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PubMed1980

Injuries of the clavicle and its articulations.

Injuries to the clavicle and articulations have been reviewed. Attention has been drawn to the more common symptoms, signs, and treatment associated with these injuries.

Acromioclavicular Joint↗
PubMed1976

Dislocations of the upper extremity in children.

Traumatic dislocations and subluxations of the upper extremity in children have been surveyed. The elbow joint is most commonly dislocated and is dislocated more frequently in children than in adults. Severe neurovascular injury may be associated with dislocation of this joint. The most common subluxation is that of the radial head, secondary to a "pulled elbow." Otherwise dislocations and subluxations of the upper extremity are uncommon in children, apparently because of the relative weakness of the epiphyseal plate. Most of these injuries are the result of predictable indirect forces. Principles of reduction and immobilization are based on the unique anatomic structure of the joint involved and the known anatomic disruption resulting from the trauma.

Acromioclavicular Joint↗
PubMed2004

Three-dimensional clavicular motion during arm elevation: reliability and descriptive data.

STUDY DESIGN: Cross-sectional. OBJECTIVES: To determine the reliability of a surface sensor measurement of clavicular motion during arm elevation and to describe 3-dimensional clavicular motion in an asymptomatic population. BACKGROUND: Abnormal scapular motion on the thorax has been implicated in shoulder pathology. Without the ability to measure clavicular motion, it is not possible to identify if abnormal scapular motions derive from the sternoclavicular or acromioclavicular joints. METHODS AND MEASURES: Thirty-nine subjects participated in the investigation, including an asymptomatic group (n = 30) and a group with a history or current symptoms of shoulder pathology (n = 9). Clavicular angles relative to the thorax were tracked with surface electromagnetic sensors on the thorax, clavicle, and humerus as subjects completed humeral flexion, scapular plane abduction, and abduction. Within-day reliability was assessed using intraclass correlation coefficients and SEM. Descriptive statistics quantified sternoclavicular joint motions for the various arm movements. RESULTS: Reliable measurements were obtained, with intraclass correlation coefficients ranging from 0.93 to 0.99, and SEMs from 0.9 degrees to 1.8 degrees. Between-day reliability SEM values were generally 2 degrees to 4 degrees. During elevation of the arm, the clavicle with respect to the thorax generally undergoes elevation (11 degrees-15 degrees maximum), retraction (15 degrees-29 degrees maximum), and posterior long-axis rotation (15 degrees-31 degrees maximum), with variability between subjects and planes of motion regarding the magnitude of motion. CONCLUSION: Rehabilitation approaches attempting to improve shoulder motion should benefit from improved knowledge of 3-dimensional contributions of the clavicle to normal and abnormal scapular kinematics.

Adolescent↗
PubMed1992

[Heart arrest as a sequela of clavicular fracture].

After a fracture of the medial part of the clavicle cardiac arrest occurred. This complication can be explained by vagus irritation because of fracture haematoma. The patient survived and was, six months later, of best health.

Clavicle↗
PubMed1992

Geometry parameters for musculoskeletal modelling of the shoulder system.

A dynamical finite-element model of the shoulder mechanism consisting of thorax, clavicula, scapula and humerus is outlined. The parameters needed for the model are obtained in a cadaver experiment consisting of both shoulders of seven cadavers. In this paper, in particular, the derivation of geometry parameters from the measurement data is described. The results for one cadaver are presented as a typical example. Morphological structures are modelled as geometrical forms. Parameters describing this form are estimated from 3-D position coordinates of a large number of datapoints on the morphological structure, using a least-squares criterion. Muscle and ligament attachments are represented as a plane or as a (curved) line. Muscle paths are determined by a geometrical form of the bony contour around which the muscle is wrapped. Muscle architecture is determined by the distribution of muscle bundles over the attachment area, mapping the distribution of the origin to the insertion. Joint rotation centers are derived from articular surfaces. Hence, muscle moment arms can be calculated. The result of this study is a set of parameters for each cadaver, describing very precisely the geometry of the shoulder mechanism. This set allows positioning of muscle force vectors a posteriori, and recalculation of position coordinates and moment arms for any position of the shoulder.

