Da Vinci AWARD WINNER
For medical breakthrough in the treatment of a broken collarbone
(Nominated by icon of the shoulder world, Professor Angus Wallace)
Getting you back to sport sooner
Disappointed with only an arm sling after breaking your collarbone? You are right to be, a sling is not a treatment and represents a random hit or miss, benign do-nothing approach.
Ten years of working with icons of the shoulder world have helped bring about the development of this gilet. Our studies show that it can achieve the same successful outcomes as surgery.
HOW IT WORKS Using a gilet style design offers an ideal and more comfortable means to apply constant support at the shoulders without slipping upwards Quickly stabilises the fracture by holding it in the best possible position for healing Does not cut in at the underarms or interfere with blood supply to the arms Prevents rotation at the fracture site avoiding malunion (bad joining of the two broken ends) STOPS EXCRUCIATING NERVE PAIN - lifts the broken bone ends away from underlying nerves relieving pain and preventing the risk of nerve damage Reduces disturbance at the fracture site and provides an ideal healing environment to aid faster calcification (bone hardening) * Can also be used to stabilise and treat a broken shoulder blade [Scapula] and where applicable, reduces the pain of broken ribs. The gilet has resolved the problems of the traditionally prescribed 'figure of eight splint'. A Canadian study found that the splint pressed down onto the fracture and places pressure on underlying nerves as well as cuts up at the underarms restricting blood flow to the arms and causing tingling down the arms. And that it also rotates causing pressure at the back of the neck and is uncomfortable to wear. The principle of drawing the shoulders back to bring a broken clavicle out to length in this way was proved to be flawed.
WHY USE A GILET DESIGN?
Adopting a gilet design has overcome the problems of previous conservative clavicle fracture treatments
Removes any perceived stigma about wearing a brace
Airflow breathable fabrics have been used for continuous comfortable wear
Bacteria inhibiting properties allow the gilet to be worn 24/7 for several weeks without body odour.
A bit from Ian
Having had first-hand experience of Angel Med’s new ClaviBrace Orthopaedic Gilet, I am very excited by its potential which I believe can hold the answer to managing clavicle fractures non operatively.
For me it obeys the crucial principle of supporting the three pillars, or better stepping stones - namely the pelvis, spine and shoulder blades – upon which effective shoulder function ultimately depends and it delivers this in a way acceptable to the wearer.
This is still a medical brace, but components are cleverly concealed in an everyday-looking gilet and since long-term wear may be necessary, it avoids any feeling of self-consciousness.
Mr Ian Bayley
senior consultant orthopaedic surgeon
WHAT IS A BROKEN COLLARBONE
We have two collarbones each positioned at the front of either shoulder. A sharp blow to the shoulder area can result in one or both collarbones breaking.
Our collarbones connect at the sternum (breast bone) and the shoulder blade via joints and muscles. They are important in stabilising the shoulder during movement and protecting blood vessels and underlying nerves. Their consistancy is comparative to a rib which can heal in around ten days.
If you break your collarbone, in most cases there will be pain often excruciating pain as the broken bone touches down onto the nerve bed. You can expect to feel uncomfortable for 2-4 weeks. Swelling and tenderness at the collarbone area is a good indication of a break and it is common to feel crunching as the broken ends shift and touch eachother. Purple bruising will appear after several days and may spread across the shoulder to the arm.
Most people with this injury will not be able to lift their arm. It is important to keep the injured side elbow close-in to the body to avoid rotation at the fracture site. Any rotation can prolong healing leading to non-union [failure of the bone to join together], it may also result in the bone knitting together in a contorted fashion (malunion). The latter leading to muscle malfunction and future shoulder complications.
Pain can be excruciating. If you need to take pain medication avoid Ibuprofen as this inhibits new bone formation. Use paracetamol instead.
CONSEQUENCES OF IGNORING A COLLARBONE FRACTUREby surgeon Mr Ian Bayley
A broken collarbone conservatively managed using the routinely prescribed collar and cuff or shoulder arm sling or a figure of eight splint is not a treatment and can only be described as benign neglect of the broken bone. They do nothing to elongate the bone to its original length or encourage union of the two ends.
