Quantitative Assessment of the Distal Clavicle with Its Clinical Implications in Anatomical Reconstruction of the Coracoclavicular Ligament

Abstract

Aim: Anatomical reconstruction of the coracoclavicular ligament has recently become popular in the treatment of acromioclavicular joint injuries. To perform this procedure correctly, the anatomy of the conoid tubercle and trapezoid line, which are the attachment sites of the coracoclavicular ligament, should be known accurately. Therefore, this study aimed to evaluate the distal clavicle along with morphometry of the conoid tubercle and trapezoid line. Material and Methods: In the present study, 77 human dry clavicles (39 right, 38 left) were examined using a digital caliper and digital thickness gauge. The clavicle length, thickness and width of the distal clavicle, morphometric features of the conoid tubercle, and trapezoid line were examined. Measurements were performed by two researchers independently. Results: The clavicle length was 138.37±10.69 mm. Supero-inferior thickness of the distal clavicle was 9.08±1.69 mm, and the antero-posterior width was 17.70±2.37 mm. Medio-lateral and supero-inferior dimensions of the conoid tubercle were 17.17±3.58 mm and 7.59±1.38 mm, respectively. The distance between the clavicle acromial end and the center of the conoid tubercle was 34.43±5.41 mm. Medio-lateral dimension of trapezoid line was 16.69±2.73 mm, and antero-posterior dimension was 9.61±1.80 mm. The distance between the clavicle acromial end and the center of the trapezoid line was measured as 18.15±2.80 mm. Conclusion: Accordingly, the tunnels for trapezoid and conoid ligaments should be created 18 mm and 34 mm medial from the clavicle acromial end, respectively. The measurements obtained in this study can be used as a guide for coracoclavicular ligament reconstruction.

Keywords

• anatomical reconstruction
• conoid tubercle
• coracoclavicular ligament
• distal clavicle
• morphometry
• trapezoid line

Ligamentum Coracoclaviculare’nin Anatomik Rekonstruksiyonunda Klinik Etkisi Olan Distal Clavicula’nın Kantitatif Değerlendirilmesi

Abstract

Amaç: Articulatio acromioclaviculare yaralanmalarının tedavisinde, ligamentum coracoclaviculare’nin anatomik rekonstrüksiyonu son zamanlarda popüler hale gelmiştir. Bu işlemin doğru şekilde yapılabilmesi için ligamentum coracoclaviculare’nin yapışma yerleri olan tuberculum conoideum ve linea trapezoidea’nın anatomisinin doğru şekilde bilinmesi gerekir. Bu nedenle, bu çalışmada tuberculum conoideum ve linea trapezoidea’nın morfometrisi ile birlikte distal clavicula’nın değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Bu çalışmada, 77 insan kuru clavicula kemiği (39 sağ, 38 sol) dijital kumpas ve dijital kalınlık ölçer kullanılarak incelendi. Clavicula uzunluğu, distal clavicula kalınlığı ve genişliği, tuberculum conoideum ve linea trapezoidea’nın morfometrik özellikleri incelendi. Ölçümler iki araştırmacı tarafından bağımsız olarak gerçekleştirildi. Bulgular: Clavicula uzunluğu 138,37±10,69 mm idi. Distal clavicula’nın supero-inferior kalınlığı 9,08±1,69 mm ve antero-posterior genişliği ise 17,70±2,37 mm bulundu. Tuberculum conoideum’un medio-lateral ve supero-inferior boyutları sırasıyla 17,17±3,58 mm ve 7,59±1,38 mm idi. Clavicula extremitas acromialis’i ile tuberculum conoideum’un merkezi arasındaki mesafe 34,43±5,41 mm olarak ölçüldü. Linea trapezoidea’nın medio-lateral uzunluğu 16,69±2,73 mm ve antero-posterior uzunluğu ise 9,61±1,80 mm idi. Clavicula extremitas acromialis’i ile linea trapezoidea’nın merkezi arasındaki mesafe 18,15±2,80 mm olarak ölçüldü. Sonuç: Bu çalışmadaki ölçümlere göre, ligamentum trapezoideum ve ligamentum conoideum için açılacak tüneller clavicula’nın extremitas acromialis’inden sırasıyla 18 mm ve 34 mm medialde oluşturulmalıdır. Bu çalışmadan elde edilen ölçümler, ligamentum coracoclaviculare’nin anatomik rekonstrüksiyonunda bir kılavuz olarak kullanılabilir.

Keywords

• anatomik rekonstruksiyon
• tuberculum conoideum
• ligamentum coracoclaviculare
• distal clavicula
• morfometri
• linea trapezoidea

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