As the morbidity you suffer is limited to certain postures and not affecting activities of daily living, conservative care is required in most cases. But problem tickets or painful cases may require surgical intervention like wire or cable suture repair. Some might require arthrodesis. Repair with tendon grafts have also been done by some. So the options are many and tailor-made for individual case.

Ganesh

Thanks, yes, that's right. Have you done some of those?

I in fact want to design something better than simple "figure of eight bandage" that immobilizes the clavicle in close approximation to the first rib that would help spontaneous healing but I could not arrive until now to some effective solution. Do you have some ideas?

In fact the costoclavicular ligament (rhomboid ligament) flat, strong, and rhomboid in form. It needs strong approximation immediately after injury to allow ligament healing, otherwise, it may need surgery

Thanks, Salameh.

In fact I was wondering what kind of surgery exactly? Have you done it? I need an advice of somebody who has practical experience with exactly this surgery.

I think you need to see Orthopedic surgeon to evaluate the ligament damage and he will choose an approximation procedure suitable to your case. I think conservative procedure is too late.

Wish you luck

Dear Salameh

Thanks very much indeed for your excellent advices.

I am sorry I probably was not clear with my question. I am a sports medicine physician, (30 years of muscle and circulation research and in vitro and in vivo - small animal surgery) and anesthesiologist, ICU physician (40 years of observing attentively surgeons by their valuable work!). I believe to know, more or less, what the surgeons know and can do and what they do not know and cannot do. Well, nobody is perfect

Therefore I was looking for a surgeon who performed a series of exactly those operations and has experience of the exchange of ideas with the colleagues who performed longer series of similar operations. So if you know somebody, please give me the reference.

Indeed, I greatly appreciated your answers.

(I put it now in my question, to make it more clear.)