Clavicle Reduction and Fixation

Some adventures are far more fun than others. Since the day before
Thanksgiving, my latest adventure has been to see how many miles I could
ride, how many push-ups I could endure, and how many of the stresses and
strains of ordinary living I could tolerate--all with a broken
collarbone. (X-rays taken five weeks after the injury showed only mended bone, and I was told to begin rehabilitation toward normal activity.)

It is not that I have relished this adventure. Oh, no. I have gone in to
see my primary care doctor three times to complain that the collarbone
"just isn't healing right" or "doesn't feel normal." But I was
instructed to give it more time and more rehab. (In fairness I must
also confess that the x-rays of the clavicle taken at the time look
normal to me.)

X-ray Failing to Show Fracture

So I waited -- and complained -- until I was finally able
to obtain a referral to an orthopedic surgeon specializing in sports
medicine.

By that point--four months into my adventure -- I had discovered the
perfect set of shoulder gyrations that would allow any physician with
relatively uncalloused fingertips to feel the fractured ends of my
clavicle shifting and grating beneath the surface of my skinny cyclist's
torso. Dr. Guinn was suitably impressed -- so much so that when the
first set of x-rays made by his staff proved inconclusive, he sent me
back to be zapped again from multiple angles. It seems to be an odd
feature of modern medicine that even if one's fingers can plainly feel a
broken bone, the certainty of a diagnosis still depends upon the x-rays.

X-ray Showing Fracture

In the x-ray above, the site of the fracture is fairly clear even though somewhat obscured by images of the ribs. Look at the right end of the thin yellow line. . . . Snap.

Now you may be wondering how I was able to ride my bike at all or work my way back to doing 5 sets of 12 push-ups (down from 9 sets of 30 push-ups before the injury). Frankly I wondered that too and was thus inclined to question my own impression that the bone was still broken. It turns out, however, that about 15% of clavicle fractures result in nonunion, and it also turns out that significant number of distal clavicle fractures are virtually asymptomatic. Evidently, I hit the lottery of virtually asymptomatic nonunion.

This past Friday was the day of the "clavicle reduction and fixation" at
the Outpatient Surgery Center in Jonesboro. While waiting for the knife,
I was able to overhear some of the idle chit-chat among the several
nurses and technicians arranging the various scalpels, drills, and
screwdrivers associated with my procedure. One of them was apparently
new and asked what range of procedures they handled in the facility. I
already knew from chatter in the waiting room that colonoscopies and
ingrown toenails were in the mix, but I was a little awed to hear that
"the one we are about to do is probably one of the most complex."

I came out of the surgery with a six-inch incision, a stainless-steel
plate, and enough screws to hang a solid-core door. No more whisking
through the airport metal detectors for me!

Post-Surgical X-ray