AC Disruption Deg3

[Rem]

Hi everyone,

Just had a huge crash yesterday at Stromlo, and ends up with a beautiful AC join disruption deg 3.
Obviously it sounds like surgery, but the ortho give me choice to wait 6 weeks and see how it goes and if no improvement, surgery anyway...
That sounds a bit stupid to me as I don't want to wait that much for something that need surgery when it is deg. 3.

Anyway I though if you have any experience with that injury, how long it takes, the reconstruction, and fitness afterwards.

Thanks for sharing.

 

[Mywifesirrational]

Nice pic, that's a big step defect, if you could take one from the front to show the shoulder drop the morbid person in me would be very happy to see that.

I did a grade 2 about 4 months ago, no need for surgery luckily. I couldn't move or lift my arm at all for the first week, then from weeks 2-4 it slowly got better, but any rapid loading (like swing the arm or throwing something) was still very painful. Grade three will take a lot longer as from memory the coracoclavical ligamnet is completely torn (?) can't be arse reaching for the anatomy book. 16 weeks later it's pretty good, I still have a small step defect, strength is about 20% less still, but it only gives me trouble now with dip like movements.

My rehab went well, I do some work for a orthopeadic surgeon and am doing a PhD in rehab following joint injury + have a lab full of useful equipment to scan and test as I went along. So I had the absolute best rehab possible.

My professional advice would be to do as the surgeon says (obviously) take it really easy with the shoulder - have they allocated some rehab for you yet - mot a bad idea to start a week or so post? if not it may well be worth asking the Surgeon, GP or see a orthopaedic focused physio/EP.

You need to think about the big picture currently, you will lose a lot of strength around the shoulder and also overall. It's an important time to eat well and get on the wind trainer and clock up some miles in front of the telly. Less obviously it is very important to strength train the other shoulder - this will limit strength loss in the affected shoulder, reducing the rehab time - especially if you do need surgery.

It's a pretty shitty injury, a lot worse than a simple clavicle fracture (one that requires no surgery) in my experience.

 

[Gripo]

Jorge Lorenzo did wait 6 weeks on a broken collar bone...and it paid off...

http://www.bbc.co.uk/sport/0/motogp/23114301

 

[pharmaboy]

Hi everyone,

Just had a huge crash yesterday at Stromlo, and ends up with a beautiful AC join disruption deg 3.
Obviously it sounds like surgery, but the ortho give me choice to wait 6 weeks and see how it goes and if no improvement, surgery anyway...
That sounds a bit stupid to me as I don't want to wait that much for something that need surgery when it is deg. 3.

Anyway I though if you have any experience with that injury, how long it takes, the reconstruction, and fitness afterwards.

Thanks for sharing.

View attachment 267448

Makes me feel much better about mine. Fark - there is no good news, and surgery has significant risks , my understanding is that is a wise choice by the orthopaedic surgeon. Grade 4 is done, grade 3 is on the cusp.

I will say, get a wedge pillow and get used to sleeping up on a wedge. Truly, sleep is very important, and your opposing shoulder will get sore from sleeping on it preferentially

 

[cammas]

Been down the very same road as you a couple years back, had a small OTB and bang there goes the shoulder went to the Doc and they suggested the same 6 week wait and see. After the 6 weeks was referred to the ortho he looks at and said "you need surgery I will check my books" here I am waiting for him to come back and say I will see you in 4 weeks but no he comes back with "what are doing tomorrow".:bounce:

Had the surgery where they take part of your hamstring and tie back up, mine is pretty good now I've hit a few trees with it and bounces back for more. I can feel the differences between my shoulders but it has not slowed up my riding, I was off the bike for a while but I can't remember how long, I had a really good physio who understood about riding and helped me get back on the bike.

All I can say is best of luck.

 

[Rem]

Nice pic, that's a big step defect, if you could take one from the front to show the shoulder drop the morbid person in me would be very happy to see that.

I did a grade 2 about 4 months ago, no need for surgery luckily. I couldn't move or lift my arm at all for the first week, then from weeks 2-4 it slowly got better, but any rapid loading (like swing the arm or throwing something) was still very painful. Grade three will take a lot longer as from memory the coracoclavical ligamnet is completely torn (?) can't be arse reaching for the anatomy book. 16 weeks later it's pretty good, I still have a small step defect, strength is about 20% less still, but it only gives me trouble now with dip like movements.

