The costoclavicular ligament (rhomboid ligament) connects the undersurface of the medial clavicle to the superior surface of the first rib and its costal cartilage, providing the primary inferior SC joint constraint and limiting clavicular elevation and retraction.
Primary restraint against superior and posterior clavicular displacement, limits clavicular elevation during shoulder shrugging, maintains the SC joint inferior constraint, and is disrupted in superior SC joint dislocation.
The costoclavicular ligament is reconstructed in SC joint instability surgery — the subperiosteal figure-of-eight graft reconstruction replaces this ligament using semitendinosus or gracilis. It is also an important landmark in first rib resection for TOS.
Figure-of-eight tendon graft reconstruction of the costoclavicular ligament for recurrent SC joint dislocation, restoring the inferior clavicular constraint.
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