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fractured clavicle

 Poster: A snowHead
Poster: A snowHead
Hello,

Fell and landed on my pole on second to last day skiing last week resulting in fractured collarbone rolling eyes

Was quickly rescued, xrayed, strapped up and discharged from clinic (well after OH had turned up with a wad of cash!

Shocked )

Was told it was a small fracture but nothing else in terms of time to heal, what to do etc.

Back home I had to go through A&E to get referred into fracture clinic, finally heard from them today and given an appointment for 8th April. Nurse on phone said she couldn't give me any advice apart from to get a sick note from GP to cover me until that date.

I'm guessing I should wear shoulder strap thing and sling until seen at fracture clinic. Don't know if I should be keeping as still as possible or trying to do as much as I can.

Anyone any ideas how long a small fracture takes to heal, how long until I can drive again and most importantly get back on bike and climbing?!

Must learn more Italian for next year - if i knew more than ordering food and drink I may have been able to ask such questions when I was being seen by the doctor!

Thanks

MCL
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@MCL, that was bad luck, sympathies. Can't help with your queries though, I'm afraid. As a matter of interest, were you using the straps on your poles?
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
In my experience it depends on the severity of the fracture. If it is a complete break then the 2 ends, in rare occasions, do not heal and produce a fibrous non-union. The good thing with collar bones is that they generally tell you what to do. In a sling until fracture clinic.
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@pam w, yes did have straps on, they were loose and came off as I fell, not sure if this would have made any difference on how I landed but it's definitely a possibility. Something to think about for the future. At least it was almost at the end of the week Smile

@Frosty the Snowman, apparently it's a minor fracture, a small crack, so still in one piece- I was shown it on x ray but couldn't see anything!
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@MCL, I never use my straps these days, especially after a friend hurt his thumb quite badly falling on top of his hand. If I fall I prefer the poles not to be part of the equation.

Glad it's only a minor fracture - hopefully it will clear up really quickly.
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@MCL, Ouch! Are you in horrendous amounts of pain? I've not done this to myself thankfully, but I did nurse my unfortunate partner through this about ten years ago now, so I can give you his recovery times from what I remember, so you have an idea.

I think his break was worse than yours sounds - a complete fracture into about 5 pieces at the point of the break, causing misalignment of the collarbone and so a lump about 2cm or so. It was an over the handlebars into the concrete cycling accident.

- 2 weeks off work, mostly due to pain and the effects of mind altering painkillers
- 3-4 weeks in a sling with movement pretty restricted due to pain (not on the hard stuff by this point)
- 4-6 weeks till driving and getting back to normal. Driving and general car travel largely affected by the position of the seatbelt over the fracture, which made it very painful. Getting in and out of the car was also quite difficult for the first few weeks (he is quite tall).

Lasting effects - generally none, but the lump is quite prominent (though you can't really see it under clothes) and does affect the fit/comfort of some backpacks. There was discussion with the fracture clinic in followup appointments about surgery to reduce it, but it was felt that the risk of lasting nerve damage was too high as it doesn't really cause problems day to day.

Get well soon, it's a nasty injury.

Adjusted timings because I remembered we went on holiday after 4 weeks, so it mustn't have been as bad as I thought.


Last edited by You'll need to Register first of course. on Fri 27-03-15 18:14; edited 1 time in total
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@Scarlet, Thanks for info.

Ooh your partner's sounds much worse!

Not really in much pain as long as keep on strap thing that keeps my shoulders supported so just on paracetamol (to the surprise of GP and A and E staff)

Yes got a lump- has gone down in last week but still there- it was feeling that when I fell that made me think there was something wrong and better not try to ski down!
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@MCL, He rode his bike home, which I was quite surprised by (about 3 miles, mostly uphill). Must've been riding on adrenaline! His bike helmet was in as many pieces as his shoulder, so it could've been so much worse.

When the swelling subsides you'll find out how bad the lump is, if there is one. There isn't a lot of tissue between that bone and the outside, unfortunately. I think 6 weeks is pretty standard for fracture recovery. I remember asking the doctor at A&E if he'd be ok to fly after 4 weeks as we had a holiday booked. The sling must've been off by then and I think he was still a bit delicate, but we did quite a bit of walking (fairly gentle, no mountains) and excursions and it was fine. He managed to lug a suitcase up almost 100 steps to the hillside apartment, so it can't have been too bad!
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I bet it's fine after 3 weeks and fixed after 6......providing you are under 25. Longer as you get older.
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Quote:

