Reduction of wide shoulders can be effectively achieved through shoulder narrowing surgery. By removing a segment of the clavicle at its inner third, the width of the shoulders is brought in as the bone is put back together,pulling the shoulder closer to the clavicle.
To remove an adequate length of clavicle bone surgical access is needed and not that typically associated with clavicle fracture repair. (direct incision) The best place to locate the incision for clavicle osteotomies is at its inner third where an overlying supraclavicular hollow exists. This skin recess is located above the bone and provides the only place along the bone where at least the incision can be more ‘hidden’. (or at least not directly exposed on the anterior surface of the bone)
The supraclavicular fossa incision is used like a mobile window. The incision is slid down over the bone where the bone removal and plate fixation can be done through it. The skin is very flexible once it is detached from the underlying tissues.
Once the bone operation is completed the deep tissues and muscles are closed over the bone and the incision slides back superiorly into the supraclavcular fossa.
The healing of the supraclavicular fossa incision is usually very favorable. A subcuticular skin closure ensures that no suture track marks result. The thinner skin of the fossa tends to heal better than the thicker skin that lies on the anterior surface of the bone. The scar is fairly red early on but fades quickly. Positioned at the lower end of the sternocleidomastoid muscle the incision actually lies along the relaxed skin tension lines of the skin…always a favorable orientation for optimal scar healing.
Dr. Barry Eppley
Indianapolis, Indiana