Tony Romo and the cracked collarbone

Dallas Cowboys quarterback Tony Romo will not need surgery to repair a broken collarbone he sustained in Sunday’s game against the Giants. Romo was injured in the second quarter when he was hit by Giants linebacker Michael Boley during a blitz.  According to Romo: “I tried lifting my shoulder and it hurt like heck, but I was like, ‘OK, it will just keep getting better’ …The adrenaline of the game will allow me to [play], it’s my left shoulder, I don’t need to use it too much. I will figure out a way what I can handle when I’m out there, but that was before I knew it was broken.”

Coach Wade Phillips reported that, although a CT scan showed that surgery is unnecessary, that Romo will need to be out for six to eight weeks.

Left: Normal shoulder  Above: Left clavicle fracture

The collarbone, also called the clavicle, is considered part of the shoulder, connecting the arm to the body. 80% of clavicle fractures occur in the middle third of the collarbone.
Although several important blood vessels and nerves lie underneath the clavicle, they are rarely injured when the clavicle is fractured. Common causes of a fractured clavicle include falls onto a shoulder, sports injuries and trauma from traffic accidents.Newborns are also at risk of clavicle fracture while squeezing through the birth canal.

Symptoms of a clavicle fracture include:

  • Sagging shoulder (down and forward)
  • Inability to lift the arm because of pain
  • A grinding sensation if an attempt is made to raise the arm
  • A deformity or “bump” over the fracture site

Most broken collarbones heal well without surgery. A simple arm sling can usually be used to immobilize the arm. A child may have to wear the sling for 3 to 4 weeks; an adult may have to wear it for 6 to 8 weeks. Depending on the location of the break, a physician may apply a figure-of-eight strap to help maintain shoulder position.

Analgesics such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory medications, such as naproxen or ibuprofen (Alleve or Advil/Motrin), will help reduce pain.

For more information, click here to go to the Resounding Health Casebook on clavicle fractures.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

1 Comment

  1. Greta Shwachman

    September 23, 2014 at 9:23 am

    The Diagnostic Power of Images

    Most of us take for granted the images of the human body that we see on a daily basis—a doctor holding an x-ray scan on a soap opera, the classic case of animated mucus playing house in your lungs (see Mucinex commercial), a skeleton costume at a Halloween party, etc.—but these images are powerful, and they have important implications for how patients and physicians approach the diagnosis and treatment of certain medical conditions. Over the past half-century, the medical world has charged full steam ahead with the process of visualization in health care. The transition from the use of other senses (touch, hearing, smell) to primarily sight was driven by the ever-present mission to achieve the highest possible standards of objectivity in medicine. The common line of thought is that doctors are human and thus embody subjectivity, while imaging technologies are machines and are therefore capable of delivering objective truths about the state of the human body.

    I was at a loss as to how to tie the topic of images and objectivity to celebrities when I came across a particular quote in last week’s reading—a chapter on “The Body as Image” written by Kelly Joyce. In this chapter, Joyce discusses the increasing visualization of medicine, and in particular addresses the scientific, social, and economic dimensions of Magnetic Resonance Imaging (MRI). The quote that grabbed my attention reads: “Stories that link sports stars’ diagnosis and recovery to the use of MRIs also help legitimize MRI examinations in the public eye” (Joyce 201). With the relationship of celebrity athlete and imaging technology in mind, I took to the Celebrity Diagnosis archives, and dug up this gem back from October 2010: “Tony Romo and the cracked collarbone.” While this is not a recent article, I think it is important to discuss because it represents the archetypal sports injury story that we continue to see in the news on a daily basis. What legitimizes sports injuries and determines whether or not our favorite players will be hitting the field or court again any time soon is the image—the visual proof that something is “broken” inside of the body. In the above story, Romo describes the pain of his injury, but there is still a sense of uncertainty before he knows for sure that his shoulder is broken. This is where the image comes in—it is crucial to knowing, to certainty, to making an objective and accurate diagnosis and determining a course of treatment and recovery. In the case of Romo, the “CT scan showed that surgery [was] unnecessary.” The wording here is reflective of the diagnostic authority of the image—it is not a doctor that determines the necessity of surgery but rather an image.

    Of course, doctors haven’t been entirely replaced by machines—rather a new type of diagnostic interaction has emerged with three participants: the doctor, the patient, and the image. This interaction can be visualized as a triangle, with information shared by each participant leading to an overall diagnosis and course of treatment.

    High profile sports injuries that publicly acknowledge the diagnostic role of the image—such as Romo’s cracked collarbone—serve as advertisements of this new model, which has become increasingly common in today’s biomedicalized world. Patients who experience similar injuries (i.e. broken bones) are primed to expect imaging technology to play a key role in their medical interactions. In many cases the image is taken not as a last resort, but as a first step in the diagnostic process.

    Sources:
    Boguski, Mark. “Tony Romo and the cracked collarbone.” Celebrity Diagnosis, 27 Oct 2010.
    Web. 19 Sept 2014.
    Joyce, Kelly. “The Body as Image: An Examination of the Economic and Political Dynamics of
    Magnetic Resonance Imaging and the Construction of Diffeence.” Biomedicalization: Technoscience, Health and Illness in the United States. Ed. Adele Clarke et al. Durham, NC: Duke University Press, 2010. 197-212. Print.

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