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At least 19 recordsLinked to original sources

PubMed1987

Resection of the lateral end of the clavicle following osteolysis, with emphasis on non-traumatic osteolysis of the acromial end of the clavicle in athletes.

Preoperative radiographs of 38 patients who had undergone resection of the lateral end of the clavicle were reviewed. Seven cases of osteolysis of the lateral end of the clavicle were found, of which four followed severe injury of the shoulder girdle. Three of the cases were young male athletes, with nontraumatic osteolysis. One additional patient with this disorder, in whom resection has not yet been performed, was also included. All four had practised weightlifting and benchpressing as part of their training. Hence, a feasible explanation for the osteolytic process seems to be repeated microfractures due to stresses imposed by these activities. Several conservative regimens provided only temporary relief. After resection, the symptoms ceased and the patients were able to return to competitive sport. With the increasing interest in bodybuilding, non-traumatic osteolysis of the acromial end of the clavicle should be borne in mind in cases of pain in the shoulder in athletes.

Adult↗

PubMed1990

The early development and ossification of the human clavicle--an embryologic study.

Morphologic studies of the early development of the clavicle were carried out in 46 human embryos and fetuses ranging in age from 6 to 12 weeks. We confirmed that the clavicle is formed by two membranous primary ossification centers appearing by 6 weeks and fusing approximately 1 week later. Cartilage at both ends of the clavicle then develops. In time, the medial cartilaginous mass contributes more to the growth in length of the clavicle than the lateral cartilaginous mass. The spatial orientation of both ossification centers and the development of enchondral bone formation at the ends of the clavicle lead to its characteristic shape. Interestingly, the primary ossification centers contribute little to the growth in length. The junction of the two centers of ossification is situated between the lateral and middle third of the clavicle and, consequently, does not correspond to the site of congenital pseudarthrosis, which is located in the middle part of the clavicle.

Clavicle↗

PubMed1988

The growth pattern of the clavicle in the rat.

The mode of growth of the rat clavicle from 17 to 45 days of age was studied by means of vital staining (alizarin red S), histology and autoradiography (tritiated thymidine). In addition the clavicle on one side was subjected to periostomy at the age of 10 days and its length compared with that of its unoperated counterpart at the ages of 17 and 45 days. The alizarin red staining revealed that the medial end of the clavicle contributes to the length of the bone, while the lateral end appears to have mainly an articulatory function. Histologically, the medial end cartilage closely resembles the condylar cartilage of the mandible, whereas the lateral end appears to be composed of two cartilaginous structures separated by a mesenchymatous layer. Tritiated thymidine was deposited in the mesenchymal cells covering the medial end cartilage, whereas virtually no activity was observed in the mesenchyme of the lateral end cartilage. The periostomised clavicle was more slender in appearance than its control throughout the observation period. The two clavicles were of the same length at 17 days, but by 45 days the periostomised clavicle was significantly longer than the control. It is suggested that the growth of the clavicle is essentially comparable to the growth of the mandible. Length growth occurs in response to the action of the surrounding structures, while analogously to the mandibular condyle, the medial end cartilage actively translates the bone in a direction perpendicular to the articular surface, giving rise to its curved shape.

Aging↗

PubMed1992

Brief communication: histological age estimation using rib and clavicle.

Histological methods for estimating age at death using osteon population densities for the rib, clavicle, and rib and clavicle combined are presented. Predicting formulas were generated from a sample of 40 individuals of known age, sex, and race. Independent samples of 12 ribs and 7 clavicles were used to test the formulas. Mean differences between known and predicted ages were 1.1 years, 2.6 years, and 3.4 years for the clavicle, rib and clavicle combined, and rib formulas respectively. An analysis of variance found no significant differences among the means for predicted and known ages. Since the formula based upon rib and clavicle combined has the higher standard error and r2, and includes data from different bones, it should provide better overall accuracy and reliability, and is recommended whenever both bones are available.

