Department of Orthopaedics & Rehabilitation, Penn State College of Medicine, 17033 Hershey, United States.
Jt Dis Relat Surg. 2023;34(1):63-68. doi: 10.52312/jdrs.2023.937. Epub 2023 Jan 6.
The aim of the study was to investigate whether clavicular symmetry was a valid assumption and to assess the factors that could predict clavicular asymmetry.
Between January 2021 and April 2021, a total of 100 consecutive patients (61 males, 39 females; mean age: 63.6±15.5 years; range, 27 to 94 years) whose both clavicles were adequately seen on chest computed tomography (CT) were retrospectively analyzed. Clavicular lengths were measured on three-dimensional (3D) reconstruction of chest CTs by two independent orthopedic surgeons on two separate occasions. The longest distance passing the straight line between the most lateral part of the clavicle at the acromioclavicular joint and the most medial point of the clavicle on the sternoclavicular joint was given as the clavicle length after adjusting tilt of convertible 3D CTs. Clavicular length difference was calculated by subtracting the short clavicle's length from the long clavicle's length. Patients' age and sex were noted. The calculated clavicular length differences were assigned into three groups: ≤5 mm, >5 mm and ≤10 mm, and >10 mm.
The mean right and left clavicle lengths were 13.9±1.3 cm and 14.1±1.2 cm, respectively (p<0.001). A total of 29 patients (29%) had >5 mm clavicle asymmetry and six patients (6%) had more than 10 mm clavicular length difference. Age, sex, and clavicular length were not associated with the clavicular length difference.
Our study results showed that 29% of the patients had >5 mm clavicular length asymmetry. The clavicular symmetry may not be a valid assumption in the decision making for the surgical treatment of mid-shaft clavicle fractures; thus, this assumption may lead to maltreatment. More factors that can predict clavicle asymmetry should be investigated in future studies.
本研究旨在探讨锁骨对称性是否成立，并评估可能导致锁骨不对称的因素。
回顾性分析 2021 年 1 月至 2021 年 4 月期间因胸部 CT 可见双侧锁骨而接受手术的 100 例连续患者（男 61 例，女 39 例；平均年龄 63.6±15.5 岁；年龄范围 27 岁至 94 岁）。通过两名独立的骨科医生在两次不同的时间，在胸部 CT 的三维重建上测量锁骨的长度。调整可转换 3D CT 的倾斜度后，将通过锁骨肩峰关节最外侧部分与胸锁关节最内侧点之间的直线的最长距离定义为锁骨长度。通过从长锁骨长度中减去短锁骨长度来计算锁骨长度差。记录患者的年龄和性别。将计算出的锁骨长度差分为三组：≤5mm、>5mm 且≤10mm、>10mm。
右锁骨和左锁骨的平均长度分别为 13.9±1.3cm 和 14.1±1.2cm（p<0.001）。共有 29 名患者（29%）的锁骨不对称>5mm，6 名患者（6%）的锁骨长度差异>10mm。年龄、性别和锁骨长度与锁骨长度差无关。
我们的研究结果表明，29%的患者存在>5mm 的锁骨长度不对称。在决定锁骨中段骨折的手术治疗时，锁骨对称性可能不是一个有效的假设；因此，这种假设可能导致治疗不当。未来的研究应该探讨更多可以预测锁骨不对称的因素。
