BACKGROUND: Subacromial erosion remains a major concern after surgical fixation of acromioclavicular (AC) joint using a clavicular hook plate. To minimize postoperative subacromial erosion, we investigated the structural relationship between distal clavicle and acromion around the AC joint by considering the surgical fixation of the joint using the hook plate technique. METHODS: Computed tomography scans of 101 AC joints without any inherent pathology were analyzed. The angle between the distal clavicle and acromion around the AC joint (AC angle), depth of the acromion, differences in height between distal clavicle and acromion (AC height difference), and thickness of distal clavicle and acromion at the AC joint were measured. Descriptive statistics were calculated for each anatomical parameter, and all results were compared between gender groups. RESULTS: The mean AC angle was 17.1°(range, −8.0° to 39.0°), and the mean AC height difference was 3.5 mm (range, −0.7 to 8.7 mm). Both factors showed very high variability (coefficients of variation=62.6% and 46.6%, respectively). The mean AC angle was significantly higher in the female gender than in the male gender (19.8° vs. 13.8°, p=0.048). The mean acromion thickness and distal clavicular thickness were both significantly thinner in the female group than in the male group (p < 0.001) CONCLUSIONS: Taken together, we believe our results might be helpful in minimizing postoperative subacromial erosion when performing surgical fixation of the AC joint using the hook plate, and be valuable in improving future design of the hook plate.
Acromioclavicular Joint ; Acromion ; Clavicle ; Female ; Humans ; Joints ; Male ; Pathology ; Shoulder Fractures

OBJECTIVETo compare the efficacy of suture anchor with clavicular hook plate in treatment of type II fractures of the distal clavicle.

METHODSForty patients with Neer type II fractures of distal clavicle were treated in our hospital from May 2009 to May 2010, including 21 cases treated with suture anchors and 19 cases treated with clavicular hook plate. The time of fracture union and Constant Murley scores were compared between two groups.

RESULTSAll incisions reached primary healing, and there was no infection or hematoma formation. Postoperative follow-up time was 12-24 months, mean 14.5 months. The mean time of fracture reunion in suture anchors group was 13.2±2.0 weeks (9-17 weeks) and that in clavicular hook plate group was 13.3±2.0 weeks (10-16 weeks, P>0.05). The mean postoperative Constant Murley scores in suture anchors and hook plate groups were (91.1±6.5)% and (89.2±7.6)%, respectively (P>0.05). But the pain score in suture anchor group was higher than that in hook plate group (12.6±1.9 vs 11.3±2.3, P<0.05).

CONCLUSIONCompared with claviculer hook plate, the suture anchor has good clinical results and less complications in treatment of type II fractures of distal clavicle.

Bone Plates ; Clavicle ; pathology ; surgery ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Suture Anchors ; Treatment Outcome

Desmoplastic fibroma of bone is a rare locally aggressive, but non-metastatic tumor. In this case report, we present a desmoplastic fibroma in an unusual location, the clavicle. Desmoplastic fibroma involving the clavicle is extremely rare, with only 2 reported cases before 1985. We report the imaging findings of a desmoplastic fibroma of the clavicle with a review of the relevant literature.
Adult ; Bone Neoplasms/*diagnosis/pathology/radiography ; *Clavicle/pathology/radiography ; Fibroma, Desmoplastic/*diagnosis/pathology/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

UNLABELLED: Patients with cervical painless mass for 3 months with swallowing not feeling a week for the chief complaint. PHYSICAL EXAMINATION top right sternocleidomastoid before hitting a 7.0 by 3.0 cm size, lower limb reached 2.0 cm x 1.8 cm, the size of the mass on the left side of the supraclavicular reached 3.0 cm x 2.5 cm of the size of the mass, the three homogeneous medium hard, focally border and clear, the activity can be puncture cytological examination in return for: left supraclavicular see more protein and blood samples and a small amount of sample are arranged heap of fiber cells. Nuclear magnetic resonance (NMR): on the right side of the neck, with three at the left supraclavicular neoplasm, between 2.5-5.5 cm in size, high in T2, T1 low mixed signals, lesion boundaries clear.
Clavicle ; Deglutition Disorders ; etiology ; Head and Neck Neoplasms ; complications ; pathology ; Humans ; Magnetic Resonance Imaging ; Meningeal Neoplasms ; pathology ; Meningioma ; pathology ; Neck ; Neurilemmoma ; complications ; pathology ; Sensation Disorders ; etiology ; Tumor Burden

OBJECTIVE: To investigate the clinical applications of endoscopic thyroid lobectomy through subclavