Men's Sports

Sports Docs Weekly Blitz: Collarbones and clavicles

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Many years ago….

This was going to be the perfect Saturday morning for a third grade boy. First, a tasty breakfast of Wheaties (breakfast of champions!) to prepare for a neighborhood football game followed by a quick clean up.

Then, a bike ride on my new Schwinn 5-speed to Clyde Williams Stadium for a key matchup between Iowa State and those Missouri Tigers. I wondered how many leaping touchdowns Eppie Barny would make. Dad had scored knot-hole tickets for brother Stew and me. Those Cyclones will look sharp in their gold pants and cardinal jerseys.

After the game, we will sneak into State Gym and snarf more than our share of doughnuts put out for the big donors. Game day was a big deal and the crisp October air and blue skies portended an epic day.

I remember the instant like it was yesterday. Steve Larson, Carl Schaller and I were playing football in Steve’s front yard. Carl and I were big 8 year olds and Steve a diminutive 7 year old. Steve caught a pass and was heading to the goal line near the garden bush when Carl and I tackled him. Our combined weight of 100 pounds landed on Steve’s body driving his right shoulder into the ground. We heard a twig snap, or so we thought. Steve winced in pain and took himself out of the game. Of course the rest of us kept playing.

Later, we found out that his parents took him to the doctor where x-rays showed a collarbone fracture. Carl and I felt horrible. We didn’t mean any harm and…… heck, no flag was thrown. But gosh, we had never broke someone’s bone before. Steve sported a figure of eight brace for a few weeks and before we knew it, he was back in form, faster and quicker than ever.

I remember thinking, ‘How in the heck did this happen? All we did was land on the guy.’

Heck, we’ve been “piling on” in schoolyard ball forever and nothing ever happened.

It took me a few decades to understand how collarbone fractures occur. They almost never occur from a direct blow. Instead, it is a huge force delivered to the side of the shoulder and usually it is when a body lands on the ground with the shoulder driven into the ground. (See illustration)

As a seven year old, Steve probably sustained a simple clavicle fracture. The periosteum of a young child is thick and strong. Frequently the bone cracks and may angulate, but the ends rarely separate. With a strong external layer, the bone heals rapidly and accurately.

Football players wear shoulder pads to try to protect them from clavicle fractures. The shoulder pads act as an external strut to absorb the blows and hits in the sport. Sometimes they are not enough, especially for QB’s who wear small versions to allow for greater shoulder mobility.

As an adult, clavicle fractures often displace and snap into multiple pieces. It is true that almost all clavicle fractures will heal and function reasonably well no matter what the treatment is. That is, if you have time to let them heal before sports stress occurs again. In general, orthopedists let these fractures heal ‘as is’.

But in Aaron Rodgers’ case, if he has any chance of playing this year, his fractured clavicle needed surgery to realign the bone and hold it with a plate and screws. This allows for earlier return to function. Otherwise, the bone would have an unacceptably high chance of re-fracture. I am not saying that Aaron will play again this season. Details of the fracture are not known, but the Packers coaching staff sure want him back for the playoffs.

Adrian Peterson broke his clavicle in the 4th quarter playing against the Cyclones in Norman back in the day. He opted not to have surgery and by the next summer and the ensuing NFL season, he did just fine. So surgery is reserved for severely displaced and shortened clavicle fractures. Or if you are a highly paid and key professional athlete who wants the quickest return to activity. Surgery has its own special potential complications: infection, nerve or blood vessel trauma and significant chance for later surgery to take out an annoying piece of hardware on your prominent collarbone.

Let’s hope Cyclone shoulder pads do their job this weekend.

Onto Lubbock!

Dr. Peter Buck

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