why is cutting the clavicle bad

2 min read 28-02-2025

The clavicle, or collarbone, is a vital bone connecting the shoulder blade (scapula) to the sternum (breastbone). While rare, there are circumstances where a portion or all of the clavicle may need surgical removal (cleidectomy). However, this procedure is far from benign and carries significant risks and complications. Understanding these risks is crucial before considering such a drastic measure.

The Crucial Role of the Clavicle

Before delving into the dangers of clavicle removal, it's important to understand the bone's critical functions:

Shoulder Stability: The clavicle provides significant structural support to the shoulder joint. It acts as a strut, preventing excessive movement and dislocation.
Range of Motion: It plays a crucial role in allowing for a full range of motion in the shoulder and arm.
Force Distribution: The clavicle helps distribute forces from the arm to the axial skeleton (trunk). This protects the shoulder joint from excessive stress.
Protection of Neurovascular Structures: The clavicle partially shields the brachial plexus (nerves supplying the arm) and subclavian vessels (blood vessels supplying the arm).

Risks and Complications of Clavicle Removal

Removing even a portion of the clavicle significantly compromises these vital functions, leading to a range of potential complications:

1. Shoulder Instability and Weakness

This is arguably the most significant risk. Removing the clavicle dramatically reduces shoulder stability, making it more prone to dislocation and subluxation (partial dislocation). This instability can lead to significant pain, limited function, and reduced strength.

2. Impaired Shoulder Function

The loss of the clavicle's structural support severely limits the range of motion in the shoulder. Simple activities like reaching overhead or behind the back become difficult and painful.

3. Increased Risk of Injury

The weakened shoulder joint is much more susceptible to further injury, including fractures, sprains, and rotator cuff tears. These injuries could necessitate further surgery and rehabilitation.

4. Pain and Discomfort

Post-operative pain is common after any surgery. However, with clavicle removal, pain can be chronic and debilitating, impacting daily activities significantly. This pain stems from the instability and compromised mechanics of the shoulder.

5. Nerve and Vessel Damage

During the surgical procedure, there's a risk of accidental damage to the brachial plexus nerves or subclavian blood vessels. This can result in numbness, weakness, or even paralysis in the arm, as well as circulatory problems.

6. Aesthetic Changes

The removal of the clavicle also leads to a noticeable change in the shoulder's appearance. This can be psychologically distressing for some individuals.

7. Long-Term Rehabilitation

Recovery from clavicle removal is extensive and often requires a long period of physical therapy to regain strength and range of motion. Even with rehabilitation, full recovery may not be possible.

When is Clavicle Removal Necessary?

While the risks are substantial, clavicle removal (or partial removal) is sometimes necessary in extreme cases, such as:

Severe Fractures: In cases of comminuted (shattered) clavicle fractures that cannot be repaired with other methods.
Tumors: Removal may be necessary to excise cancerous or benign tumors located on the clavicle.
Infection: In severe cases of clavicular infection that cannot be treated with antibiotics.

It's crucial to understand that clavicle removal is a last resort. All other treatment options should be explored before considering this significant surgical intervention. The long-term consequences can be severe, impacting quality of life for years to come. Always consult multiple orthopedic surgeons to discuss all available options and the potential risks before making a decision.