What is Clavicle Surgery?

Clavicle surgery, also known as collarbone surgery, is a procedure performed to repair a fractured or broken clavicle. The clavicle, a long, slender bone connecting the shoulder to the sternum (breastbone), is susceptible to fractures, particularly from falls, sports injuries, or road accidents. When a clavicle fracture is severe, meaning the bone is broken into multiple pieces or significantly displaced (out of alignment), surgery may be necessary to restore stability and promote proper healing.

The primary goal of clavicle surgery is to realign the broken bone fragments and stabilize them using orthopedic implants. This allows the bone to heal in the correct position, restoring shoulder function and reducing pain. Without proper alignment and stabilization, the fracture may heal improperly (malunion) or not heal at all (non-union), leading to chronic pain and limited mobility.

Key Facts:

Clavicle fractures are common, especially in younger, active individuals.
Surgery is often recommended for displaced or comminuted (multiple fragments) fractures.
The procedure typically involves open reduction and internal fixation (ORIF).
Recovery involves immobilization, pain management, and physical therapy.
Outcomes are generally good with proper surgical technique and rehabilitation.

Why is Clavicle Surgery Performed?

Clavicle surgery is typically recommended when a clavicle fracture is severe and unlikely to heal properly with non-surgical treatment (such as a sling). The main indications for clavicle surgery include:

Displaced Fractures: When the broken ends of the clavicle are significantly out of alignment.
Comminuted Fractures: When the clavicle is broken into multiple pieces.
Open Fractures: When the bone breaks through the skin, increasing the risk of infection.
Shortening of the Clavicle: A significant overlap of the fracture fragments leading to a noticeable shortening of the collarbone.
Associated Injuries: When the clavicle fracture is associated with other injuries, such as nerve or blood vessel damage.
Non-union or Malunion: When a previous clavicle fracture has failed to heal (non-union) or has healed in a poor position (malunion), causing pain and limited function.

When Doctors Recommend It:

Doctors in India will typically recommend clavicle surgery after a thorough evaluation, including physical examination and X-rays (and sometimes CT scans) to assess the fracture pattern. The decision is based on the following factors:

Severity of the Fracture: The degree of displacement and the number of fragments.
Patient's Age and Activity Level: Younger, more active individuals may benefit more from surgery.
Patient's Overall Health: The patient's general health and ability to tolerate surgery.
Presence of Complications: Nerve or blood vessel damage, or an open fracture.
Failure of Non-Surgical Treatment: If conservative treatment (sling immobilization) fails to provide adequate pain relief or healing.
Cosmetic Concerns: In some cases, significant deformity from a malunion might prompt consideration of surgery.

Preparation for Clavicle Surgery

Preparing for clavicle surgery is crucial for a smooth procedure and a successful recovery. Here's what you need to do:

Essential Preparation Steps:

Consultation with Surgeon: Discuss your medical history, medications, and allergies with your orthopedic surgeon. Ask all your questions about the surgery, risks, and recovery process.
Physical Examination: Undergo a thorough physical examination to assess your overall health.
Imaging Tests: Your doctor will likely order X-rays to visualize the fracture. A CT scan may also be necessary for a more detailed assessment.
Blood Tests: Blood tests will be performed to check your blood count, kidney function, and liver function.
Medication Review: Inform your doctor about all medications you are taking, including over-the-counter drugs, herbal supplements, and vitamins. Some medications, such as blood thinners, may need to be stopped before surgery.
Fasting Instructions: Follow your doctor's instructions regarding fasting before surgery. Typically, you will be asked to refrain from eating or drinking anything for at least 6-8 hours before the procedure.
Quit Smoking: If you smoke, try to quit several weeks before surgery. Smoking can impair bone healing and increase the risk of complications.
Arrange for Transportation and Support: You will need someone to drive you home after surgery and help you with daily activities for the first few days.
Prepare Your Home: Make sure your home is comfortable and safe for your recovery. Remove any tripping hazards and set up a comfortable place to rest.

