Morphometric parameters of clavicles among adult Black people in Tanzania

Morphological clavicular variation has been studied extensively by orthopaedic surgeons, anatomic and forensic experts to explain developmental, gender and age-related differences. The design of fixation devices for displaced clavicular fracture management depends largely on anatomic characteristics of clavicle. Eighty-one unpaired clavicles of unknown sex were studied, 42 clavicles were of right side and 39 clavicles of left side. All the clavicles were collected from adult cadavers which were dissected in Departments of Anatomy at Muhimbili and Herbert Kairuki Memorial Universities. The length of clavicle was measured by a vernier calliper; the middle point of this length was taken as the point where midclavicular circumference was measured with the help of a measuring thread and the angle of curvature of clavicle was measured by using protractors. The average lengths of the left and right clavicles were 15.23±1.12 cm and 15.43±1.01cm respectively. The average medial angle of curvature of left clavicle was 155.33° ± 4.39°and that of right clavicle was 153.40° ± 3.96°. The mean total angle of curvature of left clavicle was 293.54˚± 9.55°and the average total angle of curvature of right clavicle was 290.05±8.94°. The average midclavicular circumference of left clavicle was 3.88cm ± 0.33cm and that of right clavicle was 3.94cm±0.33cm. The right clavicle was longer than the left clavicle, the average medial angle of curvature of left clavicle was greater than medial angle of right clavicle, the average lateral angle of curvature of left clavicle was more than the average lateral angle of curvature of right clavicle and the mean of midclavicular circumference of right clavicle was greater than that of left clavicle. Keywords: Morphometric, clavicle, curvatures, circumference

A rare case of osteomyelitis of the clavicle in a child due to Group A streptococcal infection

Acute osteomyelitis of the clavicle is rare in the paediatric age group. We treated a 5-year-old boy who presented initially with fever and left shoulder pain, and subsequently developed swelling in the region of the left clavicle. Group AStreptococcus(GAS) was isolated in blood culture. MRI of the clavicle showed osteomyelitis of the medial clavicle. The child had incision and drainage of his clavicular collection. The child received intravenous benzylpenicillin and oral cephalexin in the initial presentation; he was treated with 2 weeks of intravenous ceftriaxone and 4 weeks of oral penicillin thereafter with the resolution of his symptoms. There are no previous case reports of osteomyelitis of the clavicle in children caused by GAS. This case highlights the importance of identifying the microbial aetiology in these children to ensure early initiation of treatment with appropriate antibiotics.

Vacuum phenomenon in the shoulder of a child

A 10-year-old boy struck a car bonnet following which his left shoulder got pinned under the wheel. No life-threatening injuries were identified. However, the patient sustained extensive abrasions to the back and the left shoulder, a closed deformity of the left clavicle and a swollen, but stable right knee. The patient was neurovascularly intact globally and all joints had a full range of motion. Plain radiographs suggested a possible greenstick fracture of the left clavicle, but also free gas within the left glenohumeral joint. Concern was raised of an unidentified open injury to the joint. CT was supportive of the finding of gas within the left glenohumeral joint, but ruled out the possible greenstick fracture as a spurious finding. There were no other injuries. The gas was within the left glenohumeral joint and was consistent with vacuum phenomenon. The injury was treated expectantly and the child made a full recovery.

Secondary Chondrosarcoma Presenting with Symptoms Similar to Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is caused by heterogeneous factors that compress the brachial plexus and subclavian artery; tumor is rarely a cause of TOS. Here, we present the case of a 26-year-old man with secondary chondrosarcoma arising from osteochondroma of the left clavicle causing TOS, with a direct compression of the brachial plexus and subclavian artery. Immediately after surgery, the symptoms of TOS reduced. To our knowledge, this is the first case of a secondary chondrosarcoma of the clavicle causing TOS, which is possibly the key symptom for diagnosing malignant transformation of osteochondroma of the clavicle.

Unusual Migration of Kirschner's Wire into Intervertebral Foramen after Lateral Clavicle Fracture Fixation: A Case Report

The migration of metallic devices such as Kirschner's wire (K-wire) from the shoulder is a well-recognized and significant complication of operation, the wire ending up in the lungs, the heart, the esophagus, the aorta or the subclavian artery. However, spinal migration is very rare. We report the case of a 72-year-old female patient with K-wire migration into the C7-T1 intervertebral foramen, 2 months after surgery for a lateral end fracture of left clavicle.