A shoulder specialist can perform a clinical examination and x-ray to see whether surgical or non-surgical treatment will be the best. Brent J. Morris is a board-certified orthopedic surgeon and fellowship-trained shoulder and elbow specialist inin Lexington, Kentucky at Baptist Health Lexington — Orthopedics and Sports Medicine. Morris has expertise in treating shoulder fractures and is very experienced in treating clavicle fractures.
Morris and his research team have published extensively on shoulder surgery and ways to improve outcomes and patient satisfaction following shoulder surgery. He is co-author of a textbook devoted to shoulder surgery. For more information about Dr. Morris, visit online at www. An initial trial of non-surgical treatment is warranted before consideration of surgical treatment with shoulder replacement surgery.
We will discuss non-surgical treatment options and when it may be time to consider shoulder replacement surgery. Most clavicle separations are minimally displaced grade 1 or 2. There is little or no deformity and surgery is not needed.
Moderately displaced clavicle separations grade 3 often have a visible bump at the end of the clavicle near the shoulder. These injuries can do well without surgery, and it is usually worthwhile to have a few weeks of physiotherapy. If shoulder function improves quickly, surgery can be avoided. If it does not, surgery may be needed. Severely displaced clavicle separations grade 4, 5 or 6 often have a visible bump at the end of the clavicle.
These usually require surgery. Grading clavicle separations is difficult, so it is important to see a health care professional experienced in their management. The risks of surgery are present but should not be overplayed. Most complications are minor, such as a numb patch under the scar and metal that can be felt under the skin. The large blood vessels that supply the arm are very near the clavicle and can be damaged by surgery, but this is extremely rare.
People with clavicle fractures should have a discussion with their surgeon about the specific risks for them. It is helpful to have a list of questions to ask. If you need more time to think things over, ask to come back in a week. If your clavicle fracture or separation is an old injury, you can ask your GP to refer you to a shoulder surgeon.
A phone consultation with your GP may be the most convenient way of arranging this. If you want a second opinion after seeing a surgeon, you can ask them. The NHS routinely treats clavicle fractures. If you have health insurance, it will usually cover the cost of treating a clavicle fracture in a private hospital. Miller: So does it matter what type of an athlete you are? Might you consider surgery to get back into the playing field sooner in some cases?
Thomas: They're finding it definitely affects the biomechanics. Traditionally, you would accept 2. And keeping that strut at the right length helps in the position of your shoulder and the movement of your shoulder blade. Miller: So if it doesn't heal appropriately or if the distance between the fracture is, you know, there is a gap I guess, then you could lose function or sacrifice some function in the shoulder?
Thomas: You could. Without a nice, strong strut there as you load the shoulder, you'll feel weakness. But interestingly, the older literature shows that half of the patients that have a non-union don't have a lot of symptoms.
But that could be depending on what their activity is. Miller: What their activity level is. So kind of who you are matters in terms of whether you might consider surgery. So I guess it's a bit of a personal decision and you as the orthopedic surgeon explain that to the patient.
Thomas: That's true. And what your demands are make a big difference on whether you need surgery or not. Miller: And so how do you repair the clavicle? Do you put a plate in or do you just. I mean, it's kind of hard to put a cast on the shoulder, obviously. And so, the hardware serves as an internal cast and supports the bone and keeps it aligned while it heals.
And most commonly is used a plate, either on the top of the collarbone or on the front of the collarbone. Thomas: On the top, eventually the bone heals, the swelling goes away. And on top, there's not much tissue between the collarbone and the skin. And those are kind of prominent and people will feel them with their seatbelts or backpacks.
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