India-Specific Tips:

Arrange for Accommodation: If you are travelling from another city or state for the surgery, arrange for accommodation near the hospital.
Consult with a Local Physician: If possible, consult with your family physician (PCP) to get a general health check-up and obtain necessary medical clearances.
Gather Medical Records: Bring all relevant medical records, including previous X-rays, lab reports, and medication lists, to the hospital.
Arrange for Post-Operative Care: Discuss post-operative care and rehabilitation with your surgeon and arrange for physical therapy sessions.
Consider Local Customs: Be aware of local customs and traditions regarding medical care and recovery.

What to Expect:

You will be admitted to the hospital a day before or on the day of surgery.
You will meet with the anesthesiologist to discuss the anesthesia plan.
The surgical site will be cleaned and prepped.
You will be given medication to help you relax.
After surgery, you will be monitored in the recovery room.
You will likely experience pain and discomfort, which will be managed with pain medication.
You will be discharged from the hospital once you are stable and comfortable.

The Clavicle Surgery Procedure

Clavicle surgery typically involves open reduction and internal fixation (ORIF). Here's a concise breakdown of the procedure:

Anesthesia: You will be given general anesthesia, so you will be asleep during the procedure.
Incision: The surgeon makes an incision over the clavicle to access the fracture site. The length and location of the incision will depend on the fracture pattern.
Reduction: The surgeon carefully realigns the broken bone fragments into their proper anatomical position.
Fixation: Once the bone fragments are aligned, they are held in place using internal fixation devices. These devices may include:
- Plates and Screws: A metal plate is placed along the clavicle and secured to the bone with screws. This is the most common method of fixation.
- Intramedullary Rods: A rod is inserted into the hollow center of the bone to stabilize the fracture.
- Wires and Sutures: In some cases, wires or sutures may be used to hold the bone fragments together.
Closure: The incision is closed with sutures or staples. A sterile dressing is applied to protect the wound.
Immobilization: After surgery, your arm will be placed in a sling to immobilize the shoulder and allow the bone to heal.

Duration and Comfort Level:

The surgery typically takes 1-2 hours, depending on the complexity of the fracture. You will be under general anesthesia, so you will not feel any pain during the procedure. After surgery, you will experience pain and discomfort, which will be managed with pain medication.

What Happens During the Test:

This section is not applicable, as clavicle surgery is a procedure, not a test.

Understanding Results

This section refers to the outcome of the surgery and the healing process, not specific test results.

After clavicle surgery, the primary indicator of success is the healing of the fracture. This is typically monitored through follow-up appointments with your surgeon and regular X-rays.

Normal vs. Abnormal Healing:

Normal Healing (Union): X-rays show evidence of new bone formation (callus) across the fracture site. The fracture line gradually disappears as the bone heals. You will experience a gradual decrease in pain and improved shoulder function. Most fractures unite within an average of 3 months with surgical treatment using locking compression plates.
Abnormal Healing (Non-union or Malunion): X-rays show little or no evidence of new bone formation. The fracture line remains visible, and you may continue to experience pain and limited shoulder function. Malunion refers to the fracture healing in a misaligned position, which can also cause pain and functional limitations.

What Results Mean:

Successful Healing: Indicates that the surgery was successful, and the bone is healing properly. You will need to continue with your rehabilitation program to regain full shoulder function.
Non-union: Indicates that the fracture is not healing properly, and further treatment may be necessary. This may involve additional surgery to stimulate bone growth.
Malunion: Indicates that the fracture has healed in a misaligned position, which may require corrective surgery.

Next Steps:

Follow-up Appointments: Attend all scheduled follow-up appointments with your surgeon.
X-rays: Undergo regular X-rays to monitor the healing process.
Physical Therapy: Continue with your physical therapy program to regain full shoulder function.
Pain Management: Manage pain with prescribed medications.
Hardware Removal: In some cases, the internal fixation devices (plates and screws) may need to be removed after the bone has healed, especially if they are causing discomfort. This is usually a minor procedure.

