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Shoulder narrowing surgery is accomplished by the straightforward concept of removing  a segment of the clavicle bone which pulls the shoulder inward. While there are certainly technical challenges in performing this surgery the operation is completed in about 2 1/2 hours. The formidable part of the  surgery to me is the postoperative recovery. Most patients take 4 to 6 weeks to have a near complete recovery.

The most critical part of the recovery is in the immediate time after surgery when the patient has the most limitations of arm movement. This is one of the many areas where clavicle reduction osteotomies are different than clavicle fracture repairs. While clavicle fracture patients may be put in an arm sling to recover that is an effective management strategy because they have one good free arm. That does not work in clavicle reduction osteotomies where both arms are limited. Despite the double plate fixation I am not yet adventurous enough to allow patients unrestricted arm motion immediately after surgery.  

At the end of the surgery I place an elbow wrap to keep the arms in good position for the early hours and night after surgery. Most patients really like the wrap as it gives them support. In the first two weeks after surgery I advise the patients to keep their elbows by their side as much as possible and short arm what they can. The elbow wrap helps in that regard as an aid in the process and most patients continue to use it.

Once patients get to two weeks after surgery they are allowed to have their elbows further from their side and the wrap is no longer needed. 

Dr. Barry Eppley

World-Renowned Plastic Surgeon

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