Adolescent↗

PubMed1989

Current concepts in the treatment of fractures of the clavicle.

Clavicle fracture is a common injury in all age groups. Injuries can be classified into groups. Group I includes fractures of the middle one third, the most frequent site. Group II fractures account for 10% of fractures of the clavicle and involve the clavicle lateral to the coracoclavicular ligament and are caused by direct violence. These injuries are divided into two subsets. Group II Type I fractures occur lateral to the coracoclavicular ligaments and are stable. Group II Type II fractures occur just medial to the coracoclavicular ligaments and are unstable. These latter injuries require stabilization. Group III fractures are uncommon and involve the medial end of the clavicle and are rarely caused by direct violence. Most fractures of the clavicle can be treated closed with excellent results. Open treatment is only occasionally indicated and then only under certain stringent conditions. Most complications occur with open treatment and include nonunion and infection. Neurovascular complications are uncommon but not unusual. Although reasonable shoulder function is compatible with surgical resection of the clavicle, it cannot be done with impunity.

Adolescent↗

PubMed1989

Nonunion of the clavicle and thoracic outlet syndrome.

Fifteen adult patients with clavicular nonunions were evaluated over a 10-year period. Fourteen of these patients were treated initially with a "figure-of-eight" clavicle strap. Seven presented with narrowing of the costoclavicular space, and symptoms of intermittent brachial plexus impingement or thoracic outlet syndrome. Two of these resulted from resection of the mid-portion of the clavicle with subsequent impingement from hypertrophy of the lateral stump. Most commonly, hypertrophic nonunion of the clavicle caused the thoracic outlet syndrome, frequently many months after the initial injury. This delayed onset led to diagnostic confusion with other causes of radiating upper extremity pain, including cervical disc disease. Treatment of the adult clavicle fracture is different from that of the child with potential for greater functional impairment. The "figure-of-eight" harness frequently does not provide pain relief or adequate reduction of the fracture. If an acutely displaced fracture in an adult cannot be reduced and held by closed casting technique, open reduction and internal fixation may occasionally be indicated. We have found transcortical fixation by locking Knowles pins to be effective for treating hypertrophic nonunions, as well as for unreducible acute fractures. Atrophic nonunions require plate fixation and autologous grafting. Nonunion of the clavicle has been among the most responsive of nonunions in our experience, since all fractures treated by adequate reduction and fixation healed promptly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Solitary osteochondroma of the clavicle.

There are no clinicopathologic reports of solitary osteochondroma of the clavicle other than listings in tumor registries. Two boys had solitary asymptomatic osteochondroma, in one at the medial and in the other at the lateral aspect of the clavicle. One underwent excision to correct cosmetic deformity. Several histologic and experimental studies have shown that osteochondromas originate from cells of the growth plate. During development of the clavicle, cartilage appears on both the medial and lateral aspects. Histologic studies have suggested that this cartilage is similar to a physeal growth plate. Experimental studies, however, have shown it to be a randomly organized secondary cartilage that develops in membranous bones once ossification has begun. The occurrence of an osteochondroma at the ends of the clavicle lends support to the theory that the cartilage at the ends of the developing clavicle functions as a growth plate.

Bone Neoplasms↗

PubMed1989

Growth of the clavicle and development of clavicular secondary cartilage in the embryonic mouse.

Whether secondary cartilage develops in the mammalian clavicle has been a matter of controversy. This study documents, in the embryonic mouse: (a) the onset of clavicular osteogenesis at 14 days of gestation (Theiler stage 22); (b) the appearance of secondary cartilage at 16 days of gestation (Theiler stage 24) and its persistence as a prominent cartilage until 18 days of gestation; (c) that the relative growth rate of the clavicle is much higher (0.097 mg/g body weight/day) between 16 and 17 days of gestation than at later ages (mean of 0.005 mg/g/day between 17 days of gestation and 4 days postnatally), and (d) that secondary cartilage failed to form in clavicles from 15-day-old embryos maintained in vitro. We conclude that secondary cartilage is a feature of the developing mouse clavicle, that it arises when the relative growth rate of the clavicle is highest, and that the most likely stimulus for differentiation of this cartilage is mechanical, muscle-based and associated with rapid relative clavicular growth.

