Friday, January 06, 2012

Lost Bones Reunited! (Hopefully)

Ten weeks after my bike crash in February 2009, I wrote with optimism that my left clavicle fracture was beginning to heal.  And for the most part, the pain subsided over time.  Later in 2009, I was able to complete the 206-mile cycling race, Lotoja, and also Ironman Arizona; although, there were lingering issues with my back strength and upper arm strength, especially on my left side.  Also, I still experienced a sort of searing pain, like the pain a tearing muscle might inflict, in my upper left arm with certain reaching movements.  The pain became worse after I fractured my right clavicle in May 2010 and had to rely on my left arm while that healed.  From the medical imaging, it became clear that the left clavicle fracture had never healed; and after months of PT and ruling out shoulder joint problems (cortisone injection, MR arthrogram, etc.), the orthopedic surgeon determined that the most likely cause of my continued searing upper arm pain was this "non-union" fracture.  Surgery was scheduled for October 24, 2011, approaching 3 years after the original injury.

The surgical plan was to scrape off the substantial hypertrophic (i.e., overgrown) bone growth at the bone edges and to use that material as a sort of grout between the fractured bone ends.  The bone would be properly realigned and then secured with a plate and several screws.  Aside from some pretty unpleasant complications from the general anesthesia and pain meds, the surgery and immediate recovery went smoothly.  The surgeon was unable to remove all of the hypertrophic growth from underneath the clavicle because of the proximity to major blood vessels; but otherwise, things went as planned.  Currently, there is some skin tenderness on the surface of the plate, and it is still too soon to know whether the pain is resolved.  But so far I feel hopeful that it will be better than before.  If the plate bugs me, there is an option to have it removed once the bone has completely healed.

Six weeks post injury; hypertrophy of bone has not occurred yet. (Xray March 16, 2009)
About six weeks post surgery. There is one longer screw to insert into the hypertrophic bone that couldn't be removed.  A healed fracture from 2009 is visible in the 3rd rib down, (Xray 12/6/2011)

What I didn't anticipate about this is that, although planned, the surgery was essentially the same as re-fracturing the clavicle and required a recovery period just as long.  So, I am yet again facing another period of regaining fitness lost to injury.  Of course, I am grateful that I was able to have the repair and the pain was substantially less (not even comparable, really) to the original injury.