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Home/Sports Medicine/Collarbone Breaks Special Hazard for Cyclists
Sports Medicine

Collarbone Breaks Special Hazard for Cyclists

December 12, 2017 2 min read Premium comments

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Collarbone Breaks Special Hazard for Cyclists
Source: Wikimedia Commons and Tomasz Sienicki
Secondary

When a cyclist starts to fall off his bike he, often puts out his arms to break the fall. The force of the fall then travels through the arms to the shoulder, breaking the collarbone.

Breaks of the clavicle or collarbone account for about 5% of all adult fractures according to the American Academy of Orthopedic Surgeons (AAOS).

Surgeon Kevin D. Plancher, M.D., founder of Plancher Orthopaedics & Sports Medicine, repairs a lot of collarbones.

He says, “Located between the breastbone and the shoulder blade, the clavicle essentially connects the arm to the body and lies above several vital nerves and blood vessels. Many fractures occur in the middle portion of the bone, but some can shatter the bone in pieces or push pieces far out of place.”

Plancher lists five symptoms of a broken collarbone. They are:

  • Shoulder sags downward and forward
  • Pain creates inability to lift arm
  • Raising arm causes grinding sensation
  • Deformity or “bump” found over the break
  • Collarbone area is bruised after 5-7 days

Plancher says that for uncomplicated fractures, where the broken bone ends have not shifted significantly out of place, treatment can include arm support such as a sling to keep the arm and shoulder immobile and in line while the fracture heals.

Plancher, who lectures globally on to orthopedic procedures and sports injury management, notes that because cyclists fall from several feet above the ground, their broken collarbones more often fall into the “complicated” category.

“In addition to being broken in several places, the bone could be poking through the skin or the bone ends might be dangerously close to nerves and blood vessels running underneath,” he explains. “In cases like these surgical intervention is often performed.”

He says that a surgical collarbone repair requires placing a small metal plate over the fracture. Occasionally a surgical pin or screws may be used for the same reason, to hold the proper shape of the collarbone and keep it the same length as it was before the injury. “If a collarbone fracture doesn’t heal correctly, it could heal shorter than it was, increasing the chances of having rotator cuff problems later in life. But surgical collarbone repair offers patients the best possible chances of optimal healing. For cyclists, this means they’ll be back on the road and comfortable again within a matter of weeks.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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