My rehab went well, I do some work for a orthopeadic surgeon and am doing a PhD in rehab following joint injury + have a lab full of useful equipment to scan and test as I went along. So I had the absolute best rehab possible.

My professional advice would be to do as the surgeon says (obviously) take it really easy with the shoulder - have they allocated some rehab for you yet - mot a bad idea to start a week or so post? if not it may well be worth asking the Surgeon, GP or see a orthopaedic focused physio/EP.

You need to think about the big picture currently, you will lose a lot of strength around the shoulder and also overall. It's an important time to eat well and get on the wind trainer and clock up some miles in front of the telly. Less obviously it is very important to strength train the other shoulder - this will limit strength loss in the affected shoulder, reducing the rehab time - especially if you do need surgery.

It's a pretty shitty injury, a lot worse than a simple clavicle fracture (one that requires no surgery) in my experience.

Thanks man, Yeah I'm a bit scared about the future.
But I took good note of your comment and will do ASA I can move a bit and after surgery of couse.
For now it is pain killer time.

Cheers.

 

[Rem]

Makes me feel much better about mine. Fark - there is no good news, and surgery has significant risks , my understanding is that is a wise choice by the orthopaedic surgeon. Grade 4 is done, grade 3 is on the cusp.

I will say, get a wedge pillow and get used to sleeping up on a wedge. Truly, sleep is very important, and your opposing shoulder will get sore from sleeping on it preferentially

Thanks Pharmaboy,

Thought the sleeping would be important too, last night was not too bad, fortunate it is my opposite sleeping side.
What sort of risks should I consider for the surgery apart from the anesthetic.

Cheers

 

[Rem]

Been down the very same road as you a couple years back, had a small OTB and bang there goes the shoulder went to the Doc and they suggested the same 6 week wait and see. After the 6 weeks was referred to the ortho he looks at and said "you need surgery I will check my books" here I am waiting for him to come back and say I will see you in 4 weeks but no he comes back with "what are doing tomorrow".:bounce:

Had the surgery where they take part of your hamstring and tie back up, mine is pretty good now I've hit a few trees with it and bounces back for more. I can feel the differences between my shoulders but it has not slowed up my riding, I was off the bike for a while but I can't remember how long, I had a really good physio who understood about riding and helped me get back on the bike.

All I can say is best of luck.

Thanks Cammas,

Good to hear your ope was successful.
Makes me feel more confident.

 

[MRO]

i did a grade 4 on mine. I had the hook plate surgery and was off the bike for 5 months and only just back to near full pace now. 3 months of horrible pain while the plate was in and then a slow rehab to get movement back. All looks normal now but still cant fully spin my arm around if i needed to.

 

[pharmaboy]

Thanks Pharmaboy,

Thought the sleeping would be important too, last night was not too bad, fortunate it is my opposite sleeping side.
What sort of risks should I consider for the surgery apart from the anesthetic.

Cheers

That's for your orthopaedic surgeon, who will know the numbers, but its not as simple and reliable as a clavicle op. which is why they tend to be conservative. Surgeons despite mythology, aren't gunho types

 

[tasdisco]

Hey there,

I did mine at the start of November 2012, a grade 5, surgery required. I am very fortunate to know an awesome ortho surgeon, who did a fantastic job. I had a hook plate put in two weeks after the crash (had to wait for skin abrasions to heal) and not trying to scare you but woke from that op in the worst pain I have ever felt.

It soon settled down though and the next three months consisted of pain relief, no sleep and anti inflam drugs. Got about 75% movement back while the plate was in there, but you get used to living with a base level of pain! Had a few easy rides in during this time as well!! I really suggest getting a good physio involved while the plate is in there, worked wonders for me!

Plate removed after three months and woke from that surgery pain free which was an amazing feeling! Took it very easy for the next month then have been building, with Physio, till now!

Have 95-98% movement back, working on strength now which is going well! Also have a ripper of a scar to show for it! Still suffering a few mind issues approaching large drop offs but that memory is fading as well!!

Good luck, it is a long recovery but it will heal! Make sure you do the boring as bat sh!t band exercises and stretches etc, it is what will give you your range of motion back, not the surgery!

