Piecing Things Together

A firefighter undergoes trauma surgery to repair a broken clavicle.

The risks associated with Cory Dugas’ love for extreme sports, including snowboarding and mountain biking, eventually caught up with him.Cory Dugas underwent trauma surgery to repair his collarbone at Advanced Orthopedic Center in Port Charlotte.

“I absolutely love the thrill I get from extreme sports,” Cory says. “It’s a rush like no other. I’ve been playing extreme sports ever since I was a teenager. I always thought I was invincible.”

Cory soon found out that wasn’t the case.

In March, he was thrown from his mountain bike after crashing into a tree during a ride in Ocala. He ended up breaking his collarbone – for the third time.

“I was doing some jumps on my bike, and I lost control and crashed. I actually hit a tree and was thrown from the bike,” Cory recalls. “The impact shattered the bone. I was in a lot of pain. My shoulder was swollen. I was a mess.”

After an emergency room visit to stabilize the break, Cory turned to a friend he knew could help.

“My friend’s dad is Dale Greenberg, MD, at Advanced Orthopedic Center,” Cory shares. “I called Dr. Greenberg and told him what had happened, and he referred me to his colleague,
Dr. Mlnarik, who specializes in trauma injuries. Since it was the third time I have broken my collarbone, surgery was definitely unavoidable.

“The first time I broke it, I was a teenager playing football, and the second time, I was in my early twenties, and I was snowboarding,” he adds.  “I’m kind of reckless, I suppose. But, I really love the thrill of extreme sports. I’m a risk taker.”

Only One Option

Cory immediately made an appointment at Advanced Orthopedic Center, where he met with Jason M. Mlnarik, DO, a board-certified orthopedic surgeon.

“Cory was in quite a bit of pain, and his shoulder was really swollen when he came into the office,” Dr. Mlnarik shares. “He had no ability to move his arm at that point because of the clavicle break. Based on the presentation of that fracture and the way the pieces of bone were malaligned, we scheduled him for surgery a few days later.”

Despite the name, the collarbone isn’t really in your neck, Dr. Mlnarik describes. Instead, it’s one of two long, thin bones that connect the breastbone to your shoulder blades. You can feel or see your collarbones toward the top of your chest, running beneath the top of your shoulders.

Dr. Mlnarik says that because Cory had suffered multiple clavicle breaks before, the surgery to repair was challenging.

“His particular fracture had more than two pieces to realign,” Dr. Mlnarik explains. “Through a four- to five-inch incision, I was able to realign those pieces of bone and hold them together with screws. I also placed a plate on top of the clavicle to further stabilize and hold the fracture aligned.

“In Cory’s situation, he was what I classify as a high-energy injury. He actually had a classic pattern that has been discussed in trauma literature called the Z-type fracture pattern. When you look at his x-rays, you can see the two main bone fragments are split apart, and there’s an extra piece of bone that actually sits in there that looks like the letter Z. This exact injury has been well documented in trauma literature.”

Dr. Mlnarik says the newer plates and hardware he uses conform much better to a person’s natural bone structure than ever before.

“The newer plates are now contoured and designed to fit most clavicles, either sitting on top of or sitting in the front, underneath the shelf of the bone,” he explains. “Overall, these new plates are much more comfortable for the patient and long-lasting.”

Surgical Advancements

A firefighter with the Englewood Fire Department, Cory was out of work for two months following the surgery.

“Typically, the recovery period is six to eight weeks, and that is also inclusive of non-weight-bearing activity,” Dr. Mlnarik explains. “Range of motion as far as moving the arm is tolerated and encouraged, but no weight-bearing activity is allowed. This meant, as a firefighter, he was unable to carry all of his equipment.

“At the six- to eight-week point, weight-bearing tolerance is usually dependent on the extent of the healing up to that point, but can range anywhere from fifteen to twenty pounds up to forty or fifty pounds.

“Cory actually pushed the envelope a little bit because he was doing so well and wanted to get back to work, so I allowed him to resume activity as tolerated once we got to the eight-week mark post-surgery. But, I am very pleased with how well and how fast he recovered, considering the extent of his break.”

Cory says his recovery time was quicker than he originally thought it would be.

Cory Dugas underwent trauma surgery to repair his collarbone at Advanced Orthopedic Center in Port Charlotte.

Cory shows a picture of his
broken collarbone.

“Initially, the recovery was painful, but as time went by, things got a lot easier and the pain subsided,” he describes. “Overall, the recovery was excellent. I was happy to be back at work sooner, rather than later.”

Extreme Limits

Dr. Mlnarik says it is unlikely Cory would suffer a fourth fracture in his lifetime, thanks to the surgical advancements available today.

“The force and the energy required to break that same bone again with the same intensity would be extremely rare,” he educates. “Anything is possible, but chances are he’s actually stronger in that area now than he was before because of the plate being there. I think the chances of any additional fractures are very slim, but not impossible.”

Cory says he’s not quite ready to give up his love for extreme sports, but says it may be time for him to take things a bit easier.

“I’m young and I still love it, and I know I can’t stay away, but I also have learned to be much more careful and not think I am invincible,” Cory shares. “I can have fun and still get that thrill, but I have to be safer about it.”

Cory says he is grateful for Dr. Mlnarik’s expertise and skill.

“He has a great bedside manner, and he is very knowledgeable about these kinds of traumatic injuries,” Cory says. “I was able to go back to work sooner than I had thought and resume my normal activities as well. I’m no longer afraid of breaking this bone again because I feel it is stronger than ever before.

  “I would recommend Dr. Mlnarik and Advanced Orthopedic Center to anyone with a traumatic injury without hesitation. They’re really awesome!”

FHCN article by Judy Wade. Photos by Fred Bellet. Graphics from istockphoto.com. mkb
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