Would A Prior Shoulder Joint Injury Or Arthritis Prevent A Clavicle Lengthening Procedure To Heal Properly?
Q: Dr. Eppley, I hope you are well. I have a few questions regarding the clavicle lengthening procedure I have scheduled with you in June and was hoping you’d be able to help.
The first thing is regarding a potential complication. It appears I may have either a Type 1 or Type 2 acromioclavicular joint injury (I’ll attach pictures). I don’t recall any particular trauma, and it may have just been caused from weightlifting over time, or by something that I didn’t think was painful enough to seek out medical attention or suspect an injury. Either way, this was taken a few months ago and it appears to be the same (no further healing). From what I’ve read (but I may be incorrect of course), it seems that if a few months has passed and the injury persists, it likely will not heal on it’s own. I’m curious if you think this is any reason to be concerned when planning lengthening of the clavicles.
Although it is not causing me trouble now, I’m not sure if it may need to be corrected by surgery if it gets worse (or possibly now to prevent it from getting worse). If you think clavicle lengthening is still feasible, would you think it may cause any complications to a potential A/C joint repair in the future? I ask because I wonder if this is something best corrected now, or if it can probably wait until later (if needed at all) after a recovery from clavicle lengthening. I just wanted to make you aware of this before my X-rays the day before surgery, and to get your opinion.
The second question is regarding exercises and preparation for surgery. Since the lengthening procedure will stretch some muscles, I would imagine it would be beneficial to stretch affected muscles as much as possible beforehand. Would you think this is a good idea, and if so, would you be able to provide a list of muscles that I should be stretching?
Thank you for your time and insight.
A: In answer to your questions:
1) I am not an AC joint authority but I don’t see the correlation between a lengthening osteotomy done on the inner third of the clavicle to whatever injury exists at the distant outer joint. The clavicle bone is of good bone stock so I see no reason why it would have any trouble healing.
2) The reverse question seems more pertinent….how does a lengthened clavicle affect an injury at the AC joint? That is a question outside my field of knowledge but I would think important to know. This would have to be answered by an Orthopedic Shoulder Surgery specialist.
3) I would certainly see no harm in any shoulder strengthening or stretching exercises before surgery…although I can say they are absolutely essential. The amount of clavicle lengthening achieved in the surgery is not going to be limited by the natural flexibility of the tissues. But I think it is always a good idea to ‘train’ for body surgery almost regardless of what that surgery is.
Dr. Barry Eppley