Mal/Non-United Clavicle Fractures
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Even if the clavicle has healed in an incorrect position many years ago, we have found that the bone can be re-broken and realigned into its previous normal position. - Dr Duckworth
Often patients have fractures that have been treated in a sling and heal in the wrong position. These can cause ongoing problems for patients and the reason why they seek further specialist opinion. In these circumstances patients complain of pain, a palpable lump, or the fact that their shoulder just doesn’t feel right.
Over the last years in my practice we have had some remarkable results from re-breaking the clavicle and realigning the bones. In some cases the malunion had been present for up to 20 years. Patients often wake up immediately after surgery and say their shoulder feels like it is back in the right spot.
In specific patients an operation can be done to re-break the clavicle and realign the bones. This is called an “osteotomy” and the bone is broken and re-aligned back to its original position. This operation can be done many years after the original break.
Recovery and bone healing from these operations does take a little longer than a standard fracture and one has to be a little more cautious during the healing period.
Successfully treated mal-union fractures
This man is 38 years old and originally fractured his clavicle when much younger. It was left to heal naturally but unfortunately healed in a poor position. He fell while playing soccer and fractured through the previous mal-union and callus. He had surgery and within just six weeks was almost healed and had a good range of motion, function and strength.
This lady is 65 years old and fractured her clavicle 28 years previously in a motor vehicle accident. At that time she was told that nothing could be done for her. It never really healed and as a result she had ongoing pain in her scapula, shoulder and clavicle. I managed to fix her fracture with a plate and screws and kept her in a sling longer than I normally would and reviewed her for a longer period of time than normal but at her final visit eleven months after her surgery she was delighted with the result as she had no pain, a full range of motion, the fracture was solidly healed and she was doing everything she wanted to do.
This young man first fractured his clavicle when he was 9 years old and it was treated conservatively and healed. Then three years later he fell from his skateboard and broke it again and was again treated conservatively but this time did not heal and continued to be painful so he had a plate put on and he had healed eight weeks later.
This is a 45 year old lady who fell from a horse fracturing her clavicle in at least 3 pieces.
The image on the left shows the fracture through the midpart of the clavicle and that it is in 3 pieces or more and displaced.
The image on the right shows the fracture fixed with plate and screws and 2 screws going in different directions to the plate to hold the separate fragments of bone in place.
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02 9806 3333
drduckworth@specortho.com.au
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Wahroonga, NSW 2076
NORWEST PRIVATE HOSPITAL
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Bella Vista, NSW 2153