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October 2nd, 2012

Cycling and Clavicle Fractures

A few years ago, running for exercise was getting a little boring so I bought a bike. I was very nervous about being able to get in and out of the clipless pedals without falling over. I fell over spectacularly in my driveway on one of my first rides confirming my fears. Fortunately, I did master the pedals and began going out for rides.

It seemed like I wasn’t the only one to discover the joy of bicycling. I didn’t just see lots of people out on the road but I started seeing many patients who had crashed their bikes. One of the most common injuries I treat from cycling is a clavicle fracture.

The treatment of clavicle fractures has changed dramatically in the past 15 years. Prior to that time, nearly all fractures were treated without surgery and were thought to do well. However, several fracture patterns emerged that were found to have less predictable healing. Also, there was evidence that excessive shortening of the clavicle fractures could affect shoulder function.

Most clavicle fractures are still treated without surgery. However, when a cyclist going 20-25 MPH lands on his/her shoulder, a high energy injury occurs. Very often the clavicle fracture is widely displaced, shortened, and with many fragments. These are the characteristics of clavicle fractures that may heal better with surgery.

So be careful out there on your bikes. Stay alert for obstacles and other riders. And of course, practice getting out of your clips before you hit the road.