Old clavicle fracture before surgery
Old clavicle fracture after surgery

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Non-Union Clavicle Fracture: What Happens in Hospital

Q1. What do I need to do to prepare for surgery?
It’s important to stay as healthy as possible prior to surgery. Try to stay clear of people who are unwell, or anyone that has a cough, cold or the flu. Also, avoid sports or activities that could result in grazes to the shoulder area, as these could be a potential risk for infection, and surgery would need to be delayed until they had healed. If you are taking regular aspirin, anti-inflammatories or natural remedies, like fish oil, these may need to be stopped about a week prior to surgery. We will discuss this with you.

Q2. What preparation is needed on the day of surgery?
The hospital will contact you the day before surgery to confirm the exact fasting and admission times. As a general rule, if surgery is scheduled in the morning, you will fast from midnight. If it’s in the afternoon, you will normally fast from 7am. Once at the hospital, you’ll meet the staff that will show you around, check your paperwork and inform you of the exact time of your surgery. You’ll see the anaesthetist before your operation and he/she will check the information you have provided, paying particular attention to allergies and your past medical history.

Q3. Can you explain step-by-step what will be done during the operation?
An incision measuring approximately four to five centimetres in length is made just below your clavicle and the ends of the broken clavicle are identified. Great care is taken to expose the ends of the fracture and to “unpick” any bony collections that have formed as the clavicle attempted to heal itself. In instances where the fracture has failed to heal, swabs are generally taken and sent to the lab to check that infection isn’t the reason why the fracture hasn’t healed. The fracture fragments are then realigned and the plate is applied and screwed in place. The operation takes about an hour.

Q4. Will the plate need to be removed?
It depends on the age of the patient. Generally, if the plate doesn’t cause any irritation or discomfort, it can stay in for the long-term. However, in the case of adolescents, it is removed as they are still growing.

Q5. What happens immediately after surgery?
Once the operation is over, you will be taken to recovery where you will be monitored until you are awake. Recovery staff will monitor your vital signs and ensure that you remain comfortable. You will stay in recovery for one to two hours before being transferred back to the ward. There, staff will continue to monitor your vital signs. You will be able to have something to drink once you feel up to it (within the first few hours), then something to eat.

Q6. How will I feel when I wake up, and during the first couple of days?
It varies. Some people say they feel a little bit uncomfortable, while others say their collar bone feels better straight away, as it’s back in its correct position, giving immediate relief. You will have access to regular pain relief, however after a day or two of surgery, the majority of patients are just having Panadol, or nothing at all. You will be able to get out of bed and move around as soon as you feel able.

Q7. Will I see a physio or need to start special exercises in hospital?
It is extremely rare to need physiotherapy after this surgery. You will be able to use your arm straight after surgery for normal activities, such as cutting up food, eating, dressing, writing, typing etc. You should avoid raising your arm above shoulder height and lifting anything heavier than the weight of a full coffee cup. Be careful not to overdo things, as despite having a plate to stabilise the fracture, you may still get movement at the fracture site.

Q8. How soon will I be able to go home?
If surgery takes place in the morning, you can go home later that day so long as you are feeling comfortable. If surgery occurs in the afternoon, you will need to stay overnight. You cannot drive after surgery, so someone will need to drive you home. You should be able to drive a week after surgery, so long as you feel confident of being able to control the steering wheel in an emergency situation.

Q9. Will I need medication for pain or anything else on discharge?
You will be discharged with pain relief, however most patients say they don’t need anything stronger than Panadol after the first couple of days.

Q10. When do I come back in for a post op check?
We like to see patients about a week after surgery. A new x-ray is required so we can check the plate’s position. At this stage, the wound dressing is removed, the threads of your dissolving stiches are clipped and fresh bandages are applied. Plans are then made to check progress five weeks later. Another x-ray will be taken at that time to check on healing. A final visit is usually organised for two months later. Once again, another x-ray is arranged to check progress.

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

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