Will Clavicle Lengthening Cause Loss Of Arm Motion and Function?

Q: Dr. Eppley, I am scheduled to have clavicle lengthening surgery next month. I wanted to ask about the possibility of permanent loss of motion and function in my arms. An orthopedic surgeon friend recently warned us against this surgery, stating “this does not ‘simply make your shoulders wider’–it  permanently rotates your shoulders into an abnormal position and you will loose motion and function.

A:Thank you for your question. In my experience that statement by the orthopedic surgeon is unfounded. That might be true if the clavicles were significantly lengthened by many inches per side, which I doubt that would happen even then, but that is not the amount of lengthening which can be done. I don’t know the basis of the orthopedic surgeon’s statement but unless he has done the actual surgery and seen that happen that is a conjecture and not a documented outcome.

Rather than that expressed concern the real potential complications of the surgery are nonunion of the lengthened bone, hardware loosening, and secondary surgery for these potential problems. Clavicle lengthening is very different from clavicle reduction due to the limitations the soft tissues of the shoulder. Thus the gains to be had, with a low risk of potential complications, is not to try to do too much lengthening. This means keeping  the lengthening per side 2 cm or less based on how much the soft tissues of the shoulder will allow the bone to be lengthened. I suspect the basis of the orthopedic surgeon’s comments come from the  belief that much more clavicle  lengthening can be accomplished then what can actually be done.

Dr. Barry Eppley

World-Renowned Plastic Surgeon