He managed to lug a suitcase up almost 100 steps to the hillside apartment

and you let him! Poor sod. wink
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@pam w, I was carrying the other one!
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Post above edited due to improved memory rolling eyes
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@Scarlet, you should have run up and down twice! Frightfully good for you. wink
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 You know it makes sense.
You know it makes sense.
@pam w, It was about 30°C! I would've collapsed! (My brain fails after about 25°C, which is another reason for holidaying in winter!)
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MCL, do i understand correct? You injured yourself in Italy and didn't get any helpful advice - unfortunately rather common. Then back in UK you contacted your local A&E and talked to a nurse who referred you to the Fracture Clinic? I suggest you might have done better if you had actually attended your local A&E. A fracture clavicle can be awfully simple or simply awful. A wait of 2 weeks until April 8th might be ok, but it also might not. Try a bit of googling:
http://www.patient.co.uk/doctor/clavicle-fracture
http://www.nhs.uk/conditions/broken-collarbone/Pages/Introduction.aspx
nhs.uk wrote:
If you think you've injured your collarbone, or you think your child has, see your GP straight away. They may be able to tell whether the bone is fractured (broken or cracked) just by feeling it. If your GP thinks it is fractured, they will refer you to hospital for an X-ray to confirm the injury and to have it treated with a sling and brace.
If you can't see your GP or if the injury is severe (for example, the bone is poking through the skin or the pain is unbearable), go straight to your nearest hospital accident and emergency (A&E) department.
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 Poster: A snowHead
Poster: A snowHead
Quote:

You injured yourself in Italy and didn't get any helpful advice - unfortunately rather common.

Well, the OP confesses to speaking scarcely any Italian. How many doctors in the UK would be able to have a detailed conversation in Italian about the prognosis for a fractured clavicle?
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@Jonpim, yes I did attend the a and e- took X-ray s etc from Italy along with me. After much waiting they referred me to fracture clinic who I chased up today and got appointment for8th April . So never seen by a doctor there.
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Really depends on how bad it's broken. It appears that yours is a minor crack/break so imobilise for a few weeks in a sling and that should be all. The clacicle acts a s a bridge over all sorts of important things which need its protection so it is quite a good idea to let it set before doing anything silly.
I'm no doctor but have broken mine apparently quite bad and then didn't let it set. Silly me.
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Scarlet wrote:
@MCL, Ouch! Are you in horrendous amounts of pain? I've not done this to myself thankfully, but I did nurse my unfortunate partner through this about ten years ago now, so I can give you his recovery times from what I remember, so you have an idea.

I think his break was worse than yours sounds - a complete fracture into about 5 pieces at the point of the break, causing misalignment of the collarbone and so a lump about 2cm or so. It was an over the handlebars into the concrete cycling accident.

- 2 weeks off work, mostly due to pain and the effects of mind altering painkillers
- 3-4 weeks in a sling with movement pretty restricted due to pain (not on the hard stuff by this point)
- 4-6 weeks till driving and getting back to normal. Driving and general car travel largely affected by the position of the seatbelt over the fracture, which made it very painful. Getting in and out of the car was also quite difficult for the first few weeks (he is quite tall).

Lasting effects - generally none, but the lump is quite prominent (though you can't really see it under clothes) and does affect the fit/comfort of some backpacks. There was discussion with the fracture clinic in followup appointments about surgery to reduce it, but it was felt that the risk of lasting nerve damage was too high as it doesn't really cause problems day to day.

Get well soon, it's a nasty injury.

Adjusted timings because I remembered we went on holiday after 4 weeks, so it mustn't have been as bad as I thought.


That's a pretty good summary.

Jonathan Bell
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pam w wrote:
How many doctors in the UK would be able to have a detailed conversation in Italian about the prognosis for a fractured clavicle?
I agree entirely, but that is not what was needed. Rather, a simple explanation of what one should and should not do, and how to manage the pain would suffice, along with a proper letter explaining what had been found and what had been advised to be given to the UK doctor.

I would be interested in Jonathan Bell's comment on MCL's experience when he attended his A&E department. Is this normal? It is certainly not what i would expect.
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Jonpim wrote:
pam w wrote:
How many doctors in the UK would be able to have a detailed conversation in Italian about the prognosis for a fractured clavicle?


I would be interested in Jonathan Bell's comment on MCL's experience when he attended his A&E department. Is this normal? It is certainly not what i would expect.


I suspect not unusual.

Our country is sadly unable nor willing to address the spiralling demand and spending on NHS healthcare.

No politician is willing to confront the issue whilst there is a near religious fervour that the NHS is untouchable.

No politician that wants to be re-elected is willing to "allow" their local A&E to be closed as part of reorganisation of services.

So all that is happening is that hospitals have to find cheaper ways to deliver the "service" the population demands. And thats just what MCL got when he rang the local hospital.
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Well finally seen by a doctor at the "Virtual" Fracture Clinic yesterday (yes that it says on the answerphone!).

