Nicholas K. Sablan, M.D.

Clavicle Fracture Repair

Post Operative Instructions after Clavicle Fracture Repair Helpful Hints & Important Precautions for Patients

Diet

Medications:

Before surgery you will be offered a nerve block which helps greatly with pain control and decreases your need to take narcotic medications. It is important to begin taking your pain pills before this medicine wears off to minimize the rebound pain. Pain levels 5-7 out of 10 are typical in the first few days after clavicle surgery.
The first medication I use is Percocet (Oxycodone/Acetominophen) which is a strong narcotic pain medication combined with Tylenol. It will begin to work within 15 minutes after taking it with a maximal effect in one to two hours. Normally, Percocet is taken every 6 hours but if the pain is severe, it can be used every 4 hours.
Common side effects of these medications are nausea, constipation, itching, and drowsiness.

The best way to prevent nausea is to take the medicine with a little food, start with just one pill, and be patient while the medicine begins to work. Usually, after the first few doses, the nausea will go away. I also prescribe an anti-nausea medication called Zofran (Ondansetron) to be taken if you have persistent nausea after surgery.
I strongly recommend you take an over-the-counter stool softener such as Colace 100 mg 1 tablet a day and a laxative such as Sennokot DS 1 tablet a day to avoid constipation.
Take Benadryl one-half hour before your narcotic if you experience itching.
You will be given a prescription anti-inflammatory called Naproxen (Naprosyn) to take for thirty days. This will help with pain and swelling. Do not take if you have a history of stomach ulcers or kidney dysfunction.

Transition from Percocet to Tylenol as your pain subsides, but pay attention to the dosage, as Percocet has 325 mg of Tylenol in each pill. Patients with normal liver function should not consume more than 3000 mg of Tylenol per day.

Bandages & Sling:

Your post-operative dressing has two layers you need to understand to care for your surgery site properly. Your incisions were closed with absorbable stitches covered by steri-strips
The second layer is a large white fluffy dressing and absorbent pads that are held in place with tape.
Unless directed otherwise, remove this second layer of dressing 2 days after surgery and place an Aquacel dressing or a sterile dressing over the steri-strips.

Washing & Sling:

You should be careful to keep the wound clean and dry for the first 48 hours after surgery.
Beginning on the second day after surgery it is OK to shower as long as the incisions are kept dry with plastic wrap or the Aquacel dressing. Remove the wrap after showering.
Do not take a bath until after the first post-operative visit.
It is OK to go into a swimming pool after the first post-operative visit, but no lakes or ocean until two weeks after surgery.
You will have a sling with a supporting pillow placed after surgery. The only time you are allowed to remove it is during showering.

Ice & Activity:

One important goal following surgery is to minimize swelling around your surgery site. The best way to achieve this is with the frequent application of ice. This is most important the first 48 hours following surgery. The ice pack should be large (like a big zip-lock bag or bag of peas) and held firmly on the area of your surgery. Apply for 15 minutes every hour while awake if possible. Look for signs of frost-bite.
Keep your elbow against the pillow and in front of the plane of the body to avoid stress on the repair
Keep a pillow behind the elbow while lying down to prevent the elbow from sliding backward.
While sitting in a chair you may remove the sling three times a day to perform elbow and wrist range of motion exercises.
You may return to sedentary work only or school in 3-4 days after surgery if your pain is tolerable.