Redefining the morphometry of subclavian vessels for clavicle fracture treatments
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Clavicle fractures are common injuries in adults and children. Although neurovascular damage is rarely seen, acute subclavian artery pseudoaneurysms and injuries to subclavian vessels were reported for closed fractures of the clavicle. The aim of this study was to identify the morphological details of the subclavian vessels and their relation to the sternoclavicular joint and body of the clavicle.
127 patients (66 females and 61 males) were evaluated using reconstructed three-dimensional computed tomographic angiographies. The point at which the subclavian artery crossed posterior to the clavicle was detected as a landmark. The medio-lateral distance between the sternal end of the clavicle, landmark, antero-posterior distance between the clavicle and the subclavian artery, diameter of the artery and vein, angle between the subclavian artery and vein, distance of the subclavian vein to the subclavian artery and the clavicle at the landmark were measured. Measurements were compared according to gender and right and left sides, and age correlation was determined.
Morphometric relationship between the subclavian vessels and clavicle presented differences between genders. We measured the antero-posterior distance between the subclavian artery and the clavicle to be less than 1 cm (0.91 cm).
The subclavian artery travelled longer distances in men than women to reach the point that it crossed the clavicle. Our results demonstrated that the subclavian artery does not pass from the inferior margin of the clavicle, thus, superior plate osteosynthesis does not have any risk to injury against the subclavian vessels during the management of the clavicle fractures.
KeywordsSubclavian vessels Clavicle Computed tomography 3D reconstruction
DD; study development and design, manuscript preparation. BE; study development and design, manuscript preparation. TH; data collection and management, data analysis, manuscript preparation. HÖ; study development and design, data analysis, manuscript preparation. YEŞ; data collection and management, data analysis, manuscript preparation. AV; study development and design, data collection and management, data analysis, statistical analysis, manuscript preparation.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 5.Fatimi SH, Anees A, Muzaffar M, Hanif HM (2010) Acute traumatic subclavian artery thrombosis and its successful repair via resection and end-to-end anastomosis. Chin J Traumatol 13:255–256Google Scholar
- 6.Gieger J, Beeres F, Birrer K, Babst R (2016) Misalignment of the clavicle after intramedullary fixation of a midshaft fracture with a titanium elastic nail results in acute neurovascular thoracic outlet syndrome. J Shoulder Elbow Surg 25:e110–e114. https://doi.org/10.1016/j.jse.2015.12.014 CrossRefGoogle Scholar
- 11.Nishimura K, Hamasaki T, Yamamoto S, Kawai T, Sugiura K (2015) Endovascular treatment of left subclavian artery pseudoaneurysm after clavicle fracture in an elderly adult with a 40-year history of Behcet’s disease. Ann Vasc Dis 8:328–330. https://doi.org/10.3400/avd.cr.15-00082 CrossRefGoogle Scholar
- 20.Stefanczyk L, Czeczotka J, Elgalal M, Sapieha M, Rowinski O (2011) A large posttraumatic subclavian artery aneurysm complicated by artery occlusion and arteriobronchial fistula successfully treated using a covered stent. Cardiovasc Intervent Radiol 34(Suppl 2):S146–S149. https://doi.org/10.1007/s00270-010-9959-y CrossRefGoogle Scholar