Shoulder without a Clavicle: Movement and Function after Total Claviclectomy: A Case Report

Total claviclectomy is a rare surgical procedure performed as a last resort for unresolving chronic osteomyelitis, tumors, or non-union causing complications. The clavicle plays an important role in shoulder girdle stability, and its complete removal is traditionally associated with functional compromise. We report a case of chronic osteomyelitis of the clavicle which required total claviclectomy, assessing the 2-year functional and clinical outcomes.

A 50-year-old male sustained a left clavicle fracture following a road traffic accident. The fracture was initially managed conservatively on a clavicle brace. However, as union was not progressing well, the fracture was fixed with a plate and screws. Two months postoperatively, he developed wound infection and chronic osteomyelitis, resistant to multiple debridements and antibiotics. Imaging confirmed cortical destruction and sequestration along the clavicle. The patient underwent total claviclectomy with implant removal and FiberTape coracoclavicular reconstruction. Post-operative recovery was uneventful, and he followed a structured rehabilitation program. At 2-year follow-up, he reported near-complete functional recovery with full range of motion, American Shoulder and Elbow Surgeons score of 88, and Disabilities of the Arm, Shoulder, and Hand score of 40.8.

Functional outcomes following total claviclectomy can be excellent with meticulous soft-tissue reconstruction and rehabilitation. This case highlights that even after complete clavicular excision, shoulder function may remain satisfactory in the long term.