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PubMed1986

Rhomboid fossa in the clavicles of North Indians.

The incidence and size of the rhomboid fossa were studied in paired clavicles of North Indians obtained from 20 neonates, 60 children, and 789 adult bodies of known age and sex on which postmortem examinations had been performed by the senior author (except in cases of neonates). The fossa was absent in the newborns but was present bilaterally in 44% of male and 54% of female children below 18 years of age and in 16.5% of male and 20.8% of female children unilaterally. Statistically the sexual differences were not significant (P greater than 0.05). In the adults, the incidence of bilateral fossa was 58.70% in males and 54.14% in females and a unilateral fossa was seen in 13.29% of males and 16.56% of females, but the sexual difference in both cases was insignificant (P greater than 0.05). However, in unilateral cases, the incidence of the fossa was greater on the right than on the left side in both male (P less than 0.001) and female (P less than 0.001) bones. Although racial differences cannot be ruled out, no sexual or side differences in the incidence of the fossa could be found. Factors responsible for creating a deep fossa unilaterally are not understood.

Adolescent↗
PubMed2006

Fetal clavicle length throughout gestation: a nomogram.

OBJECTIVE: To create a nomogram of fetal clavicle length (CL) throughout gestation. METHODS: Cross-sectional study of patients between 14 and 42 weeks' gestation. Inclusion criteria consisted of well-established dates (consistent with early ultrasound), singleton, non-anomalous fetuses, and intact amniotic membranes. Sonographic measurements included biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), humerus length (HL) and sonographically estimated fetal weight (SEFW). For every case, the average of three separate measurements of the CL was used. The 5th, 50th and 95th centiles were obtained by least squares regression. Pearson's correlation coefficient and associated P-values for the relationships between CL and other biometric measurements were calculated. The data were compared to a nomogram of the CL generated in 1985 from the measurement of 85 fetuses. RESULTS: A total of 623 consecutive patients were studied. In all but three cases, CL was successfully measured. Mean maternal age was 27.7 +/- 6.2 years, median gravidity 3 (range, 1-14) and median parity 1 (range, 0-9). Mean CL (mm) = -75.30 + 32.70*ln(GA) and SD = -0.41 + 0.08328*GA, where ln represents the natural logarithm and GA the gestational age in weeks. Fetal CL correlated significantly and strongly with BPD, HC, AC, HL, FL and the logarithm of SEFW, with Pearson correlation values of 0.973, 0.977, 0.976, 0.979, 0.977 and 0.979, respectively (all P < 0.001). Measurements according to comparable 1985 data were consistently substantially below the present data (smaller CL for any given GA except below 17 weeks' gestation). CONCLUSIONS: We propose a new nomogram of CL, which differs significantly from the previously published nomogram. We suggest that the present data reflect the use of high-resolution ultrasound technology and propose that these data, based on a large number of fetuses, replace the previous nomogram. We also suggest that the '1 mm = 1 week' rule of thumb should no longer be used, since it can be erroneous by as much as 6 weeks.

Adult↗
PubMed1990

Case report 623. Osteitis condensans of the left clavicle (OCC).

A case of OCC in a 35-year-old woman is presented. Proof was obtained by open biopsy. This rare entity is benign and its etiology is still obscure. No definite association with osteitis pubis or osteitis condensans ilii has been reported. The involvement of the clavicle is invariably unilateral. The clinical and radiographic characteristics of this benign condition have been discussed and the differential diagnosis has been considered. Consideration should be given to the concept that if the imaging features are characteristic, as in this case, biopsy may not be necessary.

Adult↗
PubMed1991

Case report 698: Osteoma of the clavicle.

We have presented a case of an osteoma of the clavicle in a 41-year-old man. The possibility of alternate diagnoses--in particular, ancient osteochondroma, posttraumatic hyperostosis, and parosteal osteosarcoma--was addressed. However, the pathological examination was most consistent with the diagnosis of osteoma. This benign bone lesion is most often found in the calvarium, jaw, and face. Osteomas of long bones remain extremely rare, except in the setting of Gardner's syndrome.

Adult↗
PubMed1994

Osteomyelitis of the clavicle: clinical, radiologic, and bacteriologic findings in ten patients.

