Can I Get A Scapular Shave With My Shoulder Narrowing Surgery?
Q: Dr. Eppley, I recall originally he was using a single bracket instead of a double to support the clavicle, and I’m wondering if he might again use a single on mine instead on only the back of the clavicle to prevent any chance of the bracket showing through the skin. I know he mentioned this was a possibility and I’d love to minimize the aesthetic risk even if that means longer healing time.
“Scapular Shave” – could this be performed during my clavicle reduction procedure?
A: Clavicle fixation plates are applied to the top (superior) and front (anterior) portion of the clavicle. There is no way to ever place such plates on the back (posterior) part of the clavicle.
Of the superior and anterior plates the superior plate is the most important for structural support. This is also the plate location in which the risk of plate show exists. Thus going to a single plate fixation does not eliminate the risk of plate show.
In consideration of trying to reduce the risk of plate show options include; 1) using a lower profile siuperior plate (3.5 to 2.5mm) on top or 2) only plsce a 3.5mm anterior plate. Neither of these fixation techniques i have yet used so I can not speak as to their long -term, fixation stability in this application. The question is not whether they can be intraoperatively applied and have immediate stability but how do they resist any bone displacement weeks later.
As for scapular spine reduction (aka scapular shave) that can be performed at the same time as clavicle reduction osteotomies.
Dr. Barry Eppley
World-Renowned Plastic Surgeon