Clavicle Fractures: Recovery, Rehabilitation, and Pain Management

Clavicle fracture

Hello, Doctor.
I was in a car accident on April 10th.
After being transferred to another hospital, the doctor reviewed the X-rays and diagnosed me with a left clavicle fracture consisting of four fragments, which requires surgery.
I underwent surgery on April 11th for the placement of a plate and screws, which was self-funded.
During my follow-up appointment on May 6th, it was confirmed that the plate and screws were securely fixed.
The attending physician also advised me to start performing upward lifting exercises with my arm or to begin rehabilitation at a physical therapy clinic.
However, when I visited a traditional Chinese medicine practitioner, I was advised to keep my arm in a sling for three months without removing it.
Now, it has been four weeks since the surgery, and I would like to ask the following questions:
1.
The area around the fracture still experiences pain, but it is within an acceptable range.
How long should it take for the pain to subside to be considered normal?
2.
Should I continue to wear the sling? Can I remove it at home? If I do not use the sling for support, will the bone heal improperly?
3.
When sleeping, is it okay to sleep on my right side? Can the affected area tolerate this position?
4.
Can I get the surgical wound wet now?
5.
How many times a day and for how long should I perform hand exercises?
6.
Is it necessary to go to a physical therapy clinic for rehabilitation?
7.
If I use my left hand to wash my face or perform general daily activities (such as carrying a bowl or pouring water) without putting weight on it, will this affect my recovery or cause displacement?
I apologize for the many questions, and I appreciate your help.
Thank you!

Xiao Hai, 20~29 year old female. Ask Date: 2016/05/13

Dr. Shi Guozheng reply Orthopedics

After surgery and fixation for a clavicle fracture, patients can generally engage in light activities.
1.
Pain typically subsides within about a month.
2.
However, bone healing takes time, which may range from three to six months; during this period, caution is necessary, and the use of a sling should be maintained for at least two months.
3.
It is possible to apply pressure to the affected area while sleeping.
4.
Engaging in vigorous activities too soon may cause misalignment at the fracture site; patients can usually get the surgical stitches removed and can start getting the area wet about two to three days after.
5.
Hand exercises should be performed three times a day, lasting about ten minutes each session.
6.
Patients can perform rehabilitation exercises independently.
7.
Non-weight-bearing movements are less likely to cause displacement.

Reply Date: 2016/05/13

More Info

Hello! Thank you for reaching out with your questions regarding your recent clavicle fracture and the recovery process. It's great to see that you're actively seeking information to aid your healing. Let's address your concerns one by one.

1. Pain Management: It's normal to experience some pain after a fracture and subsequent surgery. Generally, pain should start to decrease significantly within a few weeks post-surgery. If the pain remains at a manageable level, that's a good sign, but if it worsens or becomes unbearable, you should consult your physician. Pain management is crucial, and your doctor may adjust your medications or suggest alternative therapies if necessary.

2. Use of a Sling: The recommendation to use a triangular sling is common after clavicle surgery to immobilize the area and support healing. While some doctors may suggest using it for a few weeks, others may allow you to remove it for short periods, especially when performing gentle exercises. It's essential to follow your surgeon's advice, as they understand your specific case best. If you don't use the sling, there is a risk that the bone may not heal correctly, leading to malunion or nonunion.

3. Sleeping Position: Sleeping on your side can be uncomfortable after a clavicle fracture. It's generally advisable to avoid putting pressure on the affected side until you receive clearance from your doctor. You might consider sleeping on your back or propping yourself up with pillows to avoid rolling onto the injured side.

4. Wound Care: As for your surgical wound, it's crucial to keep it clean and dry until your doctor advises otherwise. Typically, you should avoid getting the incision wet for at least a week or until your doctor confirms that it is safe to do so. If you have any concerns about the wound, such as redness, swelling, or discharge, contact your healthcare provider.

5. Hand Movements: When it comes to hand movements, it's essential to start gently and gradually increase the range of motion as tolerated. Your physical therapist or doctor can provide a specific regimen, but generally, you can perform light exercises several times a day, focusing on mobility without causing pain. Start with short sessions and increase the duration as you feel comfortable.

6. Rehabilitation: While you can perform some exercises at home, working with a physical therapist is highly beneficial. They can provide tailored exercises that promote healing and restore function while ensuring you do not overexert yourself. Rehabilitation is a critical component of recovery, especially after surgery.

7. Daily Activities: Engaging in non-weight-bearing activities, such as washing your face or carrying light items, is generally acceptable as long as you are cautious. However, it's essential to listen to your body; if you experience pain or discomfort, you should stop and consult your doctor. Avoid any activities that could put undue stress on the healing bone.

In summary, recovery from a clavicle fracture involves careful management of pain, adherence to your doctor's recommendations regarding immobilization, and gradual reintroduction of movement. It's essential to communicate openly with your healthcare team about your progress and any concerns you may have. Remember, every individual's healing process is unique, and patience is key. Wishing you a smooth and speedy recovery!

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