Seeking Help for Clavicle Fracture and Concerns After Car Accident Abroad

I urgently need help with a collarbone fracture while studying abroad?

Hello Doctor,
I am currently studying in the UK.
A few days ago, I was hit by a car while crossing the street.
An X-ray at the local public hospital revealed a significant fracture of my left clavicle/collarbone.
At the time, my right knee was struck by the front of the car, causing it to bend inward, but it was not fractured.
However, I have been walking awkwardly.
The local doctor did not perform an X-ray on my knee or other injuries sustained during the fall, which worries me.

I have a noticeable contusion on the left frontal area of my head, and my entire body feels swollen.
There are small lacerations on my scalp, and I have persistent numbness from my neck to my left side.
The doctor believes that a brain scan is unnecessary.
I am concerned about potential intracranial bleeding and other complications from the accident.

Is it normal for a patient like me not to be hospitalized in the UK healthcare system? Currently, the hospital has only prescribed me paracetamol tablets (500 mg) and diclofenac sodium enteric, and they provided a triangular bandage to support my arm.
They advised me to return for a follow-up in five days.
I feel helpless and scared.

Could you please provide me with more assistance and advice? Would it be better for me to seek treatment in Taiwan? Thank you very much for your help.

jeffrey, 20~29 year old female. Ask Date: 2004/01/17

Dr. Yang Zhengfan reply Orthopedics

Dear Jeffrey,
You mentioned two issues, so I will address them separately:
1.
Clavicle fracture: Generally speaking, clavicle fractures do not require surgical intervention and can be treated with a figure-of-eight brace.
The healing rate is over 95%, provided that the fracture is not significantly displaced and occurs in the midshaft.
Regarding your mention of "collar bond," I am not quite sure what you mean.
Perhaps you could email the X-ray for review by an orthopedic surgeon to determine whether you should return to Taiwan for treatment.
2.
Right knee instability: In the case of a right knee injury, we typically first assess for any signs of instability or swelling, and check for hematoma accumulation before deciding on the management plan.
X-rays serve as an initial assessment; if the situation is more severe, an MRI or arthroscopy may be necessary, as this cannot be determined through a consultation alone.
I recommend seeking care at a major hospital in the UK, where the orthopedic surgeons will be just as competent as those in Taiwan and should be able to address your concerns.
Wishing you the best of luck.

Reply Date: 2004/01/17

More Info

I'm sorry to hear about your accident and the concerns you're facing regarding your injuries. It's understandable to feel anxious, especially when you're in a foreign country and dealing with medical care that feels inadequate. Let's break down your situation and explore your options.

Firstly, you mentioned that you have a clavicle fracture diagnosed via X-ray. Clavicle fractures are common injuries, especially in accidents, and they can often heal well with conservative treatment, which typically includes immobilization with a sling, pain management, and physical therapy as healing progresses. The medications you've been prescribed, paracetamol (acetaminophen) and diclofenac, are common for managing pain and inflammation. Paracetamol is effective for mild to moderate pain, while diclofenac is a non-steroidal anti-inflammatory drug (NSAID) that can help reduce inflammation and pain.

However, your concerns about other injuries, particularly to your knee and head, are valid. The fact that your knee felt "off" after the accident and that you have a noticeable bruise on your forehead raises the question of whether there might be more serious injuries that need to be evaluated. While the local doctors may have assessed that a CT scan or MRI is not necessary, if you are experiencing persistent symptoms such as swelling, numbness, or any neurological symptoms (like confusion, severe headache, or vision changes), it is crucial to seek further evaluation.
Regarding your head injury, even minor head trauma can sometimes lead to complications such as a concussion or intracranial bleeding. Symptoms like persistent headache, dizziness, or changes in consciousness warrant immediate medical attention. If you feel that your concerns are not being taken seriously, it may be worth seeking a second opinion, either from another local healthcare provider or by returning to Taiwan for further evaluation.

In terms of your knee, if it continues to feel abnormal or painful, you should insist on further imaging studies, such as an X-ray or MRI, to rule out any ligament injuries or fractures that may not have been initially apparent.
As for the healthcare system in the UK, while it can be different from what you might be used to in Taiwan, it generally provides a high standard of care. However, if you feel uncomfortable with the treatment you are receiving or if your symptoms worsen, don't hesitate to advocate for yourself. You have the right to request further tests or referrals to specialists if you believe they are necessary.

In summary, here are some steps you can take:
1. Monitor Your Symptoms: Keep track of any changes in your condition, especially regarding your head, knee, and clavicle. If symptoms worsen, seek medical attention immediately.

2. Seek a Second Opinion: If you feel your concerns are not being addressed, consider consulting another healthcare provider in the UK or returning to Taiwan for a thorough evaluation.

3. Follow Up: Make sure to attend your follow-up appointment in five days, but don't hesitate to seek care sooner if your symptoms change.

4. Pain Management: Continue taking the medications as prescribed, and consider discussing any concerns about their effectiveness with your doctor.

5. Rest and Recovery: Allow your body time to heal, and avoid putting weight on your injured knee until you have a clearer understanding of the injury.

Your health and safety are paramount, so please take care of yourself and seek the help you need.

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