Effect of Shortening Deformity of the Clavicle on Scapular Kinematics
- 9 March 2010
- journal article
- research article
- Published by SAGE Publications in The American Journal of Sports Medicine
- Vol. 38 (5), 1000-1006
- https://doi.org/10.1177/0363546509355143
Abstract
Background: In some short malunion cases, midshaft clavicular fractures are reported to result in unsatisfactory clinical outcomes. Shortening deformity of the clavicle could change the anatomical alignment of the shoulder girdle and is surmised to affect shoulder kinematics on arm movements. Nevertheless, no report has ever referred to documented changes. Hypothesis: Scapular motion will change with clavicular shortening in cadaveric models. Study Design: Controlled laboratory study. Methods: Twelve cadaveric shoulders were used, and sequential clavicular shortening by 0%, 5%, 10%, 15%, and 20% from the original length was simulated in this study. The scapulothoracic motion during passive arm elevation in 3 planes was monitored using an electromagnetic tracking device. Differences in kinematics of the scapula between the 0% shortening models and the other 4 experimental groups were analyzed. Results: During arm elevation, posterior tilting and external rotation of the scapula significantly decreased with ≥10% shortening of the clavicle. Decreased posterior tilting was found with a shorter clavicle and at higher positions of arm elevation in all planes and became obvious during coronal plane elevation. Upward rotation of the scapula did not change with shortening at any elevated arm positions. Conclusion: The findings of this study clearly indicated that shortening of the clavicle affects the kinematics in the shoulder girdle. Clinical Relevance: The results of this cadaveric study suggest that clavicular shortening of ≥10% affects scapular kinematics and might produce clinical symptoms.Keywords
This publication has 37 references indexed in Scilit:
- The Association of Scapular Kinematics and Glenohumeral Joint PathologiesJournal of Orthopaedic & Sports Physical Therapy, 2009
- Motion of the Shoulder Complex During Multiplanar Humeral ElevationJournal of Bone and Joint Surgery, 2009
- Length Determination in Midshaft Clavicle Fractures: Validation of MeasurementJournal of Orthopaedic Trauma, 2008
- Three-Dimensional Acromioclavicular Joint Motions During Elevation of the ArmJournal of Orthopaedic & Sports Physical Therapy, 2008
- Conservative treatment of fractures at the middle third of the clavicle: The relevance of shortening and clinical outcomeJournal of Shoulder and Elbow Surgery, 2006
- Short malunions of the clavicle: An anatomic and functional studyJournal of Shoulder and Elbow Surgery, 2005
- Effect of rotator cuff pathology on shoulder rhythmJournal of Shoulder and Elbow Surgery, 2005
- Can we predict long-term sequelae after fractures of the clavicle based on initial findings? A prospective study with nine to ten years of follow-upJournal of Shoulder and Elbow Surgery, 2004
- Clavicle malunionJournal of Shoulder and Elbow Surgery, 1999
- A system for describing positions of the humerus relative to the thorax and its use in the presentation of several functionally important arm positionsJournal of Shoulder and Elbow Surgery, 1992