Skip to main content
Erschienen in: Surgical and Radiologic Anatomy 1/2014

01.01.2014 | Original Article

Anatomical study of the clavicle: endomedullary morphology

verfasst von: Pierre-Alain Mathieu, Pierre-Sylvain Marcheix, Vincent Hummel, Denis Valleix, Christian Mabit

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 1/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

The treatment of clavicle fractures remains controversial. The objective of this study was to investigate the possibility of clavicular intramedullary fixation by nailing through an anatomic study combined with CT scan studies.

Methods

For the anatomic study, 20 clavicles of donated bodies to science (10 men, 10 women, 10 right, 10 left) were used. We measured the length of the clavicle, lateral epiphysis diameter, mean diaphysis diameter, medial epiphysis diameter, lateral width, lateral radius of curvature, medial width and medial radius of curvature. Intramedullary cavity diameter (anteroposterior and superoinferior) and calibration were measured by CT scan study on 20 clavicles.

Results

Average length was 152 mm for men and 140 mm for women. The anteroposterior curvature was most pronounced. The medullary canal had a gradually decreasing size from the distal portion to the middle segment, but never disappeared.

Conclusion

Evaluation of morphological data can clarify the specifications of an intramedullary nail: flexibility of the nail to match clavicle curvature and a locking system to ensure primary stability. Intramedullary fixation by nailing in displaced fractures of the middle portion of the clavicle is a minimally invasive surgical technique, with excellent functional and cosmetic results.
Literatur
1.
Zurück zum Zitat Andermahr J, Jubel A, Elsner A et al (2007) Anatomy of the clavicle and the intramedullary nailing of midclavicular fractures. Clin Anat 20(1):48–56PubMedCrossRef Andermahr J, Jubel A, Elsner A et al (2007) Anatomy of the clavicle and the intramedullary nailing of midclavicular fractures. Clin Anat 20(1):48–56PubMedCrossRef
2.
Zurück zum Zitat Andersen K, Jensen PO, Lauritzen J (1987) Treatment of clavicular fractures. Figure-of-eight bandage versus a simple sling. Acta Orthop Scand 58(1):71–74PubMedCrossRef Andersen K, Jensen PO, Lauritzen J (1987) Treatment of clavicular fractures. Figure-of-eight bandage versus a simple sling. Acta Orthop Scand 58(1):71–74PubMedCrossRef
3.
Zurück zum Zitat Canadian Orthopaedic Trauma Society (2007) Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am 89(1):1–10CrossRef Canadian Orthopaedic Trauma Society (2007) Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am 89(1):1–10CrossRef
4.
Zurück zum Zitat Chen Y-F, Wei H-F, Zhang C et al (2012) Retrospective comparison of titanium elastic nail (TEN) and reconstruction plate repair of displaced midshaft clavicular fractures. J Should Elb Surg 21(4):495–501CrossRef Chen Y-F, Wei H-F, Zhang C et al (2012) Retrospective comparison of titanium elastic nail (TEN) and reconstruction plate repair of displaced midshaft clavicular fractures. J Should Elb Surg 21(4):495–501CrossRef
5.
Zurück zum Zitat Ferran NA, Hodgson P, Vannet N et al (2010) Locked intramedullary fixation vs plating for displaced and shortened mid-shaft clavicle fractures: a randomized clinical trial. J Should Elb Surg 19(6):783–789CrossRef Ferran NA, Hodgson P, Vannet N et al (2010) Locked intramedullary fixation vs plating for displaced and shortened mid-shaft clavicle fractures: a randomized clinical trial. J Should Elb Surg 19(6):783–789CrossRef
6.
Zurück zum Zitat Havet E, Duparc F, Tobenas-Dujardin A-C et al (2008) Vascular anatomical basis of clavicular non-union. Surg Radiol Anat 30(1):23–28PubMedCrossRef Havet E, Duparc F, Tobenas-Dujardin A-C et al (2008) Vascular anatomical basis of clavicular non-union. Surg Radiol Anat 30(1):23–28PubMedCrossRef
7.
Zurück zum Zitat Jubel A, Andermahr J, Schiffer G, Rehm KE (2002) Technique of intramedullary osteosynthesis of the clavicle with elastic titanium nails. Unfallchirurg 105(6):511–516PubMedCrossRef Jubel A, Andermahr J, Schiffer G, Rehm KE (2002) Technique of intramedullary osteosynthesis of the clavicle with elastic titanium nails. Unfallchirurg 105(6):511–516PubMedCrossRef