 

[Rem]

Hey there,

I did mine at the start of November 2012, a grade 5, surgery required. I am very fortunate to know an awesome ortho surgeon, who did a fantastic job. I had a hook plate put in two weeks after the crash (had to wait for skin abrasions to heal) and not trying to scare you but woke from that op in the worst pain I have ever felt.

It soon settled down though and the next three months consisted of pain relief, no sleep and anti inflam drugs. Got about 75% movement back while the plate was in there, but you get used to living with a base level of pain! Had a few easy rides in during this time as well!! I really suggest getting a good physio involved while the plate is in there, worked wonders for me!

Plate removed after three months and woke from that surgery pain free which was an amazing feeling! Took it very easy for the next month then have been building, with Physio, till now!

Have 95-98% movement back, working on strength now which is going well! Also have a ripper of a scar to show for it! Still suffering a few mind issues approaching large drop offs but that memory is fading as well!!

Good luck, it is a long recovery but it will heal! Make sure you do the boring as bat sh!t band exercises and stretches etc, it is what will give you your range of motion back, not the surgery!

Hi Tasdisco,

Thanks for you comment, makes me a bit scared for suffering, but I knew It won't be an easy injury, actually I should of break my collar bone...
Spoke to the GP this morning, he showed me exactly what happen, He very skilled as well, and made me more confident for the surgery.
He said in some cases they can wired everything back together instead of screwed plate.
This could be less pain, and doesn't need back op. My next appointment is Monday next week (it's gonna be long to wait), X ray and chat with the ortho surgeon of what we can do.
In my head I'm preparing the surgery and what comes after.

Thanks

 

[pin'd_it]

I did my left shoulder in an OTB crash in December 2011. Grade 3 like yours and I was given the 6 week wait option as well. From what the Surgeon told me, only 20% of the Grade 3 separations do not heal and require the surgery, and the recovery from the surgery is longer and more painful (initially) than letting it heal without, and has all the associated risks. So the numbers are with you. But these are things to chat to the specialist about.

My shoulder healed wonderfully. No ongoing pain whatsoever. No disruption in Range of Movement or functional capacity. I go to the gym, play a bit of contact sport, ride; everything as normal.

I kept my arm in a sling for about 6 weeks (mainly because I went back to work about a week after the crash and people knew not to ask me to do anything too intensive) and by 8 weeks in I could use it as normal (minus the REALLY heavy lifting especially above your head) and started doing pushups and light resistance exercises.

I think I was recommended physio (I can't fully remember) but I know that I couldn't afford it at the time so left it out, but I don't think it made any difference to how it's healed. Not a bad idea to ask his/her opinion on this as well.

 

[MRO]

Hey there,

I did mine at the start of November 2012, a grade 5, surgery required. I am very fortunate to know an awesome ortho surgeon, who did a fantastic job. I had a hook plate put in two weeks after the crash (had to wait for skin abrasions to heal) and not trying to scare you but woke from that op in the worst pain I have ever felt.

It soon settled down though and the next three months consisted of pain relief, no sleep and anti inflam drugs. Got about 75% movement back while the plate was in there, but you get used to living with a base level of pain! Had a few easy rides in during this time as well!! I really suggest getting a good physio involved while the plate is in there, worked wonders for me!

Plate removed after three months and woke from that surgery pain free which was an amazing feeling! Took it very easy for the next month then have been building, with Physio, till now!

Have 95-98% movement back, working on strength now which is going well! Also have a ripper of a scar to show for it! Still suffering a few mind issues approaching large drop offs but that memory is fading as well!!

Good luck, it is a long recovery but it will heal! Make sure you do the boring as bat sh!t band exercises and stretches etc, it is what will give you your range of motion back, not the surgery!

Your story is almost identical to mine. The ongoing mild pain for 3 months while the hook plate is in is really bad and instant releif once removed. I lived on panadeine forte and nurofen for 3 months, didnt leave the house without it. I even took up smoking a special 'herbal' remedy to get to sleep each night - only thing that worked!

 

[Rem]

I did my left shoulder in an OTB crash in December 2011. Grade 3 like yours and I was given the 6 week wait option as well. From what the Surgeon told me, only 20% of the Grade 3 separations do not heal and require the surgery, and the recovery from the surgery is longer and more painful (initially) than letting it heal without, and has all the associated risks. So the numbers are with you. But these are things to chat to the specialist about.

