Clavicle Fractures: Recovery, Surgery, and Rehabilitation

Please inquire about clavicle issues?

Hello, Doctor! I have a mid-shaft fracture of the left clavicle with some comminution.
The orthopedic surgeon at Li Hsin Hospital suggested surgery to fix it with a titanium alloy plate.
I would like to ask the following questions:
1.
After recovery, will I be able to return to 100% function? Is it difficult, or will it be stronger? If I can lift 50 kg, how much might that decrease to? 40 kg?
2.
Is it recommended to remove the plate after one year? What are the implications of not removing it? Does leaving it in mean an extra layer of protection?
3.
What kind of rehabilitation is best? Could you provide some terms I can look up online? Thank you!

Feng, 20~29 year old female. Ask Date: 2017/10/06

Dr. Shi Guozheng reply Orthopedics

After recovery, there may be a slight decrease in muscle strength, but most patients can return to their pre-injury state.
No physician can guarantee a full 100% recovery.
Removing the plate has its benefits, as it reduces local irritation; however, if it is not removed, there is a risk of inflammation.
If there are no significant discomforts, it is also acceptable not to remove it.
Patients can focus on practicing upper limb and shoulder activities without any specific rehabilitation exercises.

Reply Date: 2017/10/06

More Info

Understanding clavicle fractures, especially those that are comminuted, involves a comprehensive approach to recovery, surgical intervention, and rehabilitation. Here’s a detailed overview addressing your questions and providing additional insights into the recovery process.

1. Recovery to Full Functionality
After a clavicle fracture, particularly a comminuted one, full recovery is possible, but it may not always mean returning to pre-injury levels of performance. The extent of recovery can depend on several factors, including the severity of the fracture, the surgical technique used, and individual healing responses.
In general, many patients can regain significant functionality, often around 80-90% of their pre-injury capabilities. However, achieving 100% recovery can be challenging. The bone may heal, but surrounding soft tissues, including muscles and ligaments, may take longer to regain strength and flexibility.
Regarding lifting capacity, if you were previously able to lift 50 kg, after recovery, you might find your capacity reduced. While some individuals can return to lifting similar weights, others may find their limit closer to 40 kg or even less, depending on their rehabilitation progress and any lingering discomfort or weakness.

2. Surgical Hardware Removal
The decision to remove the titanium plate after a year is often based on the healing progress and the patient's activity level. Leaving the plate in place can provide additional stability and protection to the bone, especially in high-impact activities. However, some patients experience discomfort or irritation from the hardware, which may warrant its removal.

If the plate is not removed, it does not necessarily mean that there will be significant negative consequences. Many patients live comfortably with the hardware in place. However, if you experience persistent pain or discomfort, discussing the option of removal with your orthopedic surgeon is advisable.

3. Rehabilitation Strategies
Rehabilitation is crucial for optimal recovery after a clavicle fracture. Here are some recommended rehabilitation strategies and terms you can research:
- Physical Therapy (PT): Engaging in a structured physical therapy program can help restore strength, flexibility, and range of motion. Look for therapists who specialize in orthopedic rehabilitation.

- Range of Motion Exercises: Early in the recovery process, gentle range of motion exercises are essential to prevent stiffness. These can include pendulum exercises and shoulder flexion and extension movements.

- Strengthening Exercises: Once cleared by your physician, you can begin strengthening exercises targeting the shoulder girdle and upper back. Resistance bands and light weights can be beneficial.

- Functional Training: This involves exercises that mimic daily activities, helping you regain confidence in using your arm and shoulder.

- Aquatic Therapy: Exercising in water can reduce strain on the shoulder while allowing for movement and strengthening.

- Proprioceptive Training: This focuses on improving balance and coordination, which can be affected after a shoulder injury.

Additional Considerations
- Nutrition: Ensure you have a balanced diet rich in calcium and vitamin D to support bone healing. Foods like dairy products, leafy greens, and fatty fish can be beneficial.

- Follow-Up Care: Regular follow-ups with your orthopedic surgeon are essential to monitor healing and adjust rehabilitation protocols as necessary.

- Patience and Consistency: Recovery from a clavicle fracture, particularly a complex one, requires time and consistent effort in rehabilitation.
In conclusion, while full recovery from a clavicle fracture is possible, it may come with some limitations. Engaging in a structured rehabilitation program, maintaining good nutrition, and following your surgeon's advice will significantly enhance your recovery journey. Always consult with your healthcare provider for personalized recommendations tailored to your specific situation.

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