Can Clavicle Lengthening Be Done As Much As 3.5cms Per Side?
Q: Dr. Eppley, One surgery I’m very interested in is clavicle lengthening. I’ve been told the common amount of lengthening is close to an inch per clavicle, but I’ve also read more can be done. Is it possible to lengthen each side by 1.5 inches/3.5cms? I’d love to get this surgery but I want the best possible result. I have very narrow shoulders to where my arms roll in.
A: Clavicle lengthening is very different than clavicle reduction. Collapsing the length of the clavicle is more structurally stable and has a virtually 100% rate of solid bony union because of the two blunt cut ends compressed against each other, almost regardless of the length of bone removed. Such solid bony consolidation also occurs quickly in the 6 to 8 week time period.
Conversely in clavicle lengthening a bone gap is created which, although an interpositional bone graft is placed, is more structurally unstable. It requires a long period of bone growth to occur through the graft and across the bone gap created until solid bony consolidation occurs. This is in the 12 week range of healing. Thus one must be very careful about how much lengthening (width of the bony gap) that is created. While in clavicle reduction an extra .5 or 1.0cm is not that consequential, in clavicle lengthening it is. I would not push that gap past 2.5cm or one inch per side to avoid the risk of a non-union.
Dr. Barry Eppley