The costoclavicular (rhomboid) ligament is the most important SC joint stabiliser, anchoring the medial clavicle to the first rib from below. Its short, strong fibres resist the upward and forward movement of the clavicle during arm elevation. SC joint dislocations that rupture this ligament require surgical stabilisation with figure-of-eight suture or tendon graft reconstruction.
| Origin | First rib and its cartilage |
|---|---|
| Insertion | Inferior surface of the medial clavicle (impression at the costoclavicular ligament) |
| Actions | Primary stabiliser of the sternoclavicular joint against elevation and protraction; prevents medial clavicular displacement |
|---|
Costoclavicular syndrome — compression of the subclavian vessels and brachial plexus in the costoclavicular space — occurs when the space is narrowed by clavicular depression or first rib elevation. This is one anatomical component of thoracic outlet syndrome.
Costoclavicular ligament reconstruction using gracilis or palmaris graft for recurrent SC joint instability after traumatic dislocation.
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