Most lesions of the clavicle are traumatic and pose few diagnostic difficulties. Nontraumatic clavicular lesions, on the other hand, are rare and frequently present problems in diagnosis. This report reviews the clinical, radiologic, and bacteriologic findings in ten patients, six of whom were diagnosed as having acute osteomyelitis and four chronic osteomyelitis. The differential diagnosis of clavicular osteomyelitis is also discussed. The clinical duration of the infectious process in these patients ranged from 2 weeks to 1.5 years. All patients presented with pain; six had fever, three had localized swelling or a mass, and three had soft tissue abscesses. The radiographic findings also varied: the lesion was predominantly sclerotic in four patients, lytic in three, and mixed in two patients; in the one patient in whom magnetic resonance imaging was the only imaging study performed, these features could not be properly evaluated. Periosteal reaction was detected in three patients. Staphylococcus aureus was the causal organism in four patients, while in the remaining six patients different microorganisms were cultured, including Coccidiodes immitis and Mycobacterium tuberculosis. Six patients required biopsy for final diagnosis. Although clavicular osteomyelitis is rare, particularly in adults, it should be considered in the differential diagnosis of a clavicular lesion. The final diagnosis often depends on the results of biopsy and cultures.

Acute Disease↗
PubMed1993

Case report 793. Periosteal osteosarcoma of the clavicle.

A case of periosteal osteosarcoma in an 18-year-old boy has been reported. This is the first reported case of periosteal osteosarcoma arising in the clavicle. The radiological features in this case were entirely similar to those in long bones such as the femur and tibia. In addition to the radiological features and pathologic findings, various clinical aspects and prognosis were also discussed.

Adolescent↗
PubMed1979

Radiology of postnatal skeletal development. III. The clavicle.

Thirty-one pairs of clavicles obtained from human cadavers ranging in age from full-term stillborn to fourteen years were studied morphologically and radiographically. Specimen roentgenography using air/cartilage interfacing demonstrated the osseous and cartilaginous portions of the epiphyses. Overall longitudinal growth appeared to occur to a greater degree in the sternal end, which also developed a secondary ossification center. No comparable ossification was seen in the acromion. The curve patterns differed in the acromial and sternal ends. The sternoclavicular joint has a meniscus throughout postnatal development. This was demonstrated by air arthrography. Finally, the sternoclavicular joint was dislocated anteriorly and posteriorly to duplicate trauma to this region. Roentgenographic aspects of development are discussed and illustrated to provide a reference index.

Adolescent↗
PubMed1989

Inflammatory metachronous hyperostosis of the clavicle and femur in children. Report of two cases, one with long-term follow-up.

Two preteenage girls developed painful swelling of the left clavicle. This was followed by painful swelling of the femur, 7 months later in one girl and 8 years later in the other. Radiographic studies showed a predominantly sclerotic process in one patient and destruction associated with cortical thickening in the other. The patients received analgesic medications only, followed by gradual healing with cortical and medullary sclerosis. Long-term follow-up suggests that the condition is self-limited and that, with or without treatment, the bones eventually return to normal. Although the etiology of the lesions remains unknown, the radiographic features suggest an inflammatory reaction.

Biopsy↗
PubMed1988

Primary tumors and tumor-like lesions of the clavicle.

Fifty eight patients seen at Memorial Sloan-Kettering Cancer Center over a 50-year period were reviewed for lesions of the clavicle. A variety of malignant neoplasms, benign neoplasms, and tumor-like lesions were seen. There were 30 malignant neoplasms, the commonest of which were plasmacytomas, osteosarcomas, and Ewing sarcomas. There were five postradiation sarcomas. An unusual granulocytic sarcoma with dense sclerosis was described. Among the benign lesions were two osteochondromas, two hemangiomas, and a giant cell tumor secondary to Paget disease. The tumor-like lesions included six aneurysmal bone cysts and five eosinophilic granulomas. There were two patients with chronic sclerosing osteomyelitis and one each with sternocostoclavicular hyperostosis (Sonozaki syndrome) and condensing osteitis. An unusually large lesion of pseudogout and a large brown tumor were also included in the series.

