McGraw Molly A, Mehlman Charles T, Lindsell Christopher J, Kirby Cassie L
Ohio University College of Osteopathic Medicine, Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
J Pediatr Orthop. 2009 Dec;29(8):937-43. doi: 10.1097/BPO.0b013e3181c11992.
The purpose of our study was to perform a large cross-sectional study aimed at determining the postnatal growth pattern of the clavicle from birth to 18 years of age.
We analyzed the digital chest radiographs of a convenience sample of 961 individuals between birth and 18 years of age. Malrotated radiographs were excluded. Right and left clavicle lengths were measured in millimeters from the most lateral ossified border to the most medial ossified border of each clavicle. Study patients were divided into 19 subgroups with the first group being labeled as "birth to 11 months of age" followed by 1-year-olds, 2-year olds, etc. Patients were also grouped by sex. There was a minimum of 25 patients in each group.
At 18 years of age the mean+/-SD clavicle length for females was 149+/-12 mm and for males it was 161+/-11 mm. Although a statistically significant difference (P=0.049) was noted between the length of right and left clavicles it was not clinically significant (0.036 mm). A steady growth rate was noted for both genders from birth to the age of 12 years (8.4 mm/y). Above the age of 12 years there were significant differences in the growth of the clavicles of girls (2.6 mm/y) versus boys (5.4 mm/y) (P<0.001). Our data suggest that females achieve 80% of their clavicle length by 9 years of age and boys by 12 years of age.
This cross-sectional study establishes that relatively little clavicle growth (20%) remains for girls beyond age 9 years and for boys beyond 12 years. The length of one clavicle may be properly judged by comparing it with the contralateral clavicle.
Remodeling of the clavicle shaft fractures is currently believed to be proportional to remaining growth. Our study questions the capacity of the clavicle to re-establish normal length beyond the age thresholds we have identified.
我们研究的目的是进行一项大型横断面研究，旨在确定从出生到18岁锁骨的出生后生长模式。
我们分析了961例出生至18岁个体的便利样本的数字化胸部X线片。排除旋转不良的X线片。从每侧锁骨最外侧的骨化边界到最内侧的骨化边界，以毫米为单位测量左右锁骨的长度。研究患者分为19个亚组，第一组标记为“出生至11个月龄”，随后是1岁、2岁等。患者也按性别分组。每组至少有25名患者。
18岁时，女性锁骨平均长度±标准差为149±12毫米，男性为161±11毫米。虽然左右锁骨长度之间存在统计学显著差异（P = 0.049），但在临床上并不显著（0.036毫米）。从出生到12岁，两性的生长速度均稳定（8.4毫米/年）。12岁以上，女孩（2.6毫米/年）和男孩（5.4毫米/年）锁骨生长存在显著差异（P<0.001）。我们的数据表明，女性在9岁时达到其锁骨长度的80%，男性在12岁时达到。
这项横断面研究表明，9岁以上女孩和12岁以上男孩的锁骨生长相对较少（20%）。通过与对侧锁骨比较，可以正确判断一侧锁骨的长度。
目前认为锁骨骨干骨折的重塑与剩余生长成正比。我们的研究对锁骨在我们确定的年龄阈值之后重新建立正常长度的能力提出了质疑。
