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My interest was piqued by Yel et al., with their fascinating article titled, “Osteomusculocutaneous flap for clavicular reconstruction: A case report[1].” The authors reported a case of persistent clavicular nonunion after pathologic fracture because of necrotic fibrosis due to radiation for breast cancer therapy. They managed it with compound rib-latissimus dorsi osteomusculocutaneous flap and a 4cm segment of the sixth rib. But our question is what happened in cases of clavicle total excision or in cases with more than 4cm nonunion gap? Clavicle orientation is found to rotate from a primarily craniocaudal orientation at the sternum to a primarily anteroposterior orientation at the acromion.