“What to do about my collarbone non union?”
I broke my collarbone in Dec 2019, I was assured that it would heal on its own after several clinic visits. In Sept 2020, the dr said it had not in fact healed and they did surgery (plate and screws) I saw the dr until March 2021, where I was told that although the bones had shortened because the surgery was not performed right away that the surgery was a success. On Aug 2021, I had a new x-ray as I am experiencing pain, my family dr informed me that there is a non union. I followed up with my ortho (phone visit) and was told to remove the hardware as it is what was causing the pain. When I mentioned the non union, they looked over my x-rays and said "oh you are right" you cannot have the hardware removed. They now want me to use a bone stimulater, which I am being told will probably not help at this point as it should have been used when the fracture occurred. What are my other options at this point? I have been in some amount of pain for almost 2 years, I want to have this corrected. Any advice?
Female | 46 years old
Complaint duration: 21 months
6 Answers
You could try bone stimulator ... i would recommend infection work-up. Do you smoke? That could be the cause of non-union. And you would probably need revision ORIF with bone graft.
Clavicle fractures are one of the most common fractures in Orthopedics. They almost always heal uneventfully with simple closed treatments, meaning a clavicle strap, etc. If there is in fact a non-union, after this much time has passed from date of injury, unfortunately, another surgery will be necessary to stabilize the fracture and promote good bony healing. Go back to your Orthopedic surgeon and ask him what he can do to provide a solid union. Was the fracture a 2-part fracture, or were there more than two fracture fragments?
Make appointment with an Orthopedic surgeon who specializes in shoulder surgery to include clavicle fractures and clavicle maluions. The issue can be addressed by a seasoned shoulder subspecialty or Orthopedic traumatologist.
Yes, I’m not sure where you are located, I would be happy to see you and revise this surgery and give the bone an opportunity to heal. I would recommend a second opinion with another orthopedic surgeon either someone with additional training in shoulder or an orthopedic trauma surgeon. I have additional training in both. I’m guessing the fixation isn’t stable enough, and you have an atrophic nonunion.
I hope you are able to have an improved result. With a shortened fracture, I tend to operate on these injuries immediately.
Thank you,
Robert D. Swift, DO, FAOAO
I hope you are able to have an improved result. With a shortened fracture, I tend to operate on these injuries immediately.
Thank you,
Robert D. Swift, DO, FAOAO
Sorry about delay in reply. These are always difficult problems. Most fractures of the clavicle heal with surgery unless they are in many pieces, open fractures or significant soft tissue injury. In most cases like this, a bone stimulator, in my experience, is unsuccessful. The standard of care is to remove the hardware, take fibrous tissue out and bone graft the site. The graft from the patient is best but allograft (from deceased) can be successful. Bone stimulator after surgery may speed recovery. Good patient nutrition and not over using arm initially usually gives better results.
Hope this helps. Good luck!
Hope this helps. Good luck!
It seems like your clavicle has not healed. I would suggest you get evaluated by your PCP for potential reasons for the bone not healing. These medical reasons can include smoking, use of NSAID's or other medications that can prevent bone healing, low calcium metabolism, low vitamin D, osteopenia, osteoporosis or other endocrine disorders. These are correctable medical issues that should be addressed prior to expecting the bone to heal. When these have been determined and improved, it sounds like you will need another surgery which would include removing any tissue that is not allowing the bone to heal, adding bone graft and a plating technique that allows for strength while the bone heals.
Jeffrey R. Carlson, MD
Jeffrey R. Carlson, MD