Turned out that the x ray that i was given in Italy was done at such an angle that it was very hard to make out so the doctor wasn't really able to compare it to yesterday's which was three weeks later. Was slightly surprised seeing yesterday's xray- bone was more broken than I thought - still in one piece but just I think!

Doctor seemed to assess my progress by how many painkillers I'm taking (only a co codamol at night) and how much I can move my arm- a fair bit I think.

He told me I could do things like go on my bike when it doesn't hurt to do so and wouldn't give a timescale. Said I could drive though!

So don't feel I really know much more than before I saw him! Annoyingly I forgot to ask about if physio would be a good plan or if I should be doing exercises.

Due back in 5 weeks

Back to work and driving (tentatively) today so definitely progress. Very Happy
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@MCL, phone the consultant to ask about Physio. Top tip...write down all your questions in advance
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@holidayloverxx, thanks good plan to call and yes was kicking myself for not writing down my many questions before I went in- i had that many!
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Get the lemsip out. Use whichever arm isn't borked. Give it a good rest for a few weeks, just imagine the complications if you came off the bike with the break as it is, get fixed then get out again.
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holidayloverxx wrote:
Top tip...write down all your questions in advance
Excellent advice. As you would when going to see a Financial Advisor, or Lawyer, or Mechanic.

MCL. I wonder who you actually saw in your Virtual Fracture Clinic. Again i am dismayed at the service you got.
Jonathan Bell is spot-on with all his comments about the NHS.

Following on from holidayloverxx advice: most of us have smart phones these days with a recording facility - why not ask the doctor if you can record the interview?
But please don't do this covertly, as discussed in this article
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@Jonpim, apparently an Orthopedic doctor (it wasn't the consultant named on my appointment letter).

Well I've left a message on the answer phone for the "virtual" clinic re physio and will see if get a call back.

@Mistress Panda, not planning on doing anything daft! thinking about going on static bike in gym for a short period soon and will see what happens- will stop if hurts. Got a 3 day bike ride in June which is far more than ever cycled before so keen to get the legs doing something until I feel safe enough to go out on bike again.
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Jonpim wrote:
holidayloverxx wrote:
Top tip...write down all your questions in advance
Excellent advice. As you would when going to see a Financial Advisor, or Lawyer, or Mechanic.

MCL. I wonder who you actually saw in your Virtual Fracture Clinic. Again i am dismayed at the service you got.
Jonathan Bell is spot-on with all his comments about the NHS.

Following on from holidayloverxx advice: most of us have smart phones these days with a recording facility - why not ask the doctor if you can record the interview?
But please don't do this covertly, as discussed in this article


Interesting point. I would have no problem if a patient asked to record an interview but i think it is perhaps more use to have a second person present who simply listens and make notes.

I would , personally, see covert recording as a sign that trust has broken down between the patient and the doctor.

In spite of the GMC's advice on the subject feel that it would be a very strong sign that that individual should find another doctor whom they believe they can trust.
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Jonathan Bell wrote:
but i think it is perhaps more use to have a second person present who simply listens and make notes.

Excellent point. Especially if it is an elderly relative (or parent), who often seem to be in awe of doctors and have difficulty in asking them questions.
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Why is second person more useful than a recording?
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 Poster: A snowHead
Poster: A snowHead
Quote:

Why is second person more useful than a recording?

if the two have discussed beforehand what the patient wants to get from the interview they can prompt a little, if necessary. And the two of you can discuss it afterwards - provided both on same wavelength this can be very helpful.
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abc, as pam w says: the second person is there to make sure there is adequate explanation and understanding.
Lots of people's brains seem to go to mush in presence of doctors and just sit there saying "Yes", despite not understanding a word and failing to ask important questions.
Posters keep popping up on this site asking questions they should have asked their doctors.

Some key questions are mentioned in these sites:
http://www.uofmhealth.org/sites/default/files/healthwise/media/pdf/hw/form_zm2256.pdf
http://www.hopkinsmedicine.org/healthlibrary/conditions/surgical_care/questions_to_ask_before_surgery_85,p01409/
http://www.royalmarsden.nhs.uk/cancer-information/patient-information/booklets/operation-and-anaesthetic.pdf

But my favourite list comes from the American College of Surgeons, especially paragraph 8:
Quote:
Could you tell me about your experience with this operation?
Do you perform this operation regularly?
What is your success rate, and how often do your patients experience any problems?
Are you board certified?
Are you a member of the American College of Surgeons?
How can I contact you if I have more questions?

