Diagnosed infection in clavicle and advised to remove. Suggest?
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Hi Our Orthopedic surgeon is considering removing my 17 year old daughters clavical due to an unknown infection that was diagnosed when she was 9. It has grown considerably and gives her incredible pain. His answer is to possibly remove this bone. Will this affect her greatly and will she still have movement. He doesn't know of anyone who has had this done before. Worried Mum Christchurch New Zealand
Posted Sun, 13 Oct 2013
in Bones, Muscles and Joints
Answered by Dr. Moustafa Saeed 1 hour later
Brief Answer:
Function will still be present
Detailed Answer:
Hi, XXXXXXX
Thank you for your question.
It is extremely uncommon procedure to excise the whole of the clavicle, and even in specialist centres they may do one every few years.
Partial excision is more common, the distal clavicle excision is the commonest and people have good function of the arm afterwards.
If the infection is localised to small part of the clavicle then that can be excised and we expect good function of the arm,
But if the whole of the clavicle is required to be removed then function in the arm will still be present but it will be weaker than a normal arm.
I hope I have answered your question adequately, if you have further concerns, please do write back.
Wishing your daughter a speedy recovery.
Best wishes
Function will still be present
Detailed Answer:
Hi, XXXXXXX
Thank you for your question.
It is extremely uncommon procedure to excise the whole of the clavicle, and even in specialist centres they may do one every few years.
Partial excision is more common, the distal clavicle excision is the commonest and people have good function of the arm afterwards.
If the infection is localised to small part of the clavicle then that can be excised and we expect good function of the arm,
But if the whole of the clavicle is required to be removed then function in the arm will still be present but it will be weaker than a normal arm.
I hope I have answered your question adequately, if you have further concerns, please do write back.
Wishing your daughter a speedy recovery.
Best wishes
Follow-up: Diagnosed infection in clavicle and advised to remove. Suggest? 1 hour later
The lump on the clavica is bone so would it be possible to scrape the bone. If so, would that leave her with no pain. It is obvious the pain is nerve cos of the transfer down arm and hand but I guess they need to find out why the lump is there and growing. She has had many blood tests and xrays which show strong healthy bone. They have been unable to work out what the infection is. They gave her I V antibiotics (amoxicillin) when she was 9 but it certainly has grown.
Answered by Dr. Moustafa Saeed 6 hours later
Brief Answer:
Trimming the bony lump is good option.
Detailed Answer:
If the pain is not due to chronic infection then no, resection of clavicle is needed.
It seems the bony lump from the clavicle pressing on a nerve locally which is giving her the pain.
Removing the bony lump or trimming it is a valid option at this age and it should not cause affect the function in the arm.
If it was the cause of her pain (ie pressing locally on a nerve ) then she should get better. however no 100 % guarantee to have all the pain settle.
I will recommend nerve studies to the arm and MRI scan to the clavicle before surgery.
All the best to you and your daughter.
Trimming the bony lump is good option.
Detailed Answer:
If the pain is not due to chronic infection then no, resection of clavicle is needed.
It seems the bony lump from the clavicle pressing on a nerve locally which is giving her the pain.
Removing the bony lump or trimming it is a valid option at this age and it should not cause affect the function in the arm.
If it was the cause of her pain (ie pressing locally on a nerve ) then she should get better. however no 100 % guarantee to have all the pain settle.
I will recommend nerve studies to the arm and MRI scan to the clavicle before surgery.
All the best to you and your daughter.
The user accepted the expert's answer