Info On Clavicles
So new years, many friends and easily as many drinks, I end up falling and breaking my clavicle! What a way to bring in the new year? Well since I found so many things confusing and it took me a while to get them straight in my head, I figured I'd pass on the info here.
The clavicle is that part of the bone that most of us call the collar bone. Most breaks dont require much more then a sling. Depending on who is asked its around 80 or 90 percent of them just put you in a sling and things work themselves out.
Here's the important part to remember. "Dont Panic". No matter how bad it is. Things will be okay. Humans have had these breaks for a long time. Even Hippocrates talked about them.
Now for those non-union ones. This is going to an important word by the way. Non-Union. Remember that one. This is what I had. This means that the bone wont connect and heal or heal correctly enough basically.
Something I found in my research was the trouble with understanding WHAT type of break you had. There were many words used in different ways so let me tell you the cliffnotes version.
You have quite a few different ways to describe your break. The most common one is the "Allman" classification (also called the Allman-Tossy). There are three types and it basically is this. Type 1, 2, 3 is where the break is. You can find a more descriptive version of this and subtypes (added by Neer I believe) that were added later here. Later on, one came along by Doctor Rockwood. You can find more detail on these here, but your doctor will probably say type 1, 2 or 3 from the Allman list. Something you'll see interchanged often is AC and acromioclavicular. This is the very outer edge of your clavicle furtherest from the body. Many times you'll see the word distal - this means furthest from the spine or in our situation - the further outside of the clavicle or type.
Now that you have an idea of what the clavicle "types" are, you'll hear some key words like pins, screws, Rockwood, Neer, Dacron, and such. The important ones I'll try to put down so you arent bogged down going through all it. One important one is ORIF. Open Reduction and Internal Fixation or ORIF. This means they're going in. Most people are not going to get this unless they have a non-union or other issue like - cosmetic or multiple breaks of some kind. You'll find some results and studies of this here.
If you are not having surgery you'll get the bone set if needed and then a sling. Either a side sling or a figure eight strap (sometimes called a cross sling). The side sling is the classic one you'd think of - side arm and around the neck. The figure eight strap is a bit harder to describe. You can look here for examples.
Now if you are one of the few who will have to have surgery then you'll want to know some more vocabulary. Intramedullary for example means to go the "long" way through a bone - usually with a pin or sometimes a screw. Another to watch out for is again Rockwood. Not only a doctor, but is used as a technique and also as pins and screws types. Goodness!
There are lots of options, different screws, pins, plates, hooks and even believe it or not wires, for keeping the bone together. I'll put the most common basic descriptions.
Plates - These are placed along the bone at the break and screwed into it to hold the bone in place. These plates are not always removed. They have thick and thin ones and ones now that follow the bone. You might hear AO / ASIF here. This means Arbeitsgemeinschaft für osteosynthesefragen (AO) - Association for the Study of Internal Fixation (ASIF) classification, used by the Orthopaedic Trauma Association. This is a classification of sorts as I understand. You'll hear about Balser plates and such - basically - the smaller the better here. Ask how much "prominence" the plate will give. Some results of using these can be found here. This is how much it will "show". Sometimes the strength of the connection using plates and screws are called compression. This isnt exactly "strength" in real turns, but for our purposes this works for us. Plates are excellent and the gold standard basically now for big breaks or breaks that need lots of support. The scar is bigger on these then screws though. Some will use a hook with these plates. More on that below.
Hooks - Hooks as far as I understand are used with plates to provide less screws in the outside break while giving more support for the break. Breaks need to be held still and the less screws in the bone the better as a general rule. Some bones are weaker or softer and such because of age or whatever and hooks can keep things held better and more stable with less screws sometimes. You can find some more results found from these here. Mind you the number of screws and hooks arent exactly as simple as above - just a general rule. Depends if they plate over the AC or C or not.
Pins - Pins are from my understanding always used intramedullary. Most common for these is if the bone is broken in the middle area since the clavicle is not straight and using it on the ends arent an option. They have Hagie and Rockwood pins being the most common names I've discover. Basically a Rockwood pin is a modified Hagie pin anyways so dont worry to much on this. The rockstar of the ortho world of using pins is Doctor Basamania at Duke. You really should look on more information on this man. From all that I've read - never heard anything but Godly things about the man. You can find information on him here and here.