For UK, questions 4 and 5 would change sligtly to "Are you a member of the Royal College of Surgeons?" and "Are you on the the specialist register of the GMC?"
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I've broken both of my collar bones on separate occasions, both were total breaks and healed (to a useful level) within 3 or so months....
A partial fracture I would expect to heal quicker, but be prepared for a little discomfort!
Oh, and try not to fall on it in the meantime Smile
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abc wrote:
Why is second person more useful than a recording?


Because they ask questions
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Jonpim wrote:
abc, as pam w says: the second person is there to make sure there is adequate explanation and understanding.
Lots of people's brains seem to go to mush in presence of doctors and just sit there saying "Yes", despite not understanding a word and failing to ask important questions.
Posters keep popping up on this site asking questions they should have asked their doctors.

Some key questions are mentioned in these sites:
http://www.uofmhealth.org/sites/default/files/healthwise/media/pdf/hw/form_zm2256.pdf
http://www.hopkinsmedicine.org/healthlibrary/conditions/surgical_care/questions_to_ask_before_surgery_85,p01409/
http://www.royalmarsden.nhs.uk/cancer-information/patient-information/booklets/operation-and-anaesthetic.pdf

But my favourite list comes from the American College of Surgeons, especially paragraph 8:
Quote:
Could you tell me about your experience with this operation?
Do you perform this operation regularly?
What is your success rate, and how often do your patients experience any problems?
Are you board certified?
Are you a member of the American College of Surgeons?
How can I contact you if I have more questions?

For UK, questions 4 and 5 would change sligtly to "Are you a member of the Royal College of Surgeons?" and "Are you on the the specialist register of the GMC?"


You cannot claim to be a surgeon unless you are already on the GMC register. Membership of the Royal College of Surgeons is obligatory if you are to call your self a surgeon.
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Jonathan Bell wrote:
abc wrote:
Why is second person more useful than a recording?


Because they ask questions

I asked the question because of your earlier statement:

Quote:

i think it is perhaps more use to have a second person present who simply listens and make notes.

If the second person join the conversation, that's quite different. But if they only listens and make notes, I thought that's better done with a recording device (aka, a phone)
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Jonathan Bell wrote:

But my favourite list comes from the American College of Surgeons, especially paragraph 8:
Quote:
Could you tell me about your experience with this operation?
Do you perform this operation regularly?
What is your success rate, and how often do your patients experience any problems?
Are you board certified?
Are you a member of the American College of Surgeons?
How can I contact you if I have more questions?


I bet to differ. Those are questions that should have been researched before going to the surgeons.

If the surgeon isn't even board certified, why would anyone even see that surgeon in the first place? That information is public so don't need to pay for the appointment fee to ask that question.

I guarantee you not to get a clear answer to question number 2. Yes, I asked that question to more than one surgeon, none of them have the "numbers", not even vaguely. Part of the problem is the definition of "problems" and "success rate" isn't well defined. I had better luck asking what kind of problem their patients had. The answer usually include a vague idea of how often of each type of problem.

I had far better luck asking what's their infection rate! Every one of the surgeons know that number by heart!

The answer to the last question is obvious, the same way one gets the appointment in the first place. Some surgeons don't answer questions outside of office visits but they won't admit it. Others happily do.

It is however very true many patients just sits there and say "yes" the whole time. My mother works as interpreter in the hospital and that's what she reports. She really needn't be there in those cases. The patients don't understand but wouldn't admit they don't understand a word of it!
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abc, actually 'twas me wot wrote your quote.
It would be best if patients were able to research their surgeon first, but for many (most?) people, they rely on their GP or a personal reccomendation. Often neither are actually fully informed.
And of course the ACS questions are American based. I wasn't' really interested in questions 4 and 5 - as Jonathan Bell posted, they are largely irrelevant if you are seeing an NHS surgeon - not necessarily quite so irrelevant if you are going Private.
But you should get sensible answers to Questions 1, 2 and 3. Questions 1 and 2 should be easy. And these days of regular audit, any good surgeon should know in detail the results of his procedures. I'm sure Mr Bell does. Smile
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I really wish there was the 'Trip Advisor' equivalent for all sorts of professionals including surgeons. It is remarkably difficult to find out which are 'good' surgeons, lawyers etc! Yes you can verify qualifications but beyond that information seems rather scarce!
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CaravanSkier wrote:
I really wish there was the 'Trip Advisor' equivalent for all sorts of professionals including surgeons. It is remarkably difficult to find out which are 'good' surgeons, lawyers etc! Yes you can verify qualifications but beyond that information seems rather scarce!


This is a site that comes closest. It is independent and like trip advisor i cant take down a post simply because i don't like it.

The person posting is anonymous.

https://www.iwantgreatcare.org/doctors/mr-jonathan-bell
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