In many cases the bone heals shortened or fails to unite, or mal unites (malunion where the bone rotates and heals at a bad angle) all resulting in shoulder instability further down the line.
Those scenarios are a frequent cause of a condition called Scapular Dyskinesis (or winging scapula or shoulder blade malfunction).
Shortening of as little as one millimetre can throw additional strain on the shoulder blade and other elements in the kinetic chain such as spine and pelvis and predispose the patient to future discomfort and even injury.
The relationship between muscles and bone framework is altered with devastating effect. Muscles contrive to work abnormally, shoulder blades can 'wing' unnaturally outward and shoulders fall forward; all adversely affecting pelvic and spinal alignment. Posture is weakened and, if left unchecked, cause the stronger muscles to reverse roles and deploy weaker sets. Chronic or intense pain ensues with a life left compromised by an altogether avoidable condition.
Our understanding of shoulder problems has increased in the forty years of my involvement in the field. We have come to understand the importance of the shoulder blade, how commonly it is compromised, and how resistant to surgery it can be.
So how do we tackle such an important and potentially life-changing condition?
Scapula dyskinesia comes in varying degrees and can often go undiagnosed. It is a debilitating but not untreatable condition and we need to be able to treat all degrees of severity, not just the critical cases that come into my clinic.
One of the complications in treating the condition is the lack in the scapular (shoulder blade) of good mechanoreceptors - sensory receptors that rapidly transmit sensory information to the brain and the means by which the brain senses the position of shoulder joints/scapula.
Patients simply don't know if their scapula is winging, added to which the brain readily accepts the abnormal movement as normal.
For the vast majority of patients, physiotherapy is the first line of combat. In many cases, again for the majority, corrective exercise alone does not solve the problem. With surgery very much a last resort and no promise of success, patients are often left disappointed and in despair.
We need new ways to tackle this condition. Having had first-hand experience of Angel Med’s new ClaviBrace Orthopaedic Gilet, I am very excited by its potential which I believe can hold the answer.
For me it obeys the crucial principle of supporting the three pillars, or better stepping stones - namely the pelvis, spine and shoulder blades – upon which effective shoulder function ultimately depends and it delivers this in a way acceptable to the wearer.
This is still a medical brace, but components are cleverly concealed in an everyday-looking gilet and since long-term wear may be necessary, it avoids any feeling of self-consciousness.
Mr Ian Bayley is a senior consultant orthopaedic surgeon with a busy clinical practice in shoulder surgery on Harley Street and has worked within BMI and The Circle Health Group.
He was appointed to open and direct the Spinal Injuries Unit at the Royal National Orthopaedic Hospital Stanmore in 1980 and to direct and develop the complex Shoulder Surgery Unit.
He also took on the role of National Clinical Chair of the NHS Orthopaedic Services collaborative and various subsequent service redevelopment roles on the national stage. His experience is therefore based firmly at “the coal face” of clinical practice and spans the whole medical spectrum from acute care through rehabilitation to community reintegration, combined with service redesign and delivery.
He is a member of the British Elbow & Shoulder Surgeons, British Orthopaedic Association and the European Shoulder & Elbow Society.
His clinical interest is in complex pain states, instability, rotator cuff pathology, primary and revision shoulder replacement.
FACTS ABOUT SURGERY
All surgery poses risk and should be used as a last resort.
Weighing up surgery against a bad natural outcome has led to a surge in surgical procedures with the idea that surgery is best.
PLATING SURGERY
A collarbone shaped piece of metal is fixed over the broken bone and is held in place with up to nine screws
It takes six months for the screws to consolidate and a further year to heal solidly enough to go back to high impact sports.
OTHER FACTORS TO CONSIDER
Not all plating surgery is successful
You will have a scar
Rejection of metal-ware
Screws may loosen causing the plate to fail
The area of plating can be left numb
It takes a full year, from initial plating surgery, to heal and a further year if you decide to have the plate removed
A recent American study has shown that after shoulder surgery, the brain can disconnect from that area, causing the shoulder to malfunction
THE PROCEDURE TO REMOVE A COLLARBONE [CLAVICLE] PLATE TAKES AROUND 35 MINUTES UNDER GENERAL ANSAESTHETIC.
