Incomplete Clavicle Healing After Fracture: Key Insights

Clavicle fracture, with partial bone healing?

Hello! I was in a car accident and fractured my left clavicle (in the mid-section).
The fracture ends are significantly misaligned.
I did not have surgery.
Each time I visited the doctor (I have seen him four times), he said, "This is healing well, no problems, don't worry, just let it heal on its own!" This has been going on for 2.5 months.
A few days ago, I went for a follow-up appointment and had an X-ray taken.
It showed that the lower part has grown quite a bit, but the upper part has not grown at all.
This time, the doctor (the same one) suddenly said, "Did you know that the first two months after a fracture are the golden period for bone growth? You have already missed it, and now it may or may not grow further." I was taken aback.

I have a few questions:
1.
Why is only part of the bone growing? (If it were an issue with my body’s healing ability, both parts should not be growing.
If my movements caused the bones to misalign, then they should not be healing at all.
How is it possible for one part to grow while the other does not?)
2.
Is it possible that the bone will stop growing as a result of this?
3.
What should I do? (Currently, the fracture site occasionally hurts a little.
My left shoulder, scapula, and neck are very tight and sore due to lack of movement.) Additionally, to expedite rehabilitation, I have been doing heat therapy at another orthopedic clinic, but that doctor advised that I should start moving my arm and shoulder quickly to prevent adhesions, or I may have issues with movement later on.
I am really unsure whose advice to follow! Thank you!

Mr. Chen, 50~59 year old female. Ask Date: 2015/02/09

Dr. Shi Guozheng reply Orthopedics

Clavicle fractures typically heal in about three months, so based on the current situation, it may be worth waiting a bit longer as there is a possibility of healing.
Rehabilitation can continue to be performed.

Reply Date: 2015/02/09

More Info

Understanding incomplete clavicle healing after a fracture can be quite complex, especially in cases where there is significant displacement and misalignment of the bone fragments. Your situation, where you have experienced a mid-shaft clavicle fracture with considerable displacement and have not undergone surgical intervention, raises several important points regarding bone healing and rehabilitation.

1. Why does only part of the bone heal?
Bone healing is a dynamic process influenced by several factors, including the type of fracture, the alignment of the bone fragments, the stability of the fracture site, and individual biological factors such as age, nutrition, and overall health. In your case, the fact that the lower part of the clavicle has shown signs of healing while the upper part has not could be attributed to several reasons. If the fracture site is unstable or if there is significant movement at the fracture site (due to the misalignment), it can hinder the healing process. Additionally, the blood supply to the area plays a crucial role; if the upper fragment has a compromised blood supply, it may not heal as effectively.
2. Will the bone stop healing?
It is concerning that your physician mentioned that you may have missed the "golden healing period." Typically, the first few weeks after a fracture are critical for bone healing, but it does not mean that healing cannot occur after this period. However, the longer the bone remains misaligned or unstable, the greater the risk of nonunion (where the bone fails to heal properly) or malunion (where the bone heals in an incorrect position). Your ongoing pain and discomfort suggest that there may still be issues with the alignment or stability of the fracture site.

3. What should you do?
Given your situation, it is essential to seek a second opinion, especially if you feel uncertain about the advice you have received. A thorough evaluation by another orthopedic specialist may provide more clarity on the healing status of your clavicle and whether surgical intervention is necessary.
In the meantime, it is crucial to follow a rehabilitation program that promotes gentle movement of the shoulder and arm to prevent stiffness and adhesions. While it is essential to avoid excessive strain on the healing bone, early mobilization under the guidance of a physical therapist can help maintain range of motion and prevent complications.
You may also want to consider modalities such as ultrasound therapy or electrical stimulation, which some studies suggest can enhance bone healing. However, these should be discussed with your healthcare provider to ensure they are appropriate for your specific situation.

In conclusion, while the healing process can be frustrating and uncertain, it is essential to remain proactive about your recovery. Regular follow-ups with your healthcare provider, adherence to rehabilitation protocols, and open communication about your concerns will be vital in navigating your recovery journey. Remember, every fracture and individual is unique, and your treatment plan should be tailored to your specific needs and circumstances.

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