Post-Surgery Rehabilitation for Clavicle Fractures: A Guide - Orthopedics

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Post-surgery rehabilitation for clavicle fractures is crucial for restoring function and strength, especially after a significant injury like a comminuted fracture. Given your situation, where you had surgery to fixate the clavicle with a plate and are now three months post-operation, it's important to approach your rehabilitation carefully.

Firstly, it's encouraging to hear that most of the fracture has healed, although the presence of a 1 cm gap on the X-ray indicates that complete healing may still be in progress. Bone healing can vary significantly from person to person, and while you may feel capable of performing daily activities without pain, the structural integrity of the bone is paramount, especially when considering returning to high-impact activities like karate.

In general, the rehabilitation process for clavicle fractures involves several phases:
1. Initial Phase (0-6 weeks post-surgery): This phase focuses on protecting the fracture site and allowing for initial healing. During this time, the use of a sling is common to immobilize the shoulder and prevent excessive movement.

2. Intermediate Phase (6-12 weeks post-surgery): As healing progresses, gentle range-of-motion exercises can be introduced. These exercises help to maintain flexibility in the shoulder joint and prevent stiffness. It's crucial to avoid any movements that cause pain or discomfort.

3. Strengthening Phase (3 months and beyond): Once the doctor confirms that the bone is healing well, you can gradually start strengthening exercises. This phase is vital for restoring muscle strength and function. However, it's essential to listen to your body and not push through pain, as this could lead to setbacks.

Regarding your specific questions:
- Returning to Karate: It is generally advisable to wait until the bone has completely healed before returning to high-impact sports like karate. This is to prevent re-injury or complications. Since you mentioned a fear of using your right hand, this could be a psychological barrier stemming from the injury. Gradual exposure to activities that mimic karate movements, without the intensity, can help build confidence.

- Alternative Activities: While waiting for full recovery, consider engaging in low-impact activities that do not strain the shoulder, such as walking, stationary cycling, or swimming (with caution). These activities can help maintain your overall fitness without risking your shoulder.

- Physical Therapy: Consulting a physical therapist can be highly beneficial. They can provide a tailored rehabilitation program that includes specific exercises to improve strength, flexibility, and coordination. A therapist can also help you safely progress towards more demanding activities.

- Monitoring Progress: Regular follow-ups with your orthopedic surgeon are essential to monitor the healing process through X-rays and physical assessments. If the gap in the bone does not close or if you experience persistent pain, further intervention may be necessary.

In conclusion, while you may feel ready to return to karate, it is crucial to prioritize complete healing and rehabilitation. Engaging in a structured rehabilitation program with the guidance of healthcare professionals will help ensure a safe return to your activities. Always communicate openly with your healthcare team about your concerns and progress, as they can provide the best advice tailored to your specific situation.