After the plate has been removed the screw holes need time to fill-in. Those holes are lined up and can re-fracture like a zipper opening making the collarbone highly unstable for 6-8 weeks.
It takes a good six months for the collarbone to heal properly and during this time, raising your arm above your head or lifting should be avoided. There are no guides on a safe lifting weight and much depends on individual circumstances
It takes a full year to heal completely and it is important during this time, not to fall or knock that shoulder.
There are mixed opinions about removing a plate. The simple rule is, if you want to return to high-impact sports activities, have it removed.
RISKS OF REMOVAL
The bone re-breaks easily along the line of screw holes causing the bone to arch upwards forming a protrusion just under the skin
RISKS OF KEEPING THE PLATE IN
With impact, the collarbone breaks beyond the plate causing a more serious and difficult-to-treat fracture than the original
Future impact could send the metal plate into the neck
Straps rub at the area of the plate
Some feel the shoulder constantly cold
Choosing ClaviBrace®, removes surgical plating risks without compromising on best outcome. Healing time is faster and bone union stronger.
Icons of shoulder surgery
In 2010 Professor Angus Wallace nominated ClaviBrace® for a Da Vinci award which it won for Medical Breakthrough in the treatment of collarbone fractures. He had hit the headlines previously for treating a woman on a flight with a coat hanger, and became known as 'Coat hanger Wallace'. He operated on Wayne Rooney in 2006. He went on to developed the brace position after researching injuries in 1989's Kegworth air crash.
Professor Wallace was awarded his Honorary Fellowship at the Royal College of Physicians in London on 28 September 2017 in recognition of his 30 years contribution to the Specialty of Sport & Exercise Medicine.
Professor Wallace and Professor Moran were invited by the England FA to provide an expert medical opinion on the fitness of Wayne Rooney to play in the World Cup.
Both consultants work at Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus (QMC), and both are professors appointed by the University of Nottingham.
QMC is the biggest trauma centre in England and treats over 16,000 fractures per year.
Professor Wallace was invited because of his extensive knowledge of both orthopaedic surgery and sports medicine - he has been a consultant orthopaedic surgeon for 22 years working as a consultant trauma surgeon from 1984 to 1996.
In addition he has been actively involved in sports medicine for over 16 years and has an in-depth understanding of rehabilitation and fitness loss in relation to sportsmen.
Professor Angus Wallace
Mr Ian Bayley is a senior consultant orthopaedic surgeon with BMI Hospitals and a busy practice at 6 Harley Street, London.
Mr Bayley was appointed to develop the Spinal Injuries Unit at the Royal National Orthopaedic Hospital Stanmore in 1980 and to direct and develop the Complex Shoulder Surgery Unit.
He also took on the role of National Clinical Chair of the NHS Orthopaedic Services collaborative and various subsequent service redevelopment roles on the national stage.
His experience is therefore based firmly at “the coal face” of clinical practice and spans the whole medical spectrum from acute care through rehabilitation to community reintegration, combined with service redesign and delivery.
He is a member of the British Elbow & Shoulder Surgeons, British Orthopaedic Association and the European Shoulder & Elbow Society.
His clinical interest is in complex pain states, shoulder instability, rotator cuff pathology, primary and revision shoulder replacement.
Mr Ian Bayley
Team Members
Mr Ian Bailey
FRCS
Consultant Orthopaedic Surgeon
Mr Rupen Dattani
BSc(Hons), MBChB, MRCSEd, MD, FRCSEd(Tr&Orth)
Consultant Orthopaedic Surgeon
Mr Tariq Zaman
MBChB, FRCS (Orth)
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Marin Julia
ART DIRECTOR
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How the service works and treatment plan
Insert clemi video here as a breif overview of care plan included (time frame)
Tina's Story
Tina chose to have her fracture plated and was advised by her surgeon to stay in an arm sling for eight weeks. With pressure from horse owners to compete and a business to run, she wore ClaviBrace and upperarm gaiter combination and competed three horses safely, four weeks sooner than would normally have been possible.
