Distal clavicle “A-frame” morphology: a reliable intraoperative guide for arthroscopic distal clavicle excision
The purpose of this cadaveric study was to describe the characteristics of the “A-frame” morphology of the distal clavicle via computed tomography (CT) to determine whether it can be used as a reliable intraoperative guide for arthroscopic distal clavicle excision. Twenty-eight fresh-frozen human ca...
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| Published in | Journal of shoulder and elbow surgery Vol. 31; no. 4; pp. 688 - 693 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.04.2022
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| Abstract | The purpose of this cadaveric study was to describe the characteristics of the “A-frame” morphology of the distal clavicle via computed tomography (CT) to determine whether it can be used as a reliable intraoperative guide for arthroscopic distal clavicle excision.
Twenty-eight fresh-frozen human cadaveric clavicles underwent a 3-dimensional CT scan using 1.0-mm cuts. The distance from the most lateral aspect of the clavicle to the point at which the superior cortex of the clavicle paralleled the inferior cortex was measured. Measurements were performed in a blinded fashion by a single author on 2 separate occasions.
The A-frame was present in all specimens (28 of 28). On the first measurement, the mean distance from the distal clavicle to the point at which the A-frame disappeared was 1.00 cm (range, 0.90-1.08 cm; standard deviation, 0.5 mm). On the second measurement, the mean distance was 1.02 cm (range, 0.90-1.11 cm; standard deviation, 0.6 mm). The intrarater reliability between measurement occasions was 0.65 (95% confidence interval, 0.36-0.82; P < .001).
This study demonstrated that the cross-sectional A-frame morphology of the distal clavicle was consistently visualized on CT scans. The A-frame disappeared 1.00-1.02 cm medial to the most lateral extent of the clavicle on CT scans. The disappearance of the A-frame morphology of the distal clavicle can serve as a reliable intraoperative guide for arthroscopic distal clavicle excision. |
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| AbstractList | The purpose of this cadaveric study was to describe the characteristics of the "A-frame" morphology of the distal clavicle via computed tomography (CT) to determine whether it can be used as a reliable intraoperative guide for arthroscopic distal clavicle excision.
Twenty-eight fresh-frozen human cadaveric clavicles underwent a 3-dimensional CT scan using 1.0-mm cuts. The distance from the most lateral aspect of the clavicle to the point at which the superior cortex of the clavicle paralleled the inferior cortex was measured. Measurements were performed in a blinded fashion by a single author on 2 separate occasions.
The A-frame was present in all specimens (28 of 28). On the first measurement, the mean distance from the distal clavicle to the point at which the A-frame disappeared was 1.00 cm (range, 0.90-1.08 cm; standard deviation, 0.5 mm). On the second measurement, the mean distance was 1.02 cm (range, 0.90-1.11 cm; standard deviation, 0.6 mm). The intrarater reliability between measurement occasions was 0.65 (95% confidence interval, 0.36-0.82; P < .001).
This study demonstrated that the cross-sectional A-frame morphology of the distal clavicle was consistently visualized on CT scans. The A-frame disappeared 1.00-1.02 cm medial to the most lateral extent of the clavicle on CT scans. The disappearance of the A-frame morphology of the distal clavicle can serve as a reliable intraoperative guide for arthroscopic distal clavicle excision. BACKGROUNDThe purpose of this cadaveric study was to describe the characteristics of the "A-frame" morphology of the distal clavicle via computed tomography (CT) to determine whether it can be used as a reliable intraoperative guide for arthroscopic distal clavicle excision. METHODSTwenty-eight fresh-frozen human cadaveric clavicles underwent a 3-dimensional CT scan using 1.0-mm cuts. The distance from the most lateral aspect of the clavicle to the point at which the superior cortex of the clavicle paralleled the inferior cortex was measured. Measurements were performed in a blinded fashion by a single author on 2 separate occasions. RESULTSThe A-frame was present in all specimens (28 of 28). On the first measurement, the mean distance from the distal clavicle to the point at which the A-frame disappeared was 1.00 cm (range, 0.90-1.08 cm; standard deviation, 0.5 mm). On the second measurement, the mean distance was 1.02 cm (range, 0.90-1.11 cm; standard deviation, 0.6 mm). The intrarater reliability between measurement occasions was 0.65 (95% confidence interval, 0.36-0.82; P < .001). CONCLUSIONSThis study demonstrated that the cross-sectional A-frame morphology of the distal clavicle was consistently visualized on CT scans. The A-frame disappeared 1.00-1.02 cm medial to the most lateral extent of the clavicle on CT scans. The disappearance of the A-frame morphology of the distal clavicle can serve as a reliable intraoperative guide for arthroscopic distal clavicle excision. |
| Author | Young, Bradley L. Ruder, John A. Connor, Patrick M. |
| Author_xml | – sequence: 1 givenname: John A. surname: Ruder fullname: Ruder, John A. organization: Department of Orthopaedic Surgery, Carolinas Medical Center, Atrium Musculoskeletal Institute, Charlotte, NC, USA – sequence: 2 givenname: Bradley L. surname: Young fullname: Young, Bradley L. organization: Department of Orthopaedic Surgery, Carolinas Medical Center, Atrium Musculoskeletal Institute, Charlotte, NC, USA – sequence: 3 givenname: Patrick M. surname: Connor fullname: Connor, Patrick M. email: patrick.connor@orthocarolina.com organization: The Sports Medicine Center, The Shoulder and Elbow Center, OrthoCarolina, Charlotte, NC, USA |
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| Copyright | 2021 Journal of Shoulder and Elbow Surgery Board of Trustees Copyright © 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved. |
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| Keywords | Anatomic Study Distal clavicle excision shoulder arthroscopy acromioclavicular arthritis cadaveric study bone morphology Imaging measurement guide |
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| SubjectTerms | acromioclavicular arthritis bone morphology cadaveric study Distal clavicle excision measurement guide shoulder arthroscopy |
| Title | Distal clavicle “A-frame” morphology: a reliable intraoperative guide for arthroscopic distal clavicle excision |
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