Lance Armstrong broke his collar bone (clavicle) on March 23, 2009. He was competing in a race in Spain when he and several other cyclists were involved in a crash. Doctors in Spain diagnosed him with a fractured clavicle, one of the most common orthopaedic cycling injuries.
How is a broken clavicle treated?
The injury
Clavicle fractures are very common – up to 5% of all fractures that occur each year. Most of these are fractures through the middle of the shaft of the bone, called mid-shaft clavicle fractures.
Most of these happen when someone falls directly onto the shoulder.
The treatment
Over the years, the vast majority of these fractures have been treated non-surgically with a sling and some early rehabilitation exercises. Light work can begin when the pain subsides, usually about 2 to 4 weeks after the fracture. The bone usually heals on its own in six to eight weeks total. Sometimes, mild discomfort persists for up to three months after the break.
Lance Armstrong had surgery to fix his broken clavicle. This was done using a plate (flat piece of metal with holes in it) and several screws. The metal holds the bones in place while they heal together.
Surgery allows patients to return to low-impact activities faster than letting the bone heal on its own. The clavicle usually stops hurting immediately after surgery, though some incision soreness is normal for a few days.
Pros, cons, and expectations
Should you have collar bone surgery after a fracture? Only you and your surgeon can decide for sure.
Surgery for a fractured clavicle has risks such as infection, injury to nerves and blood vessels, and the risks that go along with anesthesia. You can have bone healing problems whether you have surgery or not. Sometimes patients want the plate taken out after the bone heals.
Some patients want surgery to avoid a weird-looking bump on their shoulder from the shape of the bone as it heals. The problem is that after surgery, you’ll have a scar in the place of the bump, and the bone may be prominent because of the plate on top of it. This may be more noticeable the thinner you are.
image from www.jaaos.org
There are both proven and theoretical advantages to fixing these fractures with metal hardware. Some problems with non-surgical treatment are as follows:
- weakness and pain in the shoulder
- loss of shoulder motion
- loss of endurance
- neurologic symptoms like numbness or tingling
- cosmetic deformity
Most surgeons try to use x-rays to estimate how far out of place the fractured pieces are when deciding how to treat a fractured collar bone. If the pieces are over-riding or spread far apart (displaced), surgery may prevent some of the above complications.
If someone you know has broken their collar bone recently, make sure they discuss all these details with their doctor.
