Can The Bone Marrow In The Clavicles Seen In Clavicle Reduction Surgery Be Used For Other Purposes?

Q: Dr. Eppley, I’d just like to say that this case study is incredibly valuable and the results visually look excellent – very natural and impossible to detect that work was done. I think 15mm is ideal in that regard. 

I have a question about the method of surgery. When you do clavicle reduction, you obviously have segments of bone that you remove. It is possible to then remove the bone marrow from these/clean it and then use them as exogenous bone grafts for other patients? Would there be any benefit to having an entire piece of bone like this filling the gap of an osteotomy during lengthening, as opposed to doing a sagittal split osteotomy? 

Secondly, how do you ensure that the clavicles are lengthened in the correct plane when you pull them apart? ie laterally in line with the existing shape of the clavicle.

A: In answer to your questions:

1) While the clavicle has an inner cancellous space that is not bone marrow.

2) While a fibular bone graft can be used for clavicle lengthening that is going to have the patient recovering from two ‘broken’ shoulders as well as a ‘broken’ leg. That is going to make the recovery process extremely difficult. Not to mention a much longer time of limited arm motion given how long it takes a bone graft to heal vs an osteotomy.

3) When doing a sagittal split the alignment of the bone can be seen as the outer segment slides away from the inner segment.

Dr. Barry Eppley

World-Renowned Plastic Surgeon