Geometry of the Clavicle and Reliability of Measurement using PACS

Wisanuyotin, Taweechok; Tidchom, Chanchai; Chaisiwamonkhol, Kowit; Chowchuen, Prathana; Paholpak, Permsak; Sirichativapee, Winai; Kosuwan, Weerachai; Jeeravipoolvarn, Polasak

doi:10.1007/s00276-013-1225-y

Cited by 10 publications

(11 citation statements)

References 32 publications

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“…The length before fracture was calculated by adding the length of the affected clavicle to the amount of measured fracture overlap, as we did not have information of the length of the clavicle prior to fracture. The contralateral clavicle was not used as a reference, because of possible pre-existent clavicular asymmetry ( Cunningham et al 2013 , Wisanuyotin et al 2013 ). To calculate this relative shortening, the initial anteroposterior (AP) trauma radiograph was used—as well as an AP panorama radiograph comprising both clavicles that was acquired during the study visit (i.e.…”

Section: Methodsmentioning

confidence: 99%

Posttraumatic midshaft clavicular shortening does not result in relevant functional outcome changes

Stegeman¹,

Witte²,

Boonstra³

et al. 2015

Acta Orthopaedica

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Background and purposeShoulder function may be changed after healing of a nonoperatively treated clavicular fracture, especially in cases of clavicular shortening or mal-union. We investigated scapular orientations and functional outcome in healed clavicular fractures with and without clavicular shortening.Patients and methods32 participants with a healed nonoperatively treated midshaft clavicular fracture were investigated. Motions of the thorax, arm, and shoulder were recorded by standardized electromagnetic 3D motion tracking. The DASH score and Constant-Murley score were used to evaluate functional outcome. Orientation of the scapula and humerus at rest and during standardized tasks, and strength and function of the affected shoulders were compared with corresponding values for the uninjured contralateral shoulders.ResultsMean clavicular shortening was 25 mm (SD 16). Scapula protraction had increased by mean 4.4° in rest position in the affected shoulders. During abduction, slightly more protraction, slightly more lateral rotation, and slightly less backward tilt was found for the affected shoulders. For anteflexion, the scapular orientations of the affected shoulders also showed slightly increased protraction, slightly increased lateral rotation, and slightly reduced backward tilt. Scapulohumeral kinematics, maximum humerus angles, and strength were not associated with the degree of clavicular shortening. All participants had excellent performance on the Constant-Murley score and DASH score.InterpretationScapulohumeral kinematics in shoulders with a healed clavicular fracture differ from those in uninjured shoulders, but these changes are small, do not result in clinically relevant changes in outcome, and do not relate to the amount of clavicular shortening. These findings do not support routine operative reduction and fixation of shortened midshaft clavicular fractures based on the argument of functional outcome.

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Section: Methodsmentioning

confidence: 99%

Posttraumatic midshaft clavicular shortening does not result in relevant functional outcome changes

Stegeman¹,

Witte²,

Boonstra³

et al. 2015

Acta Orthopaedica

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“…We observed significant differences between genders in the anatomy around the AC joint, which we believe to be a clinically relevant observation. Similarly, Wisanuyotin et al 20) also reported that the anatomy of the clavicle is significantly different between genders. In the present study, the female gender has a significantly larger AC angle (13.8° vs. 19.8°), and thinner distal clavicle (12.2 mm vs. 10.9 mm) and acromion (8.7 mm vs. 7.7 mm) as compared to the male gender.…”

Section: Discussionmentioning

confidence: 90%

Evaluation of the Acromioclavicular Joint Morphology for Minimizing Subacromial Erosion after Surgical Fixation of the Joint Using a Clavicular Hook Plate

Kim

Kee

Park

et al. 2018

Clin Shoulder Elbow

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BACKGROUND: Subacromial erosion remains a major concern after surgical fixation of acromioclavicular (AC) joint using a clavicular hook plate. To minimize postoperative subacromial erosion, we investigated the structural relationship between distal clavicle and acromion around the AC joint by considering the surgical fixation of the joint using the hook plate technique.METHODS: Computed tomography scans of 101 AC joints without any inherent pathology were analyzed. The angle between the distal clavicle and acromion around the AC joint (AC angle), depth of the acromion, differences in height between distal clavicle and acromion (AC height difference), and thickness of distal clavicle and acromion at the AC joint were measured. Descriptive statistics were calculated for each anatomical parameter, and all results were compared between gender groups.RESULTS: The mean AC angle was 17.1°(range, ?8.0° to 39.0°), and the mean AC height difference was 3.5 mm (range, ?0.7 to 8.7 mm). Both factors showed very high variability (coefficients of variation=62.6% and 46.6%, respectively). The mean AC angle was significantly higher in the female gender than in the male gender (19.8° vs. 13.8°, p=0.048). The mean acromion thickness and distal clavicular thickness were both significantly thinner in the female group than in the male group (p < 0.001) CONCLUSIONS: Taken together, we believe our results might be helpful in minimizing postoperative subacromial erosion when performing surgical fixation of the AC joint using the hook plate, and be valuable in improving future design of the hook plate.

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“…2,44,54,57 The radiographs were viewed on a picture archiving and communication system, which allowed accurate distance measurements. 15,59 The natural variation in clavicle length was taken into consideration in interpreting results. 3,59 Statistics Statistical analysis was performed with IBM SPSS Statistics version 22 (IBM Corp., Armonk, NY, USA).…”

Section: Patient-oriented Outcomesmentioning

confidence: 99%

“…15,59 The natural variation in clavicle length was taken into consideration in interpreting results. 3,59 Statistics Statistical analysis was performed with IBM SPSS Statistics version 22 (IBM Corp., Armonk, NY, USA). Percentage, frequency distribution, mean, median, and standard deviation were used to describe the characteristics of variables.…”

Section: Patient-oriented Outcomesmentioning

confidence: 99%

The long-term outcome of displaced mid-third clavicle fractures on scapular and shoulder function: variations between immediate surgery, delayed surgery, and nonsurgical management

George

McKay

Jaarsma

2015

Journal of Shoulder and Elbow Surgery

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Geometry of the Clavicle and Reliability of Measurement using PACS

Abstract: The geometry of the clavicle is influenced by sex and side. Use of PACS as a measurement tool is reliable. Data from this study will be useful for pre-contouring plate or improving future designs of the anatomical plate of the clavicle.

Cited by 10 publications

References 32 publications

Posttraumatic midshaft clavicular shortening does not result in relevant functional outcome changes

Posttraumatic midshaft clavicular shortening does not result in relevant functional outcome changes

Evaluation of the Acromioclavicular Joint Morphology for Minimizing Subacromial Erosion after Surgical Fixation of the Joint Using a Clavicular Hook Plate

The long-term outcome of displaced mid-third clavicle fractures on scapular and shoulder function: variations between immediate surgery, delayed surgery, and nonsurgical management

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