Patted Shiddanna M, Kumar Akshay, Halawar Rudresh S
Department of Orthopaedics, BVVS S Nijalingappa Medical College and HSK Hospital and Research Centre, Navanagar, Bagalkot, Karnataka 587103 India.
Department of Radiodiagnosis, BVVS S Nijalingappa Medical College and HSK Hospital and Research Centre, Bagalkot, India.
Indian J Orthop. 2020 Sep 18;54(Suppl 2):283-291. doi: 10.1007/s43465-020-00223-2. eCollection 2020 Dec.
Intramedullary fixation is one of the common methods of treating clavicle fractures. Morphometric data of the clavicle and its medullary canal will help design a better device and surgical technique. Morphometric studies on clavicle are sparse; hence, this study.
A 3-D reconstruction of 64 clavicles of 32 patients was done from computed tomography (CT) scan data of thorax obtained for the diagnostic workup of unrelated disease. The various dimensions of the clavicle and its medullary canal were measured. The narrowest part, point of change of direction of the medullary canal, curvatures of the clavicle, the position of the coracoid process, and the relation of these features to eight equally divided segments of clavicle were noted.
The average length of the clavicle was 142.5 mm. The average height and width of the narrowest part of the medullary canal were 2.4 mm and 2.5 mm, respectively, corresponding to segment 5 (S5) in more than half of the clavicles. The change of direction of the medullary canal and the medial edge of the coracoid process were corresponding to segment 6 (S6) in the majority of the clavicles.
This computed tomographic study provides morphometric data of the clavicle applicable to intramedullary fixation of clavicle fractures. In the studied population, the clavicles were shorter, more curved, and had medullary canal dimensions less than 2.5 mm at the narrowest part. This may pose difficulties in intramedullary fixation. The coracoid process was a reliable anatomical landmark.
髓内固定是治疗锁骨骨折的常用方法之一。锁骨及其髓腔的形态学数据将有助于设计更好的器械和手术技术。关于锁骨的形态学研究较少,因此开展了本研究。
从因无关疾病诊断性检查而获取的胸部计算机断层扫描(CT)数据中,对32例患者的64根锁骨进行三维重建。测量锁骨及其髓腔的各种尺寸。记录髓腔最窄部分、髓腔方向改变点、锁骨曲率、喙突位置,以及这些特征与锁骨八等分节段的关系。
锁骨平均长度为142.5毫米。髓腔最窄部分的平均高度和宽度分别为2.4毫米和2.5毫米,超过半数的锁骨对应于第5节段(S5)。髓腔方向改变和喙突内侧边缘在大多数锁骨中对应于第6节段(S6)。
本计算机断层扫描研究提供了适用于锁骨骨折髓内固定的锁骨形态学数据。在研究人群中,锁骨较短、弯曲度较大,且髓腔最窄部分尺寸小于2.5毫米。这可能给髓内固定带来困难。喙突是一个可靠的解剖标志。