence repeated Xray are taken
Doctor :   to see for healing ( callus)
Doctor :   Of course it is immobilized with this case
Doctor :   cast
Doctor :   Immobilization should remain until repeat Xrays show callus formation and healing across the fracture site.
Doctor :   Recent studies demonstrate that operative treatment of displaced midshaft clavicle fractures may result in improved functional outcome and a lower rate of malunion and nonunion, compared with nonoperative management.
User :   but my only concern now is if a surgery is required now again i should be getting 4 to 5 weeks more leave which is currently difficult
User :   it has already been 5 weeks in my case
Doctor :   Ok, that is a different ask. You should wait now for one more week and check with repeat Xrays
Doctor :   I hope you should have consulted an expert Orthopedician
User :   i am very much worried
Doctor :   rather than a General Physician
Doctor :   I am worried if you are really immobilized the area
Doctor :   and if the healing is good
Doctor :   Because you are typing here
Doctor :   You should restrict the swing movement of arm, active movement of elbow and hand too
Doctor :   As a general guide to return to activities, nothing should cause worsening pain. If not wearing a sling causes pain, wear a sling. If driving hurts the fracture site, don't drive. If throwing a ball hurts, don't throw. Once an activity doesn't cause significant pain, a gradual return can be attempted.
User :   yes actually... i cnuslted two good surgoens
Doctor :   So both have a difference of opinion
User :   no
User :   they have the same opinion
User :   first doctor treated me the day i met with the accident
Doctor :   Ok
Doctor :   He decided with non surgical approach that is sling
User :   then he suggested shoulder belt and strict bed rest
Doctor :   Ok do not bother
User :   then after 13 days..i took permission from him and went to my home town
User :   where i consulted one good surgoen
User :   suggested by my first doctor... even my dad knows this person
User :   doctor
Doctor :   What did he say?
User :   he also said with the non surgical approach
User :   same as the first doctor said
Doctor :   Then why do you worry
User :   there is bulge on my shoulder
User :   stil after 5 weeks
Doctor :   Did you get repeat Xray and followed it up
User :   and my left shoulder is slightly bent compared to left shoulder
User :   yes
Doctor :   Any malunion?
User :   he said bone is growing and i should take ultrasound to accelerae the growth
User :   sorry....i dont know what is a malunion
Doctor :   Ok
User :   but the xray clearly shows the bone is stil one over the other
User :   and moreover...i have been more concerned from 2 days
User :   one of my schoolmates ... who is now teaching physiotherapy saw me and he was telling that... this should have been a surgical treatment...
Doctor :   Ok, what is your first Surgeon saying now?
User :   the bulge which is showing now will be there for lifetime and the shoulder will be bent and there will be no firm grip
User :   i didnot go bak to hyderabad yet
User :   i am afraid & confused & worried about LOSS OF PAY leave if i have to get a surgery again..
Doctor :   Ok, then I think the fracture is not healed well
Doctor :   as it is supposed to
User :   but there is no pain...i can use the hand upto elow
User :   elbow*
User :   i am even typing with the same hand
Doctor :   Ok
Doctor :   There is deformity as I believe
User :   what should be the possible solution now
Doctor :   Look even if you have to surgery, you do not need more than a week time for both surgery and rest
User :   oh... that relieves me of half tension
User :   then can i go to office work after 1 or 2 weeks
Doctor :   Now the next option is revision check up
User :   oh... and i am a
Doctor :   how did this heal and is there malunion of racture
Doctor :   if it is can we revise it with a surgery
User :   i will definitely take an XRAY tomorrow and go to my doctor here ... i,e, 2nd doctor
User :   but i was so worried i couldnot stand the tension and started browsing for such cases
User :   and found this site
Doctor :   Ok
Doctor :   Do not worry
Doctor :   Since you are young
Doctor :   you can heal well
Doctor :   and you can re join and work as you were as earlier
Doctor :   but right time and right consult is important
Doctor :   so do not delay
User :   can you suggest me best hospital or your clinic or anyplace where i can take have a re checup after a week
Doctor :   Which city are you in?
User :   as u said to wait for a week
User :   now i am kurnool.... after a week to 10 days...
User :   times up
User :   say soon
Doctor :  
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