Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 6 Issue 1

How Long is Your Clavicle? A Prospective Cadaveric Study Comparing the Validity of Ultra- sound and Manual Measurement of Clavicle Length

Bagouri E*, Paul Mccormack, Sheba Basheer and Manjit S Bhamra

Pinderfields General Hospital, The Mid-Yorkshire Hospitals, NHS Trust, Wakfield, United Kingdom

*Corresponding Author: Bagouri E, Pinderfields General Hospital, The Mid-Yorkshire Hospitals, NHS Trust, Wakfield, United Kingdom.

Received: October 25, 2022; Published: December 02, 2022

Abstract

Introduction: The rising trend of operative fixation of clavicles has raised questions about the clinical effects of shortening and the best methods to measure it. Most surgeons rely on X-rays or clinical examination however Furey., et al. have reported poor correlation between x-rays and CT findings.

Aim: The aim of this study is to test the validity of ultrasound as a quick and non-invasive measurement method in comparison to traditional manual measurements of clavicle length.

Methods: Nineteen cadavers (38 clavicles) were identified for potential inclusion in this study. Data was collected prospectively by two investigators using a standardised technique, the sterno-clavicular and acromio-clavicular joints were identified manually, marked and the lengths of the clavicles were measured using a metal ruler. Next, the markings were erased and the measurements were repeated following the same protocol after identification of the joints using ultrasonography (US). Finally, following dissection, the clavicles were re-measured under direct vision.

Results: We obtained Manual, US aided and direct measurements were taken from 35 clavicles (18 cadavers) using the described technique. Only paired results, either manual or US-aided with a corresponding direct clavicle measurement, were used for comparative analysis. Median clavicle length in all groups was 140 mm (ranges: Manual 130-165, US-aided 110-165, Direct 130-150). Statistical analysis was conducted using parametric tests (GraphPad Software, Inc. CA). We defined statistical significance as a p-value of 0.05 or less. Using a paired t-test, manual measurement (with palpation of adjacent joints) when compared to measurement under direct vision yielded a two tailed p-value of 0.0011, suggesting a very significant difference in the paired measurements. However, US-aided measurement when compared to direct measurement demonstrated no significant difference between the paired measurements (two-tailed p-value = 0.2001).

Conclusion: This study demonstrates that US-aided measurement of clavicle length may be more accurate than traditional manual measurement using palpation of clavicle length. Ultrasound has the benefit of being safe, non-invasive and involves no exposure of the patient to ionizing radiation. This study was conducted in cadavers with the associated limitations. Further study is required to validate these findings in vivo.

Disclosure: The study received no financial support. All authors have no conflict of interest to declare.

Keywords: Fractures; DMCF; Clavicle Length

References

  1. Neer C. “Fractures of the clavicle”. In: Rockwood CA Jr, Green DP, editors. Fractures in adults. 2nd Philadelphia: Lippincott; (1984): 707-13.
  2. Crenshaw AH. “Fractures of the shoulder girdle, arm and forearm”. In: Crenshaw AH, editor. Campbell’s operative orthopaedics. 8th St. Louis: Mosby Year Book; (1992): 989-1053.
  3. Neer CS. “2nd. Nonunion of the clavicle”. JAMA 172 (1960): 1006-1011.
  4. Canadian Orthopaedic Trauma Society. “Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial”. Journal of Bone and Joint Surgery (A) 1 (2007): 1-10.
  5. McKee MD., et al. “Deficits following non-operative treatment of displaced, mid-shaft clavicle fractures”. Journal of Bone and Joint Surgery (A) (2005).
  6. Andersen K., et al. “The treatment of clavicular fractures: Figure of eight bandage versus a simple sling”. Acta Orthopaedica Scandinavica 58 (1987): 71-74.
  7. McKee MD and the Canadian Orthopaedic Trauma Society. “A multi-centre randomized controlled trial of non-operative versus operative treatment of displaced clavicle shaft fractures”. Journal of Bone and Joint Surgery (A) 1 (2007): 1-11.
  8. , et al. “Plain film measurement error in acute displaced midshaft clavicle fractures”. Canadian Journal of Surgery 59.5 (2006): 311-316.
  9. Ledger M., et al. “Short malunions of the clavicle: an anatomic and functional study”. Journal of Shoulder and Elbow Surgery4 (2005): 349-354.
  10. RJ Hillen., et al. “The Effect of Experimental Shortening of the Clavicle on Shoulder Kinematics”. Clinical Biomechanics (Bristol, Avon) 8 (2012): 777-781.
  11. Grant L Jones., et al. “Intraobserver and Interobserver Agreement in the Classification and Treatment of Midshaft Clavicle Fractures”. American Journal of Sports Medicine 5 (2014): 1176-1181.
  12. AM Hingsammer., et al. “Three-Dimensional Corrective Osteotomies of Mal-United Clavicles--Is the Contralateral Anatomy a Reliable Template for Reconstruction?”. Clinical Anatomy7 (2015): 865-871.
  13. Kuhne JE. “Symptomatic malunions of the middle clavicle”. Journal of Shoulder and Elbow Surgery5 (1999): 539. (Abstracts: Seventh International Conference on Surgery of the Shoulder, 1999).

Citation

Citation: Bagouri E., et al. “How Long is Your Clavicle? A Prospective Cadaveric Study Comparing the Validity of Ultra- sound and Manual Measurement of Clavicle Length”.Acta Scientific Orthopaedics 6.1 (2023): 02-05.

Copyright

Copyright: © 2023 Bagouri E., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US