Alt Comp

This is me, Graham. I had managed to reach the grand old age of 52 without breaking a bone in my body. That is, until Friday 7th August 2015 when a freak cycling accident brought my life to a bit of a stand still. Within days I found myself in hospital undergoing a two hour operation followed by weeks of restricted use of my left arm. During the time between the accident and the operation I did a lot of online research, watched hours of surgical procedure footage, received direct contact from Orthopaedic surgeons in the US and the UK, as well words of wisdom from cyclists, skiers and other athletes. The upshot is that with most displaced fractures the long term function and symmetry is much improved when treated operatively.

I was inspired by this page http://john.jpy.com/clavicle/ - I came to realise that people frequently feel the need to share experiences as a part of the healing process. If you are in the unenviable position of going through consultation due to clavicle fracture, with even small amounts of displacement, and even though surgery may seem like drastic steps, the outcome is nearly always better compared to non-surgical treatment. Whilst I am not an expert, and every case should be treated individually, having now gone through the entire process myself I would definitely have advised my future self in not deliberating any further and insisted on getting 'plated' as soon as possible.

Friday 7th August, 2015 - I was coming back from a quick morning spin on my folding bike, and just round the corner from my house ran over an 1.5“ wood screw. The wood screw lodged itself in the back tyre at right angles, rotated round and hit the back of the mudguard. The mudguard compressed and shattered, and a section of the mudguard rotated around underneath the back tyre. Within a single rotation of the wheels I had a shiny piece of pvc mudguard lodged under my back tyre, at which point the friction-less nature of the contact with the road, coupled with the existing forward momentum and downward force of gravity of my 13 stone body, caused the bike to 'pop-out' completely from underneath me, resulting in a left hand superman dive into the tarmac. Due to the instantaneous nature of the above I did not have time to get my arm down and the entire force of impact was taken by my left shoulder.

“One second I was speeding along the road, the next I had an eye level view of the surface of the tarmac”

Whilst I instinctively kept my head from hitting the floor I was suddenly aware of severe pain in my ribs and shoulder. A few drivers tried to help me up, offered me lifts and dragged my bike onto the pavement. Crazily I declined their offers and pushed my bike to the house with my right arm, all the time becoming more and more aware that something was seriously wrong with my left arm / shoulder. By the time I got to the house my left arm was held protectively across the front of my body and I knew I did not want to move it. Doing so resulted in a pretty awful and sickening 'grating' sensation within the shoulder. The rest of Friday was pretty much a blur. I had passed out several times in the house with pain, rang my girlfriend who called an ambulance, was taken to hospital, given morphine and X-Rayed. The result was as you can see above: a midshaft clavicle fracture with greater than 2cm displacement!

List of plates from top to bottom, left to right;

1. My Cresswell Micro folding bike which I've since sold & bought a Dahon
2. The junction of Marshside Rd & Fylde Rd where the accident happened
3. The pieces of fractured mudguard and the naughty woodscrew
4. X-Ray on the day of the accident showing the amount of displacement
5. Just coming round on the ward following having the plate fitted
6. First X-Ray following the operation showing the plate in place
7. Back at home showing the wound following several dressing changes
8. A few months later most of the swelling is gone and scar is fading

A selection of articles that may help you in your research.

Midshaft Clavicle Fractures: A Critical Review
https://journals.healio.com/doi/10.3928/01477447-20160517-06

Clavicle Fracture: Causes, Symptoms, and Treatment
https://patient.info/doctor/clavicle-fracture

The outcome of surgical fixation of mid shaft clavicle fractures
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507327/

Surgical Treatment of Mid-Shaft Clavicle Fractures: Plate Fixation and Clinical Outcomes
https://www.researchgate.net/publication/307789423_Surgical_Treatment_of_Mid-Shaft_Clavicle_Fractures_Plate_Fixation_and_Clinical_Outcomes

A selection of educational videos showing clavicle operations as well as a longer in depth lecture.

Distal Clavicle Fracture ORIF and CC Reconstruction
https://www.youtube.com/watch?v=JjaCDo4xsIc

Comminuted Mid-Shaft Clavicle Fracture - Open Reduction & Internal Fixation
https://www.youtube.com/watch?v=awU4V32zv8g

Mid-Shaft Clavicle Fracture - Reduction & Internal Fixations
https://www.youtube.com/watch?v=hHd38haELIg

Fixation of Displaced Midshaft Clavicular Fractures
https://www.youtube.com/watch?v=O_jD8UVbZ9s

ORIF Distal Clavicle with Synthes Distal Clavicle Locking Plate
https://www.youtube.com/watch?v=AxwxjHcITX4