Shoulder Asymmetry After Clavicle Surgery: What to Expect

Uneven shoulder size?

I was in a car accident on May 12th and received treatment at a local hospital.
The doctor advised me to use a figure-eight shoulder strap for a month, but when I went to see an orthopedic specialist in Taoyuan, they informed me that my clavicle was fractured in the middle and the ligament was torn.
I was taken directly for surgery that same day.
After the surgery, I have felt that my shoulders are uneven in size.
The doctor and nurses told me that it feels this way because the wound is still swollen.
However, now that the swelling has mostly gone down, I still notice a significant difference in shoulder size when I look in the mirror.
Is this normal? Also, will the wound be raised? There is still a gap in the wound, but the surgeon who performed the operation keeps telling me not to worry because it is swollen.
However, if it is swollen, shouldn't the injured area appear larger?

Hao, 10~19 year old female. Ask Date: 2017/05/20

Dr. Shi Guozheng reply Orthopedics

Swelling after a fracture or surgery is normal, but the swelling should subside within two to three months post-surgery, and the size of both shoulders will become more equal.

Reply Date: 2017/05/20

More Info

After undergoing clavicle surgery, it is common for patients to experience shoulder asymmetry and other related symptoms. Your concerns about the size difference between your shoulders and the appearance of your surgical site are valid and warrant a thorough understanding.

Firstly, shoulder asymmetry after surgery can occur for several reasons. One of the most common causes is swelling and inflammation in the immediate postoperative period. This swelling can lead to a temporary change in the appearance of the shoulders, making one appear larger than the other. However, as you mentioned, if the swelling has subsided and you still notice a significant difference in size, it may be indicative of other factors at play.

Muscle atrophy is another potential reason for shoulder asymmetry. After surgery, particularly if the arm has been immobilized for an extended period, the muscles around the shoulder may weaken and shrink due to disuse. This can lead to a noticeable difference in size and strength between the two shoulders. Engaging in physical therapy and rehabilitation exercises is crucial to regain strength and improve symmetry. A physical therapist can provide you with a tailored exercise program to help strengthen the affected shoulder and restore function.

Regarding the appearance of your surgical site, it is not uncommon for scars to be raised or have a "bumpy" appearance initially. This is part of the healing process, and many surgical scars go through phases of healing that can include redness, swelling, and changes in texture. Over time, most scars will flatten and fade, but this can take several months to a year. If the scar remains raised or becomes more pronounced, it may be worth discussing with your surgeon, as they can assess whether any interventions, such as scar therapy or revision, are necessary.

It is also important to consider the possibility of complications from the surgery, such as improper healing or issues with the hardware used during the procedure. If you continue to experience significant asymmetry or discomfort, it would be prudent to follow up with your orthopedic surgeon. They may recommend imaging studies, such as X-rays or an MRI, to evaluate the healing process and ensure that everything is progressing as expected.

In summary, while some degree of shoulder asymmetry and changes in the surgical site can be normal following clavicle surgery, persistent differences should be monitored closely. Engaging in a structured rehabilitation program is essential for restoring strength and function. If you have ongoing concerns about the appearance of your shoulder or the healing of your surgical site, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your recovery is a priority, and addressing these concerns early can lead to better outcomes in the long run.

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