Can Non-Bone Graft Clavicle Lengthening Be Done?

Q: Dr. Eppley, I have been looking up on your clavicle lengthening procedure online and am seriously considering it. I am a 22 year old man with very short clavicles and your procedure is the only hope I have left regarding my shoulders. I am have been working out for many years and my narrow chest always disheartened me. I had a couple questions regarding the procedure. 

1) Is is possible to undergo non-bone graft clavicle lengthening and lengthen the clavicle by >= 2 cm? I read from your blog that with the diagonal cut pattern the max is 1.8 cm but with the modified sagittal split it is possible to get more. 

2) If the bone-grafting technique is chosen and when the donor bone extracted from the leg, how long does it take for the leg to heal? Also, how big is the chunk of bone taken from the leg? Is the leg bone completely split into two? 

3) How long after the surgery are patients allowed to go home? How long after the surgery can the patients perform activities like raising the arm, etc. 

4) I want to take the plates out in the future after the recovery is complete. However, I am unsure if I will be in the united states at the time. Is it safe to go to other orthopedic doctors to remove the plates? 

5) How much do you expect the surgery would cost. Around $50,000? Around 100,000? More? I am hoping to save up for this and wanted to know how long it would take for me to be able to afford it. 

Thank you so much for taking your time to read this. It would mean so much for me to finally be able to work with you in the future regarding this procedure.

A: In answer to your shoulder widening/clavicle lengthening surgery questions:

1) My current method of shoulder widening is a lengthening osteotomy of the clavicle which doesn’t use a bone graft.

2) While a bone graft is not used as described in #1, taking a 5 cm long segment of the fibula does not require it to heal by regenerating bone. The fibula bone does not need to be intact for walking or running.

3) One can go home after the surgery when they are physically able to travel. That is influenced by a variety of factors including are they here by themselves, how are they getting home, where is home etc. But as a general rule 5 to 7 days is typical.

4) An orthopedic surgeon would be able to remove the hardware secondarily.

5) My assistant Camille will provide the cost of the surgery to you.

Dr. Barry Eppley

Indianapolis, Indiana