The variance of clavicular surface morphology is predictable: an analysis of dependent and independent metadata variables

• Main Authors: Arabella D. Fontana, PhD, Harry A. Hoyen, MD, Michael Blauth, MD, PhD, André Galm, Dipl-Ing, Marcel Schweizer, MS, Christoph Raas, MD, PhD, Martin Jaeger, MD, Chunyan Jiang, MD, PhD, Stefaan Nijs, MD, PhD, Simon Lambert, FRCSEd (Orth)
• Format: Article
• Language: English
• Published: Elsevier 2020-09-01
• Series: JSES International
• Subjects: Clavicle; anatomy; clavicle curvature; clavicle bow; 3D reconstruction; implant fit
• Online Access: http://www.sciencedirect.com/science/article/pii/S2666638320300827

Background: The anatomy of the clavicle is specific and varied in reference to its topography and shape. These anatomic characteristics play an important role in the open treatment of clavicle fractures. The complex and variable topography creates challenges for implant placement, contouring, and position. Hardware prominence and irritation does influence the decision for secondary surgical intervention. Methods: Computerized tomographic scans of 350 adult clavicles with the corresponding patients' metadata were acquired and digitized. Morphologic parameters determining the shape of the clavicle were defined and computed for each digitized bone. The extracted morphologic parameters were correlated with patient metadata to analyze the relationship between morphologic variability and patient characteristics. Results: The morphologic parameters defining the shape, that is, the radius of the medial and lateral curves, the apparent clavicle height and width, and the clavicle bow position, correlate with the clavicle length. The clavicle length correlates with the patients' height. Gender differences in shape and form were dependent and related to individual height distribution and clavicle length. Asian populations showed a similarly predictable, but shifted, correlation between shape and clavicle length. Conclusion: This anatomic analysis shows that the clavicle shape can be predicted through the clavicle length and patients' stature. Smaller patients have shorter and more curved clavicles, whereas taller patients have longer and less curved clavicles. This correlation will aid surgeons in fracture reduction, implant curvature selection, and in optimal adaptation of clavicle implants, and represents the basis for anatomically accurate solutions for clavicle osteosynthesis.