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The pathology for broken collar bones was changing right as I took up mountain biking, and subsequently shattered my collarbone. It was hotly debated at the ho

• miketery 2y ago
  I had a clean break on mine. If I had not had surgery I believe my shoulder would have been a centimeter or two lower. So I got a plate and 7 screws. Am I right to understand that had I not gotten the surgery my shoulder would’ve likely returned to the normal position?
  • ghufran_syed 2y ago
    usually it shouldn’t affect position or function of the shoulder once healed, and while the clavicle does tend to heal with a “bump” in it at the site of the break, its long been thought that the risk of surgery at that site outweighs the benefit. But it does depend on the specifics of the fracture: https://www.orthobullets.com/trauma/1011/clavicle-fractures--midshaft https://www.orthobullets.com/trauma/1011/clavicle-fractures-...
• edwcross 2y ago
  Given the amount of injuries related to mountain biking, is there some specific insurance needed for it? It seems one of those "net-negative for the society activities", like trampolines.
  • erikerikson 2y ago
    Kids have so much joy on trampolines! I know they have dangers but net negative? Do you have data or anything?
  • ghaff 2y ago
    In general, "society" deciding what activities are too dangerous to routinely allow is a really nasty slope. Yes, there's some special insurance offered through private organizations for things like higher altitude mountaineering. But it's not that big a step to rule that any contact sport, for example, should require special insurance. I'm sure the insurance companies wouldn't mind.
    • 4ggr0 2y ago
      One thing which comes to mind is - why should we stop at sports, then? we'll immediately be at the point where smokers, alcoholics, obese people etc. should pay more, after all, their way of life statistically causes higher costs. (i don't think either of those things should result in higher insurance prices, just continuing the thought.)
      • doix 2y ago
        > we'll immediately be at the point where smokers, alcoholics, obese people etc. should pay more, after all, their way of life statistically causes higher costs. Wait, do they not? I genuinely assumed they did. I remember when I got private insurance through my work I had to fill in some questionnaire. It was "free", but it was a taxable benefit so you knew how much you were costing the company and me and my friends had different rates. I wonder what the actual statistics are when it comes to costs with active people that are more likely to be injured vs obese people that are less likely to be injured but more likely to suffer obesity related illnesses.
        • ghaff 2y ago
          Private life insurance may. I don't think health insurance generally does. Certainly Medicare doesn't ask about any of those things.
• mindcrime 2y ago
  Apropos of nothing in particular, when I first started mountain biking, a guy I was riding with told me: "You can divide all mountain bikers into two groups: the ones who have broken their collarbone, and the ones who are about to break their collarbone." Knock on wood, 20 years later I still haven't broken a collarbone, but I've had plenty of scrapes, bruises, cuts, etc, a couple of concussions, a torn rotator cuff, and quite probably a broken neck (never went to the doctor to have it diagnosed, but I landed on my head hard enough to crack my helmet and knock me unconscious for a few minutes and my neck hurt for like 6 months afterwards). Still, wouldn't trade it for anything in the world. Nothing like being out in the woods, on a bike.
  • hnburnsy 2y ago
    Is there padding or gear sold that can reduce the likelihood?
    • mindcrime 2y ago
      For collarbones specifically? Nothing I'm aware of. At least if the explanation that was given to me for the high prevalence of collarbone injuries is correct, that makes sense. Someone explained it to me as "when you start to fall, you instinctive tend to reach our towards the ground to try to break your fall. So your hand is the first thing that hits the ground, and all the energy of the fall goes up your arm and into your shoulder / upper chest area. And the collarbone just happens to be the "weak link" there and so tends to break." Now maybe that's just folk wisdom that isn't really true, but it sounds plausible to me. And if we reason by analogy a little, it's not too far off what my surgeon told me when I tore my rotator cuff. I fell and came down on my elbow, and he explained that the energy from the fall pushed my humerus up into my shoulder, and pinched my rotator cuff between two bone heads, which is what caused the tear. So yeah, not much padding can do about stuff like that I guess.
      • webmaven 2y ago
        Hmm. Every time I've been in a similar scenario (breaking a fall, warding off an incoming projectile) it has been my wrists that broke.