Animals↗

PubMed1992

Osteolysis of the distal clavicle in a woman. Case report and review of the literature.

An unusual case of osteolysis of the distal clavicle in a woman is presented. Although almost 100 cases of osteolysis of the distal clavicle have been reported in the literature, none have occurred in females (Neer and Rockwood, 1984). After acute acromioclavicular dislocation, surgical reduction was carried out by transferring the coracoid process to the clavicle. Three years later the osteolysis of the outer clavicle appeared to be related to pain and functional impairment of the joint. The pain is quite tolerable and surgical excision of the distal clavicle has not yet been necessary.

Accidents, Traffic↗

PubMed1991

[Clavicle fracture in the newborn].

The authors have found 244 clavicle fractures during 4131 vaginal delivery (5.91%). Both clavicles of three newborns have fractured. The incidence of fracture had relation to weight of newborns, to weakness of pains and to vacuum extraction. The Apgar score of the newborns with fractured clavicle was not less, than one of newborns with unbroken clavicle. None of 704 newborns from cesarean section, and none of 52 newborns, who was born out of the hospital had fracture of the clavicle. The cause of fracture is the violent hurry of delivery, the drawing of the head before birth of shoulders. One of 244 injured newborns had permanent brachial plexus palsy. Late complication was not found. Between the injured newborns was more frequent the jaundice requiring phototherapy.

Apgar Score↗

PubMed1990

Clavicle fractures in the newborn.

A retrospective review of 21,632 live births from January 1982 to July 1987 was performed to determine the incidence and risk factors associated with fractures of the clavicle in the newborn. Fifty-eight fractures (57 patients) were identified, for an incidence of 2.7 clavicle fractures per 1000 live births. Fractures of the clavicle were associated with heavy neonates and shoulder dystocia. Three patients had concurrent clavicular fractures and Erb's palsy. These findings suggest that the incidence of clavicle fractures in the newborn may be reduced by identifying the macrosomic fetus and by minimizing shoulder dystocia. When clavicle fractures occur, a brachial plexus injury should be ruled out.

Apgar Score↗

PubMed1988

Anatomic and radiologic observations of the clavicle of adult dogs.

In an anatomic and radiologic study of the clavicle of 50 adult dogs of 10 breeds, the clavicle had ossified in 96% of the dogs. The clavicles studied had various shapes, and each clavicle was attached to the caudomedial part of the clavicular intersection of the brachiocephalic muscle, to the mastoid part of the cleidocephalic muscle, and to 4 radiating bands of connective tissue fasciculi. One band was attached to the caudal border of the scapula and fascia deep to the latissimus dorsi muscle, 1 was attached to the manubrium of the sternum, and 1 each was attached to the epimysia of the superficial pectoral and sternocephalic muscles. We concluded that, during movements of the thoracic limb, the clavicle and the 4 fasciculated connective tissue bands associated with it stabilize the position of the brachiocephalic muscle with relation to the crest of the greater tubercle of the humerus. Also, the fasciculated band attached to the caudal border of the scapula provides protection for nerves from the brachial plexus and axillary blood vessels that supply the thoracic limb.

Animals↗

PubMedDate not supplied

Condensing osteitis of the clavicle. Report of two cases and review of the literature.