Wearing the combination ensured that her collarbone, not only broken but made fragile, with eight screws inserted to hold the plate, gave Tina the confidence and security to compete sooner.
Stage 5 Performance Coach in Complete Horsemanship,
UKCC Level 3, Centre 10 Adv Coach, Challenge Awards Trainer
Professional Event Rider & Coach
Lecturer Nottingham Trent University
Owner of Tinderbox Sport Horses
Tina has run Tinderbox Sport Horses, from her base near Newark for the last 28 years. She is a highly qualified coach (BHSI), eventing up to three-star level.
Her role as university lecturer at Nottingham Trent University, has instilled the importance of innovation and the rigorous research needed to back up new design.
Her talent in post breaking, training and preparation for young horse classes is matched by her enthusiasm for teaching and is the stimulus behind her involvement in developing innovative products for both horse and rider.
Clavicular Gilet Testimonials
The Clavicular Gilet (Formerly known as ClaviBrace) goes to the Olympics
James Tune wouldn't have made it to the Olympics without wearing a Clavicular Gilet.
He broke both his right and left collarbone after hitting a tree in a freak mountain biking accident. The retailing specialist was advised by his medical consultant, not to use his hard fought-for swimming event ticket at London 2012 Olympics.
Despite this warning there was good news for James. After being fitted with a Clavicular Gilet he felt sufficiently protected and pain-free to venture into the Stratford crowds.
With his left collarbone in three pieces and his right side a so-called 'rugby fracture', he, like most others, had left hospital with two standard gauze slings which increasing put painful pressure on his neck.
He made his date with the altar getting married three days later, and his physio aunt made him another important date soon afterwards - to have a Clavicular Gilet fitted.
"It really helped me out. Initially it felt a bit sore but that all went in about 15 minutes. It was a massive relief to have the brace on with the two slings. It felt solid and secure."
Surgery - with a difference
Richard Walsh
When Richard Walsh’s doctors heard about his broken collarbone, they seized on the chance to treat him at their surgery by fitting a Clavicular Gilet.
Their patient had been the victim of a hit and run accident when out for a routine cycle ride, waking up in hospital with no memory of what had happened but nursing a potential bleed in his skull, cuts and bruises and a painful fracture.
'‘My doctors rarely see a fresh collarbone fracture and were keen to see how Clavicular Gilet could help. I wore it 24/7 for three weeks and then went to them every week for minor adjustments."
“Clinically I think it’s very good, I have been very comfortable in it, and eight weeks in, I have got full function in my shoulder."
“Like most people I knew little of collarbone fracture treatments before I did this, and have been I amazed that there is really nothing between a thin piece of gauze round the neck and invasive surgery.”
Michael Smith, Olympia, Washington USA
When my son Nathan fractured his left clavicle in a mountain biking accident, we were so disappointed in his emergency room treatment that we immediately began researching alternate treatment methods. We quickly decided that the invasiveness of surgery was not the option we wanted to pursue, especially bearing in mind the implications of longer term recovery and possible second surgery to remove the hardware from his body.
We were so excited when we found the Clavicular Gilet as the perfect non-surgical option for Nathan's clavicle fracture treatment. The Clavicular Gilet provided the comfort and support he needed to open his fracture site, reducing the pain and discomfort and accelerating his recovery. So much so, our orthopedic physician said his fracture healed more than a month faster than he had seen in similar patients. We’re so thankful to have found the Clavicular Gilet and have recommended it to friends and family who had the misfortune of experiencing their own clavicle fractures. I highly recommend the Clavicular Gilet for those wishing to avoid a surgical option.
Jack Pike
When I broke my collarbone skiing in Italy it was not only excruciatingly painful but apparently inoperable!
I’m 22yrs old, a physically fit person and had never broken my collarbone before. I had a bad fall on the slopes and was taken to hospital where they fixed me up with a figure of eight brace. I was in excruciating pain and had to sleep the last night in Italy before flying home. The hospital brace cut into my shoulders and pressed against my broken bone. It was agony!!! I was unable to get myself out of bed and dress myself and was completely dependent on my friends to physically support me as I could barely move.
