A comprehensive, integrated study of the clavicle: Its topographical anatomy, biomechanical architecture and function; pathological anatomy of mid-shaft fractures and the decision-making process for a surgical approach when planning an intramedullary impl:  Part 5 Frustum, a geometrical creation of a malunited clavicle fracture

Gandhi Harjeet Singh

doi:10.24297/ijct.v26i.9861

Authors

Gandhi Harjeet Singh Hamilton Health Sciences, Ontario

DOI:

https://doi.org/10.24297/ijct.v26i.9861

Keywords:

Clavicle fracture, Clavicle malunion, Frustum, Clavicle kinematics, Scapular kinematics, Scapular winging, Two-bone problem, Biomechanics

Abstract

Highlights: Fractures of the clavicle within the shoulder complex are a two-bone problem, as the forces from the clavicle are mediated through the scapula to the glenohumeral joint. An angular malunion in the third-fifth and fourth sections of the clavicle from the sternal end often results in a frustum following conservative management of its fractures. This is reflected in subtle or gross winging of the scapula and dyskinesis, which affect the glenohumeral articulation.

How biomechanical forces stimulate linear bone growth, which is mostly under compression, and correct torsional deformity at the cellular level in a mature callus, remains poorly understood. Whatever the ‘normal’ range of motion return in the adolescents with malunited clavicles, it is limited by remodelling potential and physical adaptations during recovery of muscle-length tension.

This part of the study delves into the fundamentals of kinematic biomechanics pertaining to a malunited clavicle.

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