My shoulder healed wonderfully. No ongoing pain whatsoever. No disruption in Range of Movement or functional capacity. I go to the gym, play a bit of contact sport, ride; everything as normal.

I kept my arm in a sling for about 6 weeks (mainly because I went back to work about a week after the crash and people knew not to ask me to do anything too intensive) and by 8 weeks in I could use it as normal (minus the REALLY heavy lifting especially above your head) and started doing pushups and light resistance exercises.

I think I was recommended physio (I can't fully remember) but I know that I couldn't afford it at the time so left it out, but I don't think it made any difference to how it's healed. Not a bad idea to ask his/her opinion on this as well.

Ok, good to hear that surgery is not the only solution,
Only thing is my GP said that it will heal wick without surgery.
So I don't know, I guess I have to wait for the next Xray and see.

Thanks.

 

[Rem]

Your story is almost identical to mine. The ongoing mild pain for 3 months while the hook plate is in is really bad and instant releif once removed. I lived on panadeine forte and nurofen for 3 months, didnt leave the house without it. I even took up smoking a special 'herbal' remedy to get to sleep each night - only thing that worked!

Ok so I may start weeds obviously.....

:smokin:

 

[toofar22]

Jorge Lorenzo did wait 6 weeks on a broken collar bone...and it paid off...

http://www.bbc.co.uk/sport/0/motogp/23114301

These guys are made of tougher stuff than me.

 

[Rem]

Surgery or wait???

Back from my appointment, with pretty much the same position as before.
I did couple more X ray, saw a couple of guys, and they don't want to take position for surgery or not...
One guy said, yeah we may have to consider surgery, how to you feel about that? pretty good actually.
the other one, oh yeah but you can die from an operation, and there is no guaranty the op will be successful.
So they want to chat with the boss and a shoulder specialist and call me back tomorrow.

Now I'm lost completely, and don't know what to do at all.
I know the risk from the op, but it sound's like they are too busy for me and try to scare me up.

Anyways, if you guys have any comments, they are more than welcome.

Cheers.

 

[Ride_Guy]

I had a grade 3 and had hook plate put in and still have it in, shoulder has had some decent hits since then and its fine.

Doesnt give me any dramas day to day either with no restrictions of movement etc

My surgeon said I can have it out whenever I was ready but it doesnt have to come out, its not bothering me so I left it in, this was about 8 years ago now .

 

[Mywifesirrational]

Back from my appointment, with pretty much the same position as before.
I did couple more X ray, saw a couple of guys, and they don't want to take position for surgery or not...
One guy said, yeah we may have to consider surgery, how to you feel about that? pretty good actually.
the other one, oh yeah but you can die from an operation, and there is no guaranty the op will be successful.
So they want to chat with the boss and a shoulder specialist and call me back tomorrow.

Now I'm lost completely, and don't know what to do at all.
I know the risk from the op, but it sound's like they are too busy for me and try to scare me up.

Anyways, if you guys have any comments, they are more than welcome.

Cheers.

Well, from my experience working with surgeons, they always have time / will make time if the surgery is clearly needed.

The conundrum is in your case it sounds like your right in the middle, with it currently unclear if you need the surgery or will heal successfully without it. From my limited view on the matter it seems a good thing you have two surgeons consulting with the head of ortho, you going to get a answer from their combined experience and expertise.

Nothing unusual about asking about your views about having the OP, they always ask for the patients view on elective surgery, as some people really do or don't want to go through with it and it gives you the patient 'control' over the situation so to speak.

I would ask the surgeon/specialist if I was you if it hasn't been mentioned yet, if waiting to have the surgery (and see how it heals conservatively) will have any negative impact over having it ASAP. ultimately, it's your shoulder and your choice to have the OP, the surgeons are probably just trying to work out the best and safest outcome for you and give you enough info to make an informed decision.

I personally will never have surgery if it's not absolutely needed due to the risks of death, complications, infections... especially on a shoulder, seen to many that weren't ever going to get close to 100% (not that that may be a realistic goal in your case). It's definitely a stressful time, with the uncertainty hanging over you.

Just my ramblings while I wait for the lab to 'boot' up.