Condensing osteitis of the clavicle, better defined as aseptic enlarging osteosclerosis of the clavicle, is a rare and benign idiopathic lesion. It is probably of degenerative or mechanical origin, and is most commonly seen in middle-aged women as a tender swelling over the medial one-third of the clavicle. Although the clinical features may be confusing and nonspecific, the typical radiographic and histopathological findings will mostly lead to a correct diagnosis of this disorder. The differential diagnosis is quite extensive. Most difficult to differentiate are: avascular necrosis of the medial clavicular epiphysis, sternoclavicular orsteoarthritis, low-grade chronic osteomyelitis, sternocostoclavicular hyperostosis and Tietze's syndrome. The authors recommend a thorough physical examination and technical tests, not only in subjects with pain of the clavicle but also in those with shoulder pain only, especially in women who are in their fourth decade. Treatment with analgesic and anti-inflammatory medications may be variably effective. In refractory cases excisions of the medial one-third of the clavicle may be indicated to offer better relief of symptoms as well as to exclude malignancy.

Adult↗

PubMed1991

The apical oblique view of the clavicle: its usefulness in neonatal and childhood trauma.

We analyzed clavicular radiographs of 26 patients with a history of trauma. The apical oblique projection of the clavicle was obtained with the injured side of the patient angled 45 degrees towards the X-ray tube and a 20 degrees cephalad angulation of the X-ray beam. This view proved to be more informative than the routine apical anteroposterior projection. It is especially effective in detecting nondisplaced fractures of the middle third of the clavicle in neonates and children. To verify our findings, we obtained apical anteroposterior and oblique radiographs of a specimen adult clavicle. On the oblique view with 20 degrees cephalad angulation of the X-ray beam, the measurements of the projected lengths of the anatomical specimen, especially those of the middle portion of the clavicle, were very close to the corresponding anatomical lengths.

Birth Injuries↗

PubMed1989

The arterial supply of the clavicle.

This report based on delineation of the arterial system with 3 component plastic material on 10 human cadavers describes the arterial supply to the clavicle. The study was performed in 2 parts. One part, which showed the total arterial supply to the clavicle and one part with selective injections of the relevant arteries, with the intention of finding a central nutrient arterial supply to the clavicle. Three arteries were found to supply the clavicle: the suprascapular a.; the thoracoacromial a.; and the internal thoracic (mammary) a. The main supply was primarily periosteal. No nutrient artery was found.

Aged↗

PubMed1991

Sexing of human clavicles using length and circumference measurements.

Measurement of clavicular length and circumference, and computation of clavicular robustness and length-circumference product from 724 autopsied adults of known age, sex, and body length between the ages of 15 and 96 years produced useful sex-predictive values. This predominantly North American white population contained 560 males and 164 females with intact, nondeformed clavicles. Clavicle length and circumference and particularly their product have been found useful in sexing, but robustness as a single trait has not. Despite a significant overlap of male and female values, the use of single cutoff values allowed correct sex assignment of up to 93% of the entire study population, including 94% of males and 89% of females. The ratios of body length to clavicle circumference and to clavicle length are on average greater in women than in men. The former ratio yields male predictive values greater than 95% for those individuals with ratios falling below the cutoff value of 43, whereas the latter ratio is a relatively poor sex predictor.

Adolescent↗

PubMed1987

Clavicle fractures in head-injured children.

Between the years 1960 and 1985, 499 children were treated at Rancho Los Amigos Hospital for residuals of head trauma. Of these, 35 had fractures of the clavicle (38 total fractures). Two of the patients had lateral physeal injuries and subsequently developed a "double" clavicle. All of the clavicle fractures healed without immobilization and exhibited excellent remodeling. All patients recovered complete range of motion of the shoulder. Only one of the patients required surgery (for removal of a tender bony prominence after the formation of a "double" clavicle).

Adolescent↗

PubMed1992

Condensing osteitis of the clavicle: magnetic resonance imaging as an adjunct method for differential diagnosis.

Condensing osteitis of the clavicle is a benign disorder leading to osteosclerosis of the medial end of the clavicle. The differential diagnosis between condensing osteitis of the clavicle and ischaemic necrosis of the medial clavicular epiphysis (Friedrich's disease), osteoid osteoma, and low grade osteomyelitis can be difficult. In the case history reported here, magnetic resonance imaging was a useful non-invasive procedure for the diagnosis of condensing osteitis of the clavicle.

Adult↗