Sanne Vancleef1, Michiel Herteleer2, Yannick Carette3, Paul Herijgers4, Joost R Duflou3, Stefaan Nijs5, Jos Vander Sloten6. 1. Biomechanics Section, KU Leuven, Leuven, Belgium. Electronic address: sanne.vancleef@kuleuven.be. 2. Organ Systems, KU Leuven, Leuven, Belgium; Department of Traumatology, Universitaire Ziekenhuizen (UZ) Leuven, Leuven, Belgium. 3. Department of Mechanical Engineering, KU Leuven, Leuven, Belgium. 4. Anatomy Skills Center, KU Leuven, Leuven, Belgium. 5. Department of Traumatology, Universitaire Ziekenhuizen (UZ) Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium. 6. Biomechanics Section, KU Leuven, Leuven, Belgium.
Abstract
BACKGROUND: The clavicle presents a large variability in its characterizing sigmoid shape. Prominent and nonproperly fitting fixation plates (FP) cause soft tissue irritation and lead to hardware removal. It is therefore key in FP design to account for shape variations. Statistical shape models (SSMs) have been built to analyze a cluster of complex shapes. The goal of this study was to describe the anatomic variation of the clavicle using SSMs. METHODS: Two different SSMs of the clavicle were created, and their modes of variation were described. One model contained 120 left male and female clavicles. The other model consisted of 76 left and corresponding right clavicles, 41 originating from men and 35 from women. RESULTS: The model of 120 left clavicles showed that 10 modes of variation are necessary to explain 95% of the variation. The most important modes of variation are the clavicle length, inferior-superior bow, and medial and lateral curvature. Statistically significant differences between male and female clavicles were seen in length, sigmoid shape, and medial curvature. Comparison in men between left and right revealed significant differences in length and medial curvature. For women, a statistically significant difference between left and right was only seen in the length. CONCLUSIONS: Although the operative treatment of displaced midshaft clavicular fractures has clear benefits, the variable anatomy of the clavicle often makes it challenging for the surgeon to make the plate fit adequately. Based on the identified variability in the clavicle's anatomy, it seems unlikely that a clavicle plating system can fit the entire population.
BACKGROUND: The clavicle presents a large variability in its characterizing sigmoid shape. Prominent and nonproperly fitting fixation plates (FP) cause soft tissue irritation and lead to hardware removal. It is therefore key in FP design to account for shape variations. Statistical shape models (SSMs) have been built to analyze a cluster of complex shapes. The goal of this study was to describe the anatomic variation of the clavicle using SSMs. METHODS: Two different SSMs of the clavicle were created, and their modes of variation were described. One model contained 120 left male and female clavicles. The other model consisted of 76 left and corresponding right clavicles, 41 originating from men and 35 from women. RESULTS: The model of 120 left clavicles showed that 10 modes of variation are necessary to explain 95% of the variation. The most important modes of variation are the clavicle length, inferior-superior bow, and medial and lateral curvature. Statistically significant differences between male and female clavicles were seen in length, sigmoid shape, and medial curvature. Comparison in men between left and right revealed significant differences in length and medial curvature. For women, a statistically significant difference between left and right was only seen in the length. CONCLUSIONS: Although the operative treatment of displaced midshaft clavicular fractures has clear benefits, the variable anatomy of the clavicle often makes it challenging for the surgeon to make the plate fit adequately. Based on the identified variability in the clavicle's anatomy, it seems unlikely that a clavicle plating system can fit the entire population.
Authors: Johannes Christof Hopf; Andreas Jähnig; Tobias Jorg; Ruben Sebastian Westphal; Daniel Wagner; Pol Maria Rommens Journal: PLoS One Date: 2020-05-21 Impact factor: 3.240
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Authors: Arabella D Fontana; Harry A Hoyen; Michael Blauth; André Galm; Marcel Schweizer; Christoph Raas; Martin Jaeger; Chunyan Jiang; Stefaan Nijs; Simon Lambert Journal: JSES Int Date: 2020-06-19