8.
Zurück zum Zitat Kim W, McKee MD (2008) Management of acute clavicle fractures. Orthop Clin North Am 39(4):491–505PubMedCrossRef Kim W, McKee MD (2008) Management of acute clavicle fractures. Orthop Clin North Am 39(4):491–505PubMedCrossRef
9.
Zurück zum Zitat Ledger M, Leeks N, Ackland T, Wang A (2005) Short malunions of the clavicle: an anatomic and functional study. J Should Elb Surg 14(4):349–354CrossRef Ledger M, Leeks N, Ackland T, Wang A (2005) Short malunions of the clavicle: an anatomic and functional study. J Should Elb Surg 14(4):349–354CrossRef
10.
Zurück zum Zitat McKee MD, Pedersen EM, Jones C et al (2006) Deficits following nonoperative treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am 88(1):35–40PubMedCrossRef McKee MD, Pedersen EM, Jones C et al (2006) Deficits following nonoperative treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am 88(1):35–40PubMedCrossRef
11.
Zurück zum Zitat Murlimanju BV, Prabhu LV, Pai MM et al (2011) Neurovascular foramina of the human clavicle and their clinical significance. Surg Radiol Anat 33(8):679–682PubMedCrossRef Murlimanju BV, Prabhu LV, Pai MM et al (2011) Neurovascular foramina of the human clavicle and their clinical significance. Surg Radiol Anat 33(8):679–682PubMedCrossRef
12.
Zurück zum Zitat Nordqvist A, Petersson CJ (1995) Incidence and causes of shoulder girdle injuries in an urban population. J Should Elb Surg 4(2):107–112CrossRef Nordqvist A, Petersson CJ (1995) Incidence and causes of shoulder girdle injuries in an urban population. J Should Elb Surg 4(2):107–112CrossRef
13.
Zurück zum Zitat Oroko PK, Buchan M, Winkler A, Kelly IG (1999) Does shortening matter after clavicular fractures? Bull Hosp Jt Dis 58(1):6–8PubMed Oroko PK, Buchan M, Winkler A, Kelly IG (1999) Does shortening matter after clavicular fractures? Bull Hosp Jt Dis 58(1):6–8PubMed
14.
Zurück zum Zitat Renfree T, Conrad B, Wright T (2010) Biomechanical comparison of contemporary clavicle fixation devices. J Hand Surg Am 35(4):639–644PubMedCrossRef Renfree T, Conrad B, Wright T (2010) Biomechanical comparison of contemporary clavicle fixation devices. J Hand Surg Am 35(4):639–644PubMedCrossRef
15.
Zurück zum Zitat Ring D, Holovacs T (2005) Brachial plexus palsy after intramedullary fixation of a clavicular fracture. A report of three cases. J Bone Joint Surg Am 87(8):1834–1837PubMedCrossRef Ring D, Holovacs T (2005) Brachial plexus palsy after intramedullary fixation of a clavicular fracture. A report of three cases. J Bone Joint Surg Am 87(8):1834–1837PubMedCrossRef
16.
Zurück zum Zitat Robinson CM (1998) Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br 80(3):476–484PubMedCrossRef Robinson CM (1998) Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br 80(3):476–484PubMedCrossRef
17.
Zurück zum Zitat Voisin J-L (2006) Clavicle, a neglected bone: morphology and relation to arm movements and shoulder architecture in primates. Anat Rec A Discov Mol Cell Evol Biol 288(9):944–953PubMedCrossRef Voisin J-L (2006) Clavicle, a neglected bone: morphology and relation to arm movements and shoulder architecture in primates. Anat Rec A Discov Mol Cell Evol Biol 288(9):944–953PubMedCrossRef
18.
Zurück zum Zitat Zlowodzki M, Zelle BA, Cole PA et al (2005) Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma 19(7):504–507PubMedCrossRef Zlowodzki M, Zelle BA, Cole PA et al (2005) Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma 19(7):504–507PubMedCrossRef
Metadaten
Titel
Anatomical study of the clavicle: endomedullary morphology
verfasst von
Pierre-Alain Mathieu
Pierre-Sylvain Marcheix
Vincent Hummel
Denis Valleix
Christian Mabit
Publikationsdatum
01.01.2014
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 1/2014
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-013-1140-2

Weitere Artikel der Ausgabe 1/2014

Surgical and Radiologic Anatomy 1/2014 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.