• jack_pp 2y ago
  I had a broken collar bone last year in Bucharest and I moved back to my hometown because of it. I had to check in after a week or two to see how it's healing but was lazy about it so I went to the hospital after 3 weeks and was told there's a waiting list 10 days long and go to a private clinic. At the private clinic the doctor didn't even look at me, or the x-rays I just took and just told me to go into surgery back in Bucharest. Luckily when my mother heard she found a surgeon through a friend of a friend that looked at my x-rays on whatsapp and told me it's fine but just to be sure to visit him in Bucharest feel it in person, which the private care doctor never did. So after 4 weeks I went to this last guy in a public hospital, told me I'm fine and can take off my brace, wait a week or two and go into physical therapy. Also told me in 20 years he only had to once or twice do a collar bone surgery so it's almost never the answer. It's amazing that just being told I'm fine I could relax and all my muscle aches literally were gone 1 hour after that meeting so my advice in general is, be very careful what doctor you choose because medical hexing really is a thing. We put doctors on this pedestal and if God forbid you catch them in a bad mood they can fuck you up worse than before you saw them.
  • danuker 2y ago
    Placebo and nocebo are strong effects. Even when the people taking placebos knows it, they still work. https://www.nature.com/articles/s41598-021-83148-6 https://www.nature.com/articles/s41598-021-83148-6
  • interludead 2y ago
    Man, that's a wild ride just to get a proper diagnosis. It's crazy how much a doctor's attitude can shape recovery
    • jack_pp 2y ago
      I left out a bit, before I saw the doctor that told me surgery is the only way, I was consulted by another guy that was free and he scolded me because I came without the orthosis saying stuff like I don't want to get better and basically didn't even look at me or check my recovery after 3 weeks of wearing the orthosis. Told me to go to his private clinic and get a new orthosis where I decided to see any other doctor because I was put off by his attitude. I think the private clinic had a contract with the hospital I was sent to for the surgery or something. Anyway thank God I found a decent doctor.
• jamiedumont 2y ago
  I shattered my collarbone - and I do mean shattered, ~8 pieces - in a mountain bike crash September 2023. I went over the bars after the back wheel of my hardtail caught a berm. Landed on my head and shoulder and compressed it laterally inwards by about 2 inches. Even with this mess, it was hotly debated for around two weeks whether I needed surgery. A good chunk of my collarbone was trying to push through my skin and the other half was fusing to my scapular and was starting to compromise nerve function. Even then, because the non-surgical route is now considered the standard, I was meeting resistance to have an ORIF. It seems that the about turn from surgical intervention has been so strong that getting ANY surgical intervention is a battle. I eventually came across a surgeon who took one look at me (never mind the imaging) and scheduled me for surgery. ~18 months later I’m now on a waiting list to have the plate removed, and strangely have gone off cycling… Surfing has happily taken its place.
  • gnarcoregrizz 2y ago
    Shattered mine mountain biking as well (6 pieces). Ortho took one look at it and scheduled surgery for the next day. It wasn't a 'standard' break since it included my AC joint and coracoclavicular ligaments which needed a special type of plate. Ultimately it took 2 surgeries (ORIF, then plate removal). Total recovery was 9 months. My arm/shoulder is as strong as it was before, and it looks anatomically correct. My shoulder immediately felt "better" after ORIF. I would suggest it if it's way out of whack... mine was drooping probably 2". I can't imagine how much it would suck if the bones healed that way.
    • jamiedumont 2y ago
      Mine felt immediately worse after the ORIF. After two weeks getting comfortable in their new positions, all the ligaments really resented getting wrenched back into place. Good illustration was that my run of the mill, 45 minute surgery ended up taking 4.5 hours. It’s good to hear that everything felt good after your plate was removed. At 18 months post-surgery, I’m in a really good place where I can do most anything I want. Only occasionally experience discomfort if my son headbutts the plate or a backpack strap rubs on it. I was in two minds about having it removed as it would be a step backwards to post-surgical, but the likelihood of me doing something stupid again in the future means it’s worth it. Rather have the fuse that a clavicle is rather than fracture my sternum!
