Post-Surgery Concerns After Clavicle Fracture: Your Questions Answered

Postoperative Issues Following Clavicle Fracture Surgery

Hello Doctor: On July 12, I had a bicycle accident and suffered a comminuted fracture of the left clavicle with two fracture lines and a displacement of 2.31 cm.
The following day, I underwent surgery to insert a titanium alloy plate and bone graft.
Upon discharge, my attending physician advised me to avoid using my left hand for support and to keep it in a sling while sitting or standing.
Typing with my left hand while sitting at my desk is not an issue.
I have the following questions:
1.
Is it okay to temporarily remove the sling and support my left hand with my right hand while showering? Will this have any negative impact on the injury site?
2.
When bending over (with the sling on or my hand resting on the table), does this place additional strain on the clavicle?
3.
(Most importantly!) Due to my tendency to gain weight, I previously had a habit of cycling on a stationary bike daily.
My attending physician advised against vigorous exercise, and when I inquired, I was told not to cycle for three months but that I could engage in race walking.
The last time I spoke with the doctor, he added that unless I could hold onto the handlebars to prevent falling, I should avoid cycling altogether.
Therefore, I would like to ask: (a) Is the main concern about not cycling due to the risk of falling or the risk of displacing the clavicle? (b) If I really cannot cycle, do I have to wait a full three months? Race walking is not very efficient and it's hot, and I'm worried about gaining weight...
Thank you for your patience in reading this, and I sincerely hope you can provide me with answers!

Hsu Che-Wei, 20~29 year old female. Ask Date: 2020/07/19

Dr. Wang Shouji reply Orthopedics

Hello, ensuring the healing of the fracture is the most important thing at present, and other considerations can be put aside for now.
It should be fine to temporarily remove the sling while showering or during activities.
The most important thing is to avoid putting weight on the upper limb, but general activities should not be an issue.
Changhua Hospital cares about your health.
Sincerely, Dr.
Wang Shou-ji.

Reply Date: 2020/07/19

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your recovery after the clavicle fracture surgery. It's understandable to have questions during this healing process, especially after a significant injury like yours. Let’s address your questions one by one.

1. Temporary Removal of the Sling: It is generally acceptable to temporarily remove the sling while you are in a safe environment, such as during a shower, as long as you support your arm with your right hand. However, be cautious not to put any weight on the injured arm or move it in ways that could strain the healing bone. If you feel any discomfort or pain, it’s best to return to using the sling immediately.

2. Bending Over with the Sling: When you bend over, whether the sling is on or your arm is resting on a table, there can be additional strain on your clavicle. This is because bending forward can shift your body weight and may inadvertently pull on the shoulder and clavicle area. It’s advisable to maintain good posture and avoid excessive bending to minimize any undue stress on the healing bone.

3. Concerns About Exercise:
- (a) The primary concern with cycling on a stationary bike (flywheel) is indeed the risk of falling, which could lead to a re-injury of your clavicle. Additionally, vigorous movements could potentially cause the fracture site to shift or not heal properly. The clavicle is a critical bone for shoulder stability, and any excessive movement could compromise your recovery.

- (b) As for the three-month guideline, this is a common recommendation for fractures, especially those that are displaced or comminuted (like yours). The healing process for bones can vary, but typically, it takes about 6-12 weeks for significant healing to occur. After three months, your doctor may reassess your condition and determine if you can gradually return to more vigorous activities, including cycling.
In the meantime, consider low-impact activities that do not strain your shoulder, such as walking or gentle stretching (as advised by your physician or physical therapist). This will help maintain your fitness level without risking your recovery.

Additional Recommendations:
- Physical Therapy: Once your doctor gives you the green light, engaging in physical therapy can be beneficial. A physical therapist can guide you through exercises that promote healing and restore strength and range of motion in your shoulder.

- Nutrition: Ensure you are consuming a balanced diet rich in calcium and vitamin D to support bone healing. Foods like dairy products, leafy greens, and fortified foods can be beneficial.

- Weight Management: If you are concerned about weight gain during your recovery, focus on maintaining a healthy diet and consider gentle exercises that do not strain your shoulder.
Lastly, always communicate openly with your healthcare provider about any changes in your symptoms or concerns you may have. They can provide personalized advice based on your specific situation and recovery progress.

Wishing you a smooth recovery and looking forward to seeing you back to your regular activities soon!
Best regards,
Doctor Q&A Teams

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