Costs in India

The cost of clavicle surgery in India can vary significantly depending on several factors, including:

Hospital Type: Private hospitals typically charge more than government hospitals.
City: The cost of surgery is generally higher in tier-1 cities (e.g., Mumbai, Delhi, Bangalore) compared to tier-2 cities.
Surgeon's Fees: The surgeon's experience and reputation can influence their fees.
Type of Implant: The type of plate and screws used can affect the cost.
Room Type: The type of room you choose (e.g., private, semi-private) will also impact the overall cost.
Anesthesia Fees: The anesthesiologist's fees are an additional cost.

Price Range in ₹ (Approximate):

Government Hospitals: ₹30,000 - ₹60,000
Private Hospitals (Tier-2 Cities): ₹60,000 - ₹1,20,000
Private Hospitals (Tier-1 Cities): ₹1,00,000 - ₹2,50,000

Government vs. Private:

Government hospitals offer more affordable treatment options, but they may have longer waiting lists and fewer amenities. Private hospitals offer faster access to care and a more comfortable environment, but they are more expensive.

Insurance Tips:

Check Your Coverage: Contact your insurance provider to determine the extent of coverage for clavicle surgery.
Pre-Authorization: Obtain pre-authorization from your insurance company before undergoing surgery.
Cashless Facility: Inquire about the availability of a cashless facility at the hospital.
Claim Reimbursement: If a cashless facility is not available, you can file a claim for reimbursement after the surgery.
Review Policy Terms: Carefully review the terms and conditions of your insurance policy to understand any exclusions or limitations.

How Ayu Helps

Ayu helps you manage your medical records digitally. You can:

Store your X-ray images and other reports related to your clavicle surgery securely in the Ayu app.
Track your recovery progress over time by uploading follow-up reports and comparing them.
Share your medical records with your doctor or physical therapist easily using a QR code.

FAQ

Here are some frequently asked questions about clavicle surgery:

Q1: How long will I need to wear a sling after surgery?

A: You will typically need to wear a sling for 4-6 weeks after surgery to immobilize your shoulder and allow the bone to heal. The exact duration will depend on the severity of the fracture and your surgeon's recommendations.

Q2: When can I start physical therapy?

A: You will usually start physical therapy a few weeks after surgery, once the initial pain and swelling have subsided. Your physical therapist will guide you through a series of exercises to regain shoulder range of motion, strength, and function.

Q3: Will I need to have the plate and screws removed?

A: In most cases, the plate and screws do not need to be removed unless they are causing discomfort or irritation. If hardware removal is necessary, it is usually a minor procedure performed several months after the bone has healed.

Q4: How long will it take to recover fully?

A: The recovery time after clavicle surgery can vary depending on the individual and the severity of the fracture. Most people can return to their normal activities within 3-6 months. Full recovery, including regaining full shoulder strength and function, may take up to a year.

Q5: What are the risks of clavicle surgery?

A: The risks of clavicle surgery include infection, bleeding, nerve damage, non-union, malunion, hardware failure, and discomfort from the hardware. However, these complications are relatively rare.

Q6: What if I can't afford the surgery?

A: Explore options like government healthcare schemes, charitable trusts, and medical loans. Discuss payment plans with the hospital or surgeon's office.

Q7: Is clavicle surgery always necessary?

A: No. Non-displaced fractures can often heal with conservative treatment (sling immobilization). Discuss the pros and cons of surgical versus non-surgical treatment with your doctor to make an informed decision.

Q8: How can I find a good orthopedic surgeon in India?

A: Ask your family doctor for a referral. Research orthopedic surgeons online and check their credentials and experience. Read reviews from other patients. Choose a surgeon with extensive experience in clavicle fracture surgery.

What is Clavicle surgery: Purpose, Procedure & Costs in India