The costoclavicular (rhomboid) ligament is a major extrinsic stabiliser of the sternoclavicular joint, anchoring the medial clavicle to the first rib and its cartilage from below. It has anterior and posterior fibre layers that resist upward, forward and backward movement of the medial clavicle and act as a pivot during arm elevation. It is commonly recreated with a figure-of-eight tendon graft when SC joint instability needs surgical reconstruction.
An expanded entry for Costoclavicular Ligament.
| Origin | Upper surface of the first rib and its costal cartilage |
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| Insertion | Costal (rhomboid) impression on the inferior surface of the medial clavicle |
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Limits elevation of the medial clavicle and stabilises the sternoclavicular joint.
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, and is one anatomical component of thoracic outlet syndrome. The ligament is a landmark during first rib resection. In chronic SC joint instability, figure-of-eight reconstruction with semitendinosus or gracilis graft restores this inferior constraint.
Costoclavicular ligament reconstruction using gracilis or palmaris graft for recurrent SC joint instability after traumatic dislocation.
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