Anatomy of the clavicle and its medullary canal - a computer tomography study

[摘要] ENGLISH ABSTRACT: BackgroundWith recent literature indicating certain clavicle shaft fracture types are best treated surgically; there isrenewed interest in the anatomy of the clavicle. lntramedullary fixation of clavicle shaft fracturesrequires an adequate medullary canal to accommodate the fixation device used. This computertomography anatomical study of the clavicle and its medullary canal describes its general anatomy anddetermines the suitability of its medullary canal to intramedullary fixation.Description of methodsFour hundred and eighteen clavicles in 209 patients were examined using computer tomographyimaging. The length and curvatures as well as the height and width of the clavicle and its canal atvarious pre-determined points were measured. ln addition the start and end of the medullary canalfrom the sternal and acromial ends of the clavicle were determined. The data was grouped according toage, gender and lateralization.Summary of resultsThe average length of the clavicle was 151.15 mm with the average stemal and acromial curvaturebeing 146 and 133 respectively. The medullary canal starts on average 6.59 mm from the sternal endand ends 19.56 mm from the acromial end with the average height and width of the canal at the middlethird being 5.61 mm and 6.63 mm respectively.ConclusionThe medullary canal of the clavicle is large enough to accommodate commonly used intramedullarydevices in the nraprity of cases. The medullary canal extends far enough medially and laterally for anintramedullary device to adequatet'y bridge most middte third clavicle fractures. An alternative surgicaloption should be avalable in theatre when treating females as the medullary canal is toosmall to passan intranedullary device past the fracture site on rare occasions.

[发布机构] Stellenbosch University