Screws - These come in all sorts of names, sizes and techniques for bones. I currently have a Rockwood screw by Doctor Guettler who also studied at Duke and works at Beaumont in Michigan. He did work with Doctor Basamania on occasion.
Before you do anything remember that for some reason - clavicle repair options can very quite a bit from doctor to doctor. Please see more then one if possible. If they dont do these often they may not offer the best or all the options for you. Personally I had one ortho give me a figure eight and he said to see what would happen, one for plate, one for plate and hook and one for screw. I did get some great information from creating a free account with Medscape, and seeing doctor Kevin Scheid at Ortho Indy who is the head ortho for the IRL (Indy Racing League) among others. I also read as much as possible about them from others in news groups blogs and such. Some good ones to check are here, here and here.
Last but not least, be prepared for things that will help you while your bones are healing. Things I've found very useful where:
Electric Toothbrush - since you can wiggle back and forth sometimes much - this is a life saver!
Good Scissors - you'll need to open things and if you dont have a pair of these - it will be frustrating!
Spay Deodorant - since you wont be able to put it on any other way. Do remember to be light though - it can itch if you add to much.
Easy To Eat Food - think about it. You can rip open boxes or plastic bags for a bit. You cant use both hands sometimes! Get some jerky or peanuts, cheese blocks or whatever you like. Just make sure its easy.
A Good Friend - nothing will help you more.
If you do have surgery - check out the hospitals and make sure you have your trip planned out before the drive. Mapquest is wonderful here. Bring all your phone numbers. Make sure you have some simple ear phones or plugs in case after recovery the person in the room with you is loud. Make sure you have all things planned for when you wake up. The ride home, the persons number and such. You will hurt a little, but you will be way out of it! Lastly when you get home make sure you've got things in order for the next few days - you wont feel like doing much lifting or moving and sleeping isnt always easy at first, but is the best thing to do. Remember in a few weeks - you'll feel MUCH better :)
Good luck and hope this helps someone.
Shannon Bryant
Links (in no special order)
Matthew's Clavicle Page
NCBI
Best Hospitals of 2004 Newsweek
Doctor Joeseph Guettler
Doctor Carl Basamania
Shoulder1.com
EmedicineHealth
Sports Medicine Info On Clavicle Breaks
The clavicle is that part of the bone that most of us call the collar bone. Most breaks dont require much more then a sling. Depending on who is asked its around 80 or 90 percent of them just put you in a sling and things work themselves out.
Here's the important part to remember. "Dont Panic". No matter how bad it is. Things will be okay. Humans have had these breaks for a long time. Even Hippocrates talked about them.
Now for those non-union ones. This is going to an important word by the way. Non-Union. Remember that one. This is what I had. This means that the bone wont connect and heal or heal correctly enough basically.
Something I found in my research was the trouble with understanding WHAT type of break you had. There were many words used in different ways so let me tell you the cliffnotes version.
You have quite a few different ways to describe your break. The most common one is the "Allman" classification (also called the Allman-Tossy). There are three types and it basically is this. Type 1, 2, 3 is where the break is. You can find a more descriptive version of this and subtypes (added by Neer I believe) that were added later here. Later on, one came along by Doctor Rockwood. You can find more detail on these here, but your doctor will probably say type 1, 2 or 3 from the Allman list. Something you'll see interchanged often is AC and acromioclavicular. This is the very outer edge of your clavicle furtherest from the body. Many times you'll see the word distal - this means furthest from the spine or in our situation - the further outside of the clavicle or type.
Now that you have an idea of what the clavicle "types" are, you'll hear some key words like pins, screws, Rockwood, Neer, Dacron, and such. The important ones I'll try to put down so you arent bogged down going through all it. One important one is ORIF. Open Reduction and Internal Fixation or ORIF. This means they're going in. Most people are not going to get this unless they have a non-union or other issue like - cosmetic or multiple breaks of some kind. You'll find some results and studies of this here.
If you are not having surgery you'll get the bone set if needed and then a sling. Either a side sling or a figure eight strap (sometimes called a cross sling). The side sling is the classic one you'd think of - side arm and around the neck. The figure eight strap is a bit harder to describe. You can look here for examples.