Adolescent↗
PubMed1990

Bilateral congenital pseudarthrosis of the clavicle.

A case of bilateral congenital pseudarthrosis of the clavicle in a baby boy is described. The patient is fully asymptomatic, and no functional impairment is present. This is probably only the seventh case described of this rare congenital anomaly.

Clavicle↗
PubMed1987

Chronic sclerosing osteomyelitis of the clavicle. A manifestation of chronic recurrent multifocal osteomyelitis.

The cases of five children/adolescents and two young adults with unilateral chronic osteomyelitis of the clavicle are reported. The clinical course was prolonged and characterized by intermittent periods of exacerbation followed by improvement. Extensive investigations revealed no causative organisms and the disease seemed resistant to antibiotic therapy. The only laboratory abnormality was elevated ESR, present in five cases. Osteomyelitis of other bones was detected in four cases and pustulosis palmoplantaris in two, suggesting that the disease is a manifestation of chronic recurrent multifocal osteomyelitis.

Adolescent↗
PubMed1983

Condensing osteitis of the clavicle in childhood: a rare sclerotic bone lesion. Review of literature and report of seven patients.

Seven children and adolescents with sclerotic and periosteal alterations of the clavicle are reported, two of them in detail. Malignancies and bacterial inflammatory processes, which were first suspected, could be excluded. Clinical and radiographic features as well as differential diagnosis are discussed, as is the pertinent literature. The etiology of this uncommon bone lesion, which is described under different names, could not be clarified.

Adolescent↗
PubMed1982

[Pseudarthrosis of the clavicle - an unnecessary complication? (author's transl)].

The pseudarthrosis of the clavicle is a rare complication of trauma surgery. The pseudarthrosis is mainly situated in the two medial quarters of the bone. The stable plate-osteosynthesis is regarded as the best treatment in combination with an autologous bone grafting in cases of atrophic or defect-pseudarthrosis. From 1970 to 1981 20 patients were treated at the BG Unfallklinik Tübingen, indication, operative procedures and the results are given. A bony union was achieved in all cases.

Adolescent↗
PubMed1991

[Unstable fractures of the lateral end of the clavicle and principles of their treatment].

25 fractures of the lateral end of the clavicle were treated during the last six years. 22 of them were unstable because of additional rupture of the coracoclavicular ligaments. Only in two patients conservative treatment was successful, in six cases conservative treatment was unsuccessful. Altogether 20 fractures had to be operated. Coracoclavicular screw fixation (Bosworth) is recommended for simple fractures and plating for multifragmental injuries. Operative methods using K-wires are frequently impaired by wire-migration and therefore require a longer period of external immobilization. Independent of the type of surgery objective and subjective results were equally good.

Adolescent↗
PubMed1991

[Simultaneous dislocation-fracture of both ends of the clavicle].

A case of simultaneous dislocation-fracture of both ends of the right clavicle in a 17-year old patient is being described. Treatment consisted in operative reduction of both injuries. The sterno-clavicular joint was stabilized by a transarticular K-wire, the acromioclavicular injury was treated by extraarticular tension-band-wiring. Healing was without complications and the result 37 months after injury was excellent.

Acromioclavicular Joint↗
PubMed2002

[Technique of intramedullary osteosynthesis of the clavicle with elastic titanium nails].

This prospective controlled clinical trial was performed to assess fracture healing and clinical outcome after intramedullary nailing of midclavicular fractures. Within 3.5 years elastic-stable intramedullary nailing was performed in 62 patients with 65 midclavicular fractures. Surgery was performed in supine position. The ventral cortex of the proximal clavicle was opened using a 2.5 mm drill. The nail was advanced laterally under fluoroscopic control. If closed reduction failed, an additional incision was made to enable direct manipulation of the fragments. There were no infections, no implant displacements or refractures. Postoperatively, the mean subjective pain was significantly lower, and the range of motion improved. We observed one nonunion. The mean Constant-score 6 months after hardware removal was 96.9 +/- 3.3 points. Intramedullary fixation of midclavicular fractures with an elastic titanium nail is a safe minimally invasive surgical technique, producing excellent functional and cosmetic results.

Adolescent↗