Harlow Ethan Robert, Sasala Lee M, Talbot Christopher E, Desai Bijal J, Ina Jason, Miskovsky Shana
Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.
Case Western Reserve School of Medicine, Cleveland, OH, United States.
Front Surg. 2021 Oct 28;8:761441. doi: 10.3389/fsurg.2021.761441. eCollection 2021.
The coracoclavicular joint (CCJ) is an anomalous articulation between the surfaces of the inferior clavicle and superior coracoid and its etiology is controversial. Reportedly, symptomatic patients demonstrate significant functional limitations including shoulder abduction loss and potential for brachial plexus compression and impingement. To determine the prevalence of CCJ across age, gender and ethnicity, and to identify clinically useful morphological characteristics. 2,724 subjects with intact clavicles and scapulae from the Hamann-Todd Osteological Collection were evaluated for the presence of CCJ. Logistic regression was used to determine the effect of age, height, gender, and race on prevalence of CCJ. 354 clavicles with CCJ were measured for size and location of the CCJ facet. CCJ was observed in 9% of subjects. CCJ was more prevalent in African-Americans (12%) than Caucasian-Americans (6%) ( < 0.001) and more prevalent in females (11%) than males (8%) ( = 0.055). Facet location along clavicle length was consistent (average 25%, range 15-35%). But, facet location along clavicle width varied (average 60%, range 10-90%), with males having a more posterior location. For every 10-year increase in age, facet elevation ( = 0.001) and surface area ( < 0.001) increased. CCJ prevalence was 9% in our large osseous population, found more commonly in African-Americans and females. Facet location is predictable with respect to clavicle length, but less so along clavicle width. The clavicular facet may develop at some point in life and continue to grow in size after its appearance. Presence of a CCJ represents a potential overlooked source of anterior shoulder pain and supracoracoid impingement. Epidemiologic and morphological characteristics presented in our study can aid in the identification, clinical understanding, and surgical excision of a symptomatic CCJ. Level of Evidence: Level IV.
喙锁关节（CCJ）是锁骨下表面与喙突上表面之间的一种异常关节，其病因存在争议。据报道，有症状的患者表现出明显的功能受限，包括肩关节外展丧失以及臂丛神经受压和撞击的可能性。为了确定CCJ在不同年龄、性别和种族中的患病率，并识别具有临床意义的形态学特征。对来自哈曼 - 托德骨骼收藏的2724名锁骨和肩胛骨完整的受试者进行了CCJ存在情况的评估。采用逻辑回归分析来确定年龄、身高、性别和种族对CCJ患病率的影响。对354例有CCJ的锁骨进行了CCJ小平面的大小和位置测量。在9%的受试者中观察到了CCJ。CCJ在非裔美国人（12%）中比白种美国人（6%）更常见（P<0.001），在女性（11%）中比男性（8%）更常见（P = 0.055）。沿锁骨长度方向的小平面位置是一致的（平均25%，范围15 - 35%）。但是，沿锁骨宽度方向的小平面位置有所不同（平均60%，范围10 - 90%），男性的位置更靠后。年龄每增加10岁，小平面高度（P = 0.001）和表面积（P<0.001）增加。在我们的大型骨骼人群中，CCJ患病率为9%，在非裔美国人和女性中更常见。关于锁骨长度，小平面位置是可预测的，但沿锁骨宽度则不然。锁骨小平面可能在生命中的某个阶段形成，并且在出现后会继续增大。CCJ的存在代表了肩部前方疼痛和喙突上撞击的一个潜在被忽视的来源。我们研究中呈现的流行病学和形态学特征有助于对有症状的CCJ进行识别、临床理解和手术切除。证据水平：IV级。