Now if you are one of the few who will have to have surgery then you'll want to know some more vocabulary. Intramedullary for example means to go the "long" way through a bone - usually with a pin or sometimes a screw. Another to watch out for is again Rockwood. Not only a doctor, but is used as a technique and also as pins and screws types. Goodness!
There are lots of options, different screws, pins, plates, hooks and even believe it or not wires, for keeping the bone together. I'll put the most common basic descriptions.
Plates - These are placed along the bone at the break and screwed into it to hold the bone in place. These plates are not always removed. They have thick and thin ones and ones now that follow the bone. You might hear AO / ASIF here. This means Arbeitsgemeinschaft für osteosynthesefragen (AO) - Association for the Study of Internal Fixation (ASIF) classification, used by the Orthopaedic Trauma Association. This is a classification of sorts as I understand. You'll hear about Balser plates and such - basically - the smaller the better here. Ask how much "prominence" the plate will give. Some results of using these can be found here. This is how much it will "show". Sometimes the strength of the connection using plates and screws are called compression. This isnt exactly "strength" in real turns, but for our purposes this works for us. Plates are excellent and the gold standard basically now for big breaks or breaks that need lots of support. The scar is bigger on these then screws though. Some will use a hook with these plates. More on that below.
Hooks - Hooks as far as I understand are used with plates to provide less screws in the outside break while giving more support for the break. Breaks need to be held still and the less screws in the bone the better as a general rule. Some bones are weaker or softer and such because of age or whatever and hooks can keep things held better and more stable with less screws sometimes. You can find some more results found from these here. Mind you the number of screws and hooks arent exactly as simple as above - just a general rule. Depends if they plate over the AC or C or not.
Pins - Pins are from my understanding always used intramedullary. Most common for these is if the bone is broken in the middle area since the clavicle is not straight and using it on the ends arent an option. They have Hagie and Rockwood pins being the most common names I've discover. Basically a Rockwood pin is a modified Hagie pin anyways so dont worry to much on this. The rockstar of the ortho world of using pins is Doctor Basamania at Duke. You really should look on more information on this man. From all that I've read - never heard anything but Godly things about the man. You can find information on him here and here.
Screws - These come in all sorts of names, sizes and techniques for bones. I currently have a Rockwood screw by Doctor Guettler who also studied at Duke and works at Beaumont in Michigan. He did work with Doctor Basamania on occasion.
Before you do anything remember that for some reason - clavicle repair options can very quite a bit from doctor to doctor. Please see more then one if possible. If they dont do these often they may not offer the best or all the options for you. Personally I had one ortho give me a figure eight and he said to see what would happen, one for plate, one for plate and hook and one for screw. I did get some great information from creating a free account with Medscape, and seeing doctor Kevin Scheid at Ortho Indy who is the head ortho for the IRL (Indy Racing League) among others. I also read as much as possible about them from others in news groups blogs and such. Some good ones to check are here, here and here.
Last but not least, be prepared for things that will help you while your bones are healing. Things I've found very useful where:
Electric Toothbrush - since you can wiggle back and forth sometimes much - this is a life saver!
Good Scissors - you'll need to open things and if you dont have a pair of these - it will be frustrating!
Spay Deodorant - since you wont be able to put it on any other way. Do remember to be light though - it can itch if you add to much.
Easy To Eat Food - think about it. You can rip open boxes or plastic bags for a bit. You cant use both hands sometimes! Get some jerky or peanuts, cheese blocks or whatever you like. Just make sure its easy.
A Good Friend - nothing will help you more.
If you do have surgery - check out the hospitals and make sure you have your trip planned out before the drive. Mapquest is wonderful here. Bring all your phone numbers. Make sure you have some simple ear phones or plugs in case after recovery the person in the room with you is loud. Make sure you have all things planned for when you wake up. The ride home, the persons number and such. You will hurt a little, but you will be way out of it! Lastly when you get home make sure you've got things in order for the next few days - you wont feel like doing much lifting or moving and sleeping isnt always easy at first, but is the best thing to do. Remember in a few weeks - you'll feel MUCH better :)
Good luck and hope this helps someone.
Shannon Bryant
Links (in no special order)
Matthew's Clavicle Page
NCBI
Best Hospitals of 2004 Newsweek
Doctor Joeseph Guettler
Doctor Carl Basamania
Shoulder1.com
EmedicineHealth
Sports Medicine Info On Clavicle Breaks
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