Acceleration↗
PubMed2005

Early sternal erosion and luetic aneurysms of thoracic aorta: report of 6 cases and analysis of cause-effect relationship.

Six patients with luetic aneurysm of the ascending aorta eroding the sternum are presented. The erosion was an early and principal presentation and the site of erosion and location and morphology of aneurysm were identical in all six patients. The erosion mainly affected the right half of the manubrium and medial end of right clavicle. The aneurysms arose from the junction of the ascending and transverse arches of the thoracic aorta and had narrow opening close to the origin of the innominate artery. The identical presentation, aetiology, angiographic location and morphology, corroborated further at surgery, suggests that syphilitic aneurysms in this location have a strong tendency to cause early sternal erosion.

Adult↗
PubMed2003

Chest pain in athletes.

The symptom of chest pain in the athlete can represent anything from a nonspecific musculoskeletal strain to a life-threatening condition such as tension pneumothorax. For the physician charged with evaluating this patient population, a thorough knowledge of the possible etiologies, their usual diagnostic algorithms, available imaging modalities, and potential therapeutic options is essential. Although the vast majority of patients with traumatic chest pain will not harbor significant pathology, the clinician must be prepared for those few who do have such conditions, and be prepared to intervene in an appropriate, time-sensitive fashion.

Athletic Injuries↗
PubMed1992

Palmoplantar pustulotic arthro-osteitis of the peripheral joints with no sternocostoclavicular lesions.

A 45 year old woman presented with swelling and pain on joint movement of her knees, although joint movement was relatively well maintained. Five years previously the patient had been diagnosed as having pustulosis palmoplantaris by a dermatologist. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) had no effect, but treatment with 5 mg/day prednisolone caused remission of both the joint pain and swelling and the pustulosis palmoplantaris. There were no sternocostoclavicular lesions at any time during treatment. Clinical findings in this patient were different from previous reports and she was diagnosed as having palmoplantar pustulotic arthro-osteitis affecting the peripheral joints.

Arthritis, Psoriatic↗
PubMed1984

Traumatic floating clavicle. A case report.

Dislocation of both ends of the clavicle simultaneously is an injury usually sustained in a major accident; in this unusual case it resulted from a minor fall at home. The mechanism of injury and the treatment are discussed.

Accidents, Home↗
PubMed1979

Spontaneous dislocation of the sterno-clavicular joint.

A description is given of 22 patients, with a spontaneous forward subluxation of the sternal end of the clavicle, seen over a 5-year period. The majority were middle-aged women presenting with a lump at the root of the neck, which was usually associated with little or no discomfort. There was no history of injury and no interference with shoulder function. The diagnosis was obvious on clinical examination and no treatment was required other than explanation, reassurance and simple analgesia. In no case was the correct diagnosis made by the referring physician and many of the patients were unduly concerned by the nature of the swelling. The sterno-clavicular joint is a synovial articulation and consequently it may be involved in rheumati arthropathy. A condition of non-infective subacute arthritis of the sterno-clavicular joint has been described and is similar to that reported here but in contrast to the previous report we believe that the changes which occur in the joint are secondary to its subluxation.

Adult↗
PubMed2000

Traumatic scapulothoracic dissociation.

Scapulothoracic dissociation is an infrequent injury with a potentially devastating outcome. The diagnosis is based on clinical and radiographic findings of forequarter disruption. These include massive soft tissue swelling of the shoulder, displacement of the scapula and neurovascular injuries (brachial plexus, subclavian artery and osseous-ligamentous injuries). The mechanism of injury appears to be the delivery of severe rotational force sheering the shoulder girdle from its chest wall attachments around the scapula, shoulder joint and at the clavicle. Early recognition of the entity and aggressive treatment are crucial. Outcome is not dependent on management of the arterial injury, but rather on the severity of the neurological deficit.

Accidents, Traffic↗