Measurement of Clavicular Symmetry in Healthy Subjects Using Tomographic Database of Public Hospitals^[*]

Abstract

Objective This study aimed to perform an imaging evaluation to prove the existence or not of symmetry between the clavicles of healthy subjects from Curitiba, Paraná, Brazil, and identify potential factors influencing the clavicular length.

Method The study analyzed chest computed tomography (CT) scans of 211 patients with no clavicular fracture or malformations (100 women and 111 men). We measured the greatest clavicular diagonal on both sides, and the software automatically generated the maximum distance in millimeters. Relative and absolute frequencies described qualitative variables and mean values; quantitative variables used a 95% confidence interval. Value comparisons employed the student's t-test, and correlations determinations used Pearson's correlation coefficient. The significance level adopted was 5%.

Results There was a significant difference between the clavicular length (right clavicle, 143.58 mm; left clavicle, 145.72 mm; p = 0.037), indicating asymmetry. On average, the left clavicle was 3.71 mm larger. Asymmetry was significant for both men and women (p < 0.001). The average difference was 4.13 mm for men and 3.23 mm for women. Seventy-three percent of the sample had < 5 mm of asymmetry, 23.7% had 5 to 10 mm, and 3.3% had > 10 mm of asymmetry.

Conclusion The studied population did not present clavicular symmetry. On average, the left clavicle was longer than the right clavicle, with differences of 3.71 mm in the general sample, 3.23 mm in women, and 4.13 mm in men. The only significant factor was gender since men presented longer clavicles and higher differences than women.

Keywords

anatomy, regional - anthropometry - clavicle - tomography

^* Study developed at the Orthopedics and Traumatology Department, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil

Publikationsverlauf

Eingereicht: 08. September 2022

Angenommen: 27. März 2023

Artikel online veröffentlicht:
30. August 2023

• Referências

• 1 Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD. Evidence-Based Orthopaedic Trauma Working Group. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma 2005; 19 (07) 504-507
• 2 Court-Brown CM, Heckman JD, McQueen MM, Ricci WM, Tornetta III P, McKee MD. Rockwood and Green's fractures in adults. 8th ed. Philadelphia: Wolters Kluwer; 2015
• 3 Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br 1997; 79 (04) 537-539
• 4 Silva SR, Fox J, Speers M. et al. Reliability of measurements of clavicle shaft fracture shortening in adolescents. J Pediatr Orthop 2013; 33 (03) e19-e22
• 5 Lazarides S, Zafiropoulos G. Conservative treatment of fractures at the middle third of the clavicle: the relevance of shortening and clinical outcome. J Shoulder Elbow Surg 2006; 15 (02) 191-194
• 6 Thorsmark AH, Muhareb Udby P, Ban I, Frich LH. Bone shortening of clavicular fractures: comparison of measurement methods. BMC Musculoskelet Disord 2017; 18 (01) 537
• 7 Hoogervorst P, Appalsamy A, Franken S, van Kampen A, Hannink G. Quantifying shortening of the fractured clavicle assuming clavicular symmetry is unreliable. Arch Orthop Trauma Surg 2018; 138 (06) 803-807
• 8 Cunningham BP, McLaren A, Richardson M, McLemore R. Clavicular length: the assumption of symmetry. Orthopedics 2013; 36 (03) e343-e347
• 9 Sehrawat JS, Pathak RK. Variability in anatomical features of human clavicle: Its forensic anthropological and clinical significance. Transl Res Anat 2016; 3-4: 5-14