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Displaced fratured clavicle?
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April
Joined: 13 Dec 2003
Posts: 6593
Location: Westchester/NYC

8/26/13 11:12 AM

wound care

ortho appointment tomorrow. relatively low pain. sleep ok (short but restful -- a few hr a time). the sling is making my back hurt (I think that being the cause, rather than from the accident).

Would care is the question: the big ones were covered with dressing. it's now dry and sticking. Being right on the kneecap, it hurts big time when I need to bend my knees, like go up and down stairs. So I don't know what to do about them.

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sanrensho
Joined: 20 Feb 2004
Posts: 835
Location: North Vancouver

8/26/13 11:35 AM

Sorry to hear about the crash. Hope you heal up soon.

Had a few close calls myself yesterday, so I think I'll head into the safety of our conservation reserve (closed to vehicles) for today's ride.

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ErikS
Joined: 19 May 2005
Posts: 8337
Location: Slowing boiling over in the steamy south, Global Warming is real

8/26/13 1:41 PM

for wound care you can't beat tegaderm (sp). Word to the wise, CLEAN the wound very well and use a quality antibiotic on it before applying the plastic wrap.

You have recovered to long to use it now.

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KerryIrons
Joined: 12 Jan 2004
Posts: 3234
Location: Midland, MI

8/26/13 7:10 PM

Keep it wet


quote:
the big ones were covered with dressing. it's now dry and sticking. Being right on the kneecap, it hurts big time when I need to bend my knees, like go up and down stairs. So I don't know what to do about them.


You do not want anything to ever get dry. Either through the use of something like Tegaderm or with antibiotic ointment and non-stick pads held on with medical tape or a gauze sleeve, you must make sure that a scab never forms. If not using Tegaderm or equivalent, gently wash the wounds every day to get rid of the loose gunk and then reapply the ointment and the non-stick pads.

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NJRoadie
Joined: 14 Jan 2004
Posts: 52

8/26/13 7:47 PM

Collarbone smashage

I had a serious crash in June of 2010. The tally of damage: 6 broken ribs with 3 displaced, a punctured lung, broken scapula, and a broken and displaced collarbone. The collarbone had the kind of break which overlapped and was also separated. They called it a bayonet break.

My ortho did not recommend surgery. He said that the ultimate functional result would be the same regardless of surgery. The surgery would have a better aesthetic result, with the exception of the scar. The general trend with collarbone breaks is to let them heal by themselves where possible. The lack of surgery eliminates possible surgical complications. Also, plates and screws often cause discomfort, resulting in a second surgery for their removal.

A big consideration for me was that the surgery did not happen right away. The ortho said that the timeframe was about a year when he could operate if the healing process was unsatisfactory. That gave me the comfort of a fallback if the conservative approach did not work.

My outcome was very good. The bone filled into the gap and is solid. I do shoulder weights to stabilize the joint. My strength has returned and I am confident in the joint.

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NJRoadie
Joined: 14 Jan 2004
Posts: 52

8/27/13 4:56 AM

Pic

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mag7
Joined: 11 Jan 2004
Posts: 888
Location: Lake James, NC

8/27/13 12:11 PM

Wound care RN wife says Polymem Silver covered by Tegaderm for the flatter areas but for the knee or elbow, she uses a product called AQUACEL.
Also, she suggests checking to see if home health visits are an option where the nurse will come to you and do all the dressing changes with supplies they provide.
Even with an out of pocket cost/deductible, it might be cheaper than going out and buying these expensive wound care products.

http://www.convatec.com/wound-skin/aquacel%C2%AE-dressing.aspx

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April
Joined: 13 Dec 2003
Posts: 6593
Location: Westchester/NYC

8/27/13 2:45 PM

NJRoadie

Do you have an "after healing" x-ray?

I saw my x-ray today, it was as big a separation as your, only the two broken sections move in towards each other so they kind of "overlapping" forming an unconnected X rather than an open V

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Matthew Currie
Joined: 11 Jan 2004
Posts: 800
Location: Vermont

8/27/13 4:02 PM

I did a rather quick and sloppy scan of mine after healing (borrowed X-ray when looking for bone spur). You can't see a lot, but what does show is that it healed pretty well and everything is connected.

Could have been much worse.

By the way, I missed news of the crash in question here. Best luck in recovery

edit to add: I seem to have forgotten the image, for what it's worth...