• ziml77 2y ago
  You must have broken yours around the same time my dad broke his. They didn't operate and apparently some of the people who saw the x-rays were quite surprised how well the natural healing process handled pulling the bone pieces back together.
• 11235813213455 2y ago
  Also broke my collar bone and no surgery, shoulder is less large by 2cm, I had no issues in the short term, but now after 10+ years it's cracking more, it doesn't age well I asked if it was possible to do a surgery now, so they'd have to break and restore a longer collar bone, more straight, but surgeons don't seem positive for this
• noah_buddy 2y ago
  A personal philosophy in medical decisions: - unless there is a severe risk I might die from lack of intervention (on any reasonable timeline besides life), I avoid intervention. In some cases (my messed up jaw and a whole 9 wisdom teeth), I broke this rule. But generally, it has served me well.
  • tenzing 2y ago
    I have a similar viewpoint; over a decade ago, I had a nuisance tendon issue and went to a specialist who recommended surgery. The surgery had a risk of serious, life-long consequence if it went wrong. He said that if I can live with the tendon issue, we can delay surgery indefinitely... so we delayed. A month later, I stopped doing a certain workout at the gym, which resolved the issue within days. No need for surgery at all. I do think that some specialists can be so focused on their speciality (i.e. surgery) that they don't think outside of that paradigm (try a different workout at the gym), and it's up to the patient to effectively shop around to get the best advice.
• tomaskafka 2y ago
  My wife is a physiotherapist in Europe, and even ten years ago she would tell you to start exercising it (with guided exercises) as soon as possible.
• akudha 2y ago
  When I was a kid (not in the U.S), I remember village elders diagnosing all kinds of illnesses simply from checking one's pulse, without asking any questions or even talking. These are people with minimum education, minimum or zero exposure to science or labs or modern medicine. Now we have all kinds of powerful, fancy machines and drugs and procedures and today's doctors still misdiagnose, mistreat even relatively simple issues. I don't know if it is because we as humans have lost touch with nature, our own bodies or we have way more illnesses today than I was a kid 4 decades ago or what else is the reason. It is kinda depressing and mind boggling at the same time.
  • adammarples 2y ago
    I get the impression from the second part of this that you think the village elders were correctly diagnosing things?
    • burnished 2y ago
      I wonder how likely that is? I suspect their understanding of their diagnostic technique is flawed, but beyond that, would a small enough group have a similarly small pool of common afflictions such that you could develop a useful body of medical lore?
  • hatthew 2y ago
    when my grandma was a kid she remembers the village doctor telling her she has ghosts in her blood and she should do cocaine about it
• zameerb1 2y ago
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• pkulak 2y ago
  I've still never heard a satisfactory explanation for how in the hell two parts of a bone, broken such that they aren't even touching, can find their way back to each other and heal. My son broke his collar bone, and the hospital sent him home in a sling. When I looked at the x-ray, I couldn't believe that's the correct treatment. But a month or two later and he was good as new. Absolutely blows my mind every time I think of it.
  • jvanderbot 2y ago
    They sense other bone tissue and grow together I guess. Same for severed nerves, up to a point.
  • brewdad 2y ago
    I broke my collarbone about 30 years ago. Then had it partially rebroken when a friend forgot about my healing bone and greeting me with a shoulder grab from behind. (He felt like shit afterwards). I got the most basic healthcare a free college clinic could offer. Today, you can only tell I ever broke it when I'm shirtless and at my skinniest weight.
  • pgreenwood 2y ago
    Mine ended up healing with a 15mm overlap. So it is a weird shape. It gives me 0 issues however.
  • idiotsecant 2y ago
    It starts with bleeding. The blood in the region of the bones forms a squishy mass that is not bone, but through which cells can flow. Specialized cells deposit calcium into this mass, guided by hormonal and chemical signals. If you imagine the two open bone ends as emitting a sphere of chemical signals, where the two spheres interfere constructively is where the 'signal' is strongest and where you want to deposit calcium. Bones are not just calcium of course, but that's the gist.