Innervation of the clavicle: a cadaveric investigation

2021 ◽  
pp. rapm-2021-103197
Author(s):  
Prangmalee Leurcharusmee ◽  
Naraporn Maikong ◽  
Perada Kantakam ◽  
Pagorn Navic ◽  
Pasuk Mahakkanukrauh ◽  
...  

BackgroundThis cadaveric study investigated the innervations of the clavicle and clavicular joints (ie, sternoclavicular and acromioclavicular joints).MethodsTwenty cadavers (40 clavicles) were dissected. A skin incision was made to permit exposure of the posterior cervical triangle and infraclavicular fossa. The platysma, sternocleidomastoid, and trapezius muscles were cleaned in order to identify the supraclavicular nerves. Subsequently, the suprascapular and subclavian nerves were localized after removal of the prevertebral layer of the deep cervical fascia. In the infraclavicular region, the pectoralis major and minor muscles were retracted laterally in order to visualize the lateral pectoral nerve. The contribution of all these nerves to the clavicular bone and joints were recorded.ResultsAlong their entire length, all clavicular specimens received contributions from the supraclavicular nerves. The latter innervated the cephalad and ventral aspects of the clavicular bone. The caudal and dorsal aspects of the clavicle were innervated by the subclavian nerve (middle and medial thirds). The lateral pectoral nerve supplied the caudad aspect of the clavicle (middle and lateral thirds). The sternoclavicular joint derived its innervation solely from the supraclavicular nerves whereas the acromioclavicular joint was supplied by the supraclavicular and lateral pectoral nerves.ConclusionThe clavicle and clavicular joints are innervated by the subclavian, lateral pectoral, and supraclavicular nerves. Clinical trials are required to determine the relative importance and functional contribution of each nerve.

Author(s):  
Zoran Z. Sarcevic ◽  
Andreja P. Tepavcevic

BACKGROUND: Subacromial pain (SAP) is a common complaint of young athletes, independently of the sport engaged. The prevalence of SAP in some sports is up to 50%. OBJECTIVE: The study was aimed to investigate some new factors possibly associated to subacromial pain in young athletes. The factors considered were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. METHODS: This case-control study included 82 young athletes 9–15 years, 41 with the symptoms of SAP and 41 controls. All participants self-reported whether they had subacromial pain. In addition, Hawkins–Kennedy Test was performed to all the participants to evaluate the subacromial pressure. Main outcome measures were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. The grade of tightness of the clavicular portion of the pectoralis major and the dysfunction of the sternoclavicular joint were measured with an inclinometer. Serratus anterior and lower trapezius strength were measured by a handheld dynamometer with external belt-fixation. The data were analyzed using t-test for independent samples, Mann-Whitney U test, contingency coefficients and a stepwise binary logistic regression. RESULTS: Significant statistical difference was observed in the grade of tightness of the clavicular portion of the pectoralis major and in the variable representing the physiological functioning of the sternoclavicular joint, between the cases and the controls. There was no significant difference in serratus anterior and lower trapezius strength between the cases and the controls. Logistic regression analysis showed that the variable representing the physiological functioning of the sternoclavicular joint and the grade of shortening of the clavicular portion of the pectoralis major were good predictors for presence of SAP. CONCLUSIONS: A strong association was determined between subacromial pain in young athletes, clavicular portion of pectoralis major tightness and the dysfunction of the sternoclavicular joint.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ichiro Okano ◽  
Takatoshi Sawada ◽  
Katsunori Inagaki

Bipolar dislocation of the clavicle is a rare injury that is defined as a concomitant dislocation of the ipsilateral acromioclavicular joint and sternoclavicular joint. This injury is also described as a floating clavicle. Although this injury has been known for nearly two centuries, knowledge about it is limited and the treatment strategy remains controversial. Bipolar dislocation includes several combinations of both joints’ injury types. We reported two patients with bipolar dislocation of the clavicle: one with an anterior dislocation and the other with a posterior dislocation of the sternoclavicular joint. After reviewing the currently available literature, we discussed these cases to highlight the necessity of a specific treatment approach that is modified based on the pattern of each joint’s lesion.


2019 ◽  
Vol 42 (3) ◽  
pp. 501-506 ◽  
Author(s):  
Muzaffer Akkoca ◽  
Mehlika Panpallı Ateş ◽  
Kerim Bora Yılmaz ◽  
İnanç İmamoğlu ◽  
Şener Balas ◽  
...  

Author(s):  
Joaquin Sanchez-Sotelo

The management of traumatic injuries to the clavicle and its two joints, acromioclavicular and sternoclavicular, has evolved substantially over the last few years. Regarding clavicle fractures, we now realize that nonoperative treatment of certain fracture patterns does lead to poor outcomes more frequently than previously thought; precontoured plates and modern intramedullary devices facilitate fixation techniques. Regarding the acromioclavicular joint, more emphasis is placed on anatomical reconstruction of all ligamentous structures, and there is substantial interest in arthroscopically assisted techniques. Fear of a major vascular complication when dealing with sternoclavicular joint pathology still lingers, but more and more surgeons feel they can manage this particular area of the shoulder region with reliable reconstructive techniques.


2012 ◽  
Vol 35 (2) ◽  
pp. 89-94 ◽  
Author(s):  
Taku Hatta ◽  
Hirotaka Sano ◽  
Jianlin Zuo ◽  
Nobuyuki Yamamoto ◽  
Eiji Itoi

PM&R ◽  
2010 ◽  
Vol 2 (9) ◽  
pp. 817-821 ◽  
Author(s):  
Evan Peck ◽  
Jim K. Lai ◽  
Wojciech Pawlina ◽  
Jay Smith

2017 ◽  
Vol 26 (7) ◽  
pp. 1121-1127 ◽  
Author(s):  
Johannes Barth ◽  
Achilleas Boutsiadis ◽  
Pablo Narbona ◽  
Alexandre Lädermann ◽  
Paolo Arrigoni ◽  
...  

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