You make it out to civilization and are seen at an ER
or outpatient clinic. A proper examination assesses
neurologic, vascular and muscle functions. X-rays
most commonly reveal multiple fracture fragments,
usually somewhat displaced. If you are fortunate
to have a closed injury (no bone fragments sticking
through the skin) and no neurovascular deficits, you
will recover in a modest amount of time.
Treatment options were once almost always
conservative (non-operative) in nature. For the most
part, as long as the bone fragments are in proximity,
the fracture will heal with some shortening and
rotation of the bone. Five to seven weeks will pass
until the fracture has consolidated enough to start
range-of-motion exercises and gentle stretching
and strengthening.
Surgery used to be frowned upon for these injuries,
but now is much more common, as new injury-
specific internal fixation plates and screws have
been developed. Surgery is generally performed in
an outpatient or 23-hour stay setting with multiple
screws and a contoured plate securing the fracture
back into anatomic alignment. Surgical fracture
fixation will prevent rotation or overlapping and
shortening of the fracture. The disadvantages of
surgery are the scar, numbness over the surgical area
from the incision, the possibility of infection, and
possible damage to the lung or major neurological/
vascular structures from the power drill or clamps
used in the procedure.
Also, the rigidly and anatomically fixed fracture
may take longer to heal, as the blood supply to
the bone was partially stripped off to allow for
visualization and alignment of fracture fragments.
Not always, but a possibility.
The internally fixed fracture can be moved a little
sooner as the plate and screws provide stability, but several
weeks are still required for enough healing to
start a rehabilitation program.
Depending on severity, it will still be at least three months
before you will be released for riding and be able to pick up
your adventure bike in the event of another tip-over in the
sand or mud.
Common injuries like this are, sadly, unavoidable with
nearly any type of physical activity. In our case, proper
riding gear with energy-absorbing padding decreases the
incidence of these injuries but will not entirely eliminate the
chance of them occurring. Understanding our skill limits and
getting training will go a long way toward making sure we
stay as injury-free as possible.John Spieker is a board-certified orthopedic
surgeon and medical acupuncturist, recently
retired after 32 years of practice. He’s fixed scores of
clavicle fractures during his career, most commonly
sustained by motorcyclists and bicyclists. He has
been riding motorcycles since he was 20 years old and has been
adventure riding for the last 15 years with instructors (Jimmy
and Heather Lewis, Jim Hyde, and Shawn Thomas) trying to beat
some technique into his stubborn bone head. Current ownership
includes four diesel bikes (the Kawabota, two M1031M1s and a
Track imported from Holland).Markedly displaced midshaft
clavicle fracture with superior
migration of medial fragment.ADVMoto publisher Carl Parker
suffered a broken clavicle in Western
China. Here you can see the deformity
of skin and ecchymosis from the
clavicle bone fragments displaced
into the trapezius muscle.AdventureMotorcycle.com 79