Articles:shoulder 

A new surgical device to fix broken collar bones is resulting in faster healing times and better range of movement in patients, according to Sydney orthopaedic surgeon Dr David Duckworth.

Clavicle Fractures in a Professional Mountain Biker

Clavicle fractures are common in biking accidents. In the case of Jack, a 21-year-old professional mountain biker, he incurred a series of fractures to his collar bone – but I’m pleased to report he’s now well healed and back on the international mountain biking circuit.

Jack was competing in Spain in April 2015 when he came off his bike and fractured his collar bone.

He had surgery in Spain, but two weeks later his wound became infected and he had the plate and screws removed.

With the guts and determination unknown to most, Jack returned to his sport but, unfortunately, re-fractured his clavicle again in another fall in July. It appears the clavicle finally settled when the plate was removed, however I’m not sure whether the clavicle ever actually healed.

This time around, Jack decided to fly back to Australia for treatment. Within a couple of days of landing, I took him back to theatre. He had numerous scars around his shoulder. There were no clinical signs of infection, but I was suspicious that an underlying infection may have prevented the fracture from healing properly in the first place. I closely inspected the wound and bone for signs of infection, took numerous swabs and kept him hospitalised on intravenous antibiotics for what must have felt to Jack like an eternity!

He did really well after this operation and within six weeks of surgery x-rays showed that his collar bone had healed and there was no sign of infection. Within three months he had full range of motion and was back surfing.

I was happy for Jack to return to riding and had planned to see him again in February 2016 for a final visit, and to wish him luck with his next competition. However the months of being confined to barracks had clearly got the better of him, as he flew to California in January.

Once again, he was going well and back into his sport when again he fell – this time fracturing the distal end of the clavicle, just next to the plate that I had put in in July of the preceding year (see image 4 below).

Fracture of distal clavicle next to existing plate after fall from mountain bike

Fracture of distal clavicle next to existing plate after fall from mountain bike

This time he didn’t wait around for treatment overseas, and flew straight back home. He effectively went from the airport to my rooms to the operating theatre that afternoon. This time around I needed to remove the original plate which had held the mid-shaft clavicle aligned while it healed, and replace it with a longer plate which would grab the new fracture fragments at the end of the clavicle (see image below).

Fracture of distal clavicle next to existing plate after fall from mountain bike

By the end of February, four weeks after his latest operation, he was once again healing well and using his arm normally.

He stayed in Sydney and eight weeks after his surgery the collar bone had united and he had great movement and strength. He continued to improve at every visit, doing everything he wanted to do – experiencing only a slight ache from time to time.

In October, he returned to have his plate and screws removed. After having a few months off, he is now back on his bike and ready for the next 50 ft jump!

Case study of professional mountain biker back to work despite requiring repeated clavicle surgery for multiple falls.

For specific advice regarding multiple clavicle fractures, please book an appointment with Dr David Duckworth on (02) 9806 3333

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