Once I landed back in the UK, I had heard about the Clavicular Gilet and wanted to purchase one ASAP. The brace was fitted onto me within two days and the pain relief was so instant it was unbelievable! The Clavicular Gilet supported me in such a comfortable way. I couldn’t feel the bone crunching - unlike before. I was able to move properly, sleep and shortly go back to work. A few weeks later I went back to hospital for a CT scan and they were able to give me the all clear as the scan showed a perfect union. Before I tried a Clavicular Gilet, my first CT scan showed that my collarbone was broken at the sternum end - a medial third fracture - which - I’m told – is very rare and inoperable.
I felt safe in the brace and my mind was put to rest. The consultant was right when he said “the brace was my best chance” because of where the fracture was. I can’t imagine going through the past few weeks without a Clavicular Gilet.
Chris - 1st Whip with Belvoir Foxhounds
I broke my collarbone out hunting when my horse fell, and was back on a horse and hunting hounds again three weeks later. The hospital said I needed an operation to fix it, but it was in the middle of the hunting season and, as1st whip with the Belvoir Hunt; I didn't want to take time off.
As soon as Clavicular Gilet was fitted, I felt a lot more comfortable and the pain went away soon after. Although I couldn’t ride, the brace gave me confidence around the yard and horses and to get about more easily. After a week I was able to follow the hunt in the Land Rover and didn’t need to take pain killers.
Even though the consultant told me that my fracture was serious (5mm displacement and button-holed), and surgery was my best option. I kept on with the brace. My final X-ray at three weeks showed the collarbone had formed new bone and had healed nicely to its original length without surgery. Great result, thanks.
fitting video and faqs
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Can you use for jewlery and resin crafting??
As long as the pieces are small, yes. I use it for nails and for resin. -
Is there a sunuv uv, led & nail blower combined?
There is something about parenthood that gives us a sense of history and a deeply rooted desire to send on into the next generation the great things we have discovered about life. And part of that is the desire to instill in our children the love of science, of learning. -
How will I know that my order was eccepted?
There is something about parenthood that gives us a sense of history and a deeply rooted desire to send on into the next generation the great things we have discovered about life. And part of that is the desire to instill in our children the love of science, of learning. -
How long does shipping take, and how much will it cost me?
There is something about parenthood that gives us a sense of history and a deeply rooted desire to send on into the next generation the great things we have discovered about life. And part of that is the desire to instill in our children the love of science, of learning. -
Where does it come from?
There is something about parenthood that gives us a sense of history and a deeply rooted desire to send on into the next generation the great things we have discovered about life. And part of that is the desire to instill in our children the love of science, of learning.
© 2022
Clavicular Gilet Versus Surgery
Clavicular Gilet
Union
Independence, Carry on training. Return to sport in approx 3-8 weeks.
Naturally lengthens a shortened collarbone to original length
No scar
Possibility of resistance to wearing a close contact device
Stronger mending, less chance of complications if broken again
No need for general anaesthetic and potential side effects
No hospital stay - no risk of contracting infection No need for surgery to remove the metal plate
Ability to get on with life during convalescence
Independence, Carry on training. Return to sport in approx 3-8 weeks.
Naturally lengthens a shortened collarbone to original length
No scar
Removes pain as soon as fitted - minimal use of pain medication, no antibiotics
Possibility of resistance to wearing a close contact device
Stronger mending, less chance of complications if broken again
No need for general anaesthetic and potential side effects
No hospital stay - no risk of contracting infection No need for surgery to remove the metal plate
Ability to get on with life during convalescence
Surgery
Union
Similar healing time. Return to sport in approx 3-8 weeks.
Further downtime to remove plate.
Uses a metal plate to obtain original length
Scar
Medication and antibiotics
Possibility of plate rejection or failure
Risk of future impact causing a more difficult to treat fracture at one or either end of the plate
Potential for rupturing blood vessel and bleed into the chest cavity (minimal risk)
Possible infection into the chest cavity (minimal risk)
Surgery to remove a metal plate and further convalescence
6-8wks convalescence and potentially disrupting the plate