I don't know why that doesn't show up.
http://imageshack.us/photo/my-images/835/yyfi.jpg/


Last edited by Matthew Currie on 8/27/13 7:27 PM; edited 4 times in total

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Sparky
Joined: 08 Dec 2003
Posts: 19068
Location: PDX

8/27/13 5:27 PM

May as well...



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NJRoadie
Joined: 14 Jan 2004
Posts: 52

8/27/13 5:30 PM

Happy to oblige

The first image was taken some time around when the crash happened in June. The crash happened on 6/4/11. This one is from 10/27/11. You can see that the bones came together some, and that bone is starting to fill in the gap.

I would be happy to converse privately via email if you would like. I've been through it and am happy to help by relaying my experience. ken thenormalsign drakeremodeling the normal company ending.

[/img]

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NJRoadie
Joined: 14 Jan 2004
Posts: 52

8/27/13 5:45 PM

Ribs

Check out the ribs in the xrays. They look like a bowl of pretzels.

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walter
Joined: 11 Jan 2004
Posts: 4391
Location: metro-motown-area

8/27/13 6:08 PM

broken clavicles, big separations

these images and descriptions amaze me.

how can it be acceptable, when there's a large visible gap between the ends of the break and the bone is nowhere near being aligned correctly, that a trained medical professional would suggest that "letting it heal on it's own" is anywhere near acceptable -- that is un-f*cking-believable to me!

your arm/shoulder must end up with pretty wonky function when it does finally knit together. we have the medical knowledge and technology, at least figure out some way to move them so that they're at least somewhat aligned and somewhat close together.

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NJRoadie
Joined: 14 Jan 2004
Posts: 52

8/27/13 7:40 PM

Hard to believe

I agree Walter, it's hard to believe that the ortho did not recommend surgery on that mess. A surgeon who did not recommend surgery certainly got my attention.

I also got a second opinion and the second concurred with the first ortho in that surgery was unnecessary. After researching broken collarbones and their treatment, I decided to avoid the surgery, let it heal on its own and see what happened. Remember, I had a year to have surgery, so it was not time sensitive at the start of the process.

Surgery also has some significant risks; eliminating those risks was very attractive. Read message boards about collarbone surgery complications and you will think twice about jumping immediately to surgery. I would have taken those risks, but only if my healing at the end of the year was unacceptable.

It's been a little over 2 years since that crash. My shoulder function is not "wonky." I lost some range of motion, but that was going to happen regardless of surgery. The alignment is not an issue, and the gap has filled in with hard material. The sharp end even rounded itself out. I am sure if you took an xray now you would see a significant mass filling in the gap; I can feel it. The consistent weight work and exercise I have done has given me a good outcome. Strong muscles stabilize the joint and have let it heal. In fact, I am sure I have more shoulder strength now than before the accident. The joint has full functionality and is pain free. That is, to me, the best outcome I could have hoped for back in June of 2011.

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Sparky
Joined: 08 Dec 2003
Posts: 19068
Location: PDX

8/27/13 7:50 PM

Just the general anesthesia risks alone. My son had a reaction to one of the anesthesia drugs years back and took 3 hours to wake up. It was the longest 3 hours of my life. Also, I feel that for about two years after I had surgery I was less 'not right' and always wondered if maybe I may have had a reaction that wet unnoticed by everyone but me. Hard to explain it really...

Nerve damage, arteries, anesthesia mistakes or anomalies... yada

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April
Joined: 13 Dec 2003
Posts: 6593
Location: Westchester/NYC

8/27/13 7:52 PM


quote:
Wound care RN wife says Polymem Silver covered by Tegaderm for the flatter areas but for the knee or elbow, she uses a product called AQUACEL.

Doc put some Polymem Silver on today, covered by regular dressing. Gave me a bunch to change at home. I feel a lot better already. can walk without sharp pain on my kneecap.

Ortho think surgery will be the best. But the decision is shelved for now because infestion risk is too high with all the road rash I have. So back for a second consultation in 2 weeks. That also gives me time to get a second opinion.


quote:
A surgeon who did not recommend surgery certainly got my attention.

That's the wacky part of the descipline. All orthos are trained as surgens! Even if many of their patients don't need surgery...


quote:
I also got a second opinion and the second concurred with the first ortho in that surgery was unnecessary.

So that's an easy decision.

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mag7
Joined: 11 Jan 2004
Posts: 888
Location: Lake James, NC

8/28/13 7:28 AM

Good to hear the PolyMem Silver is working for you as it did for me when I crashed hard a couple of years ago. It is non-stick and provides just the right amount of moisture for healing....and with the Tegaderm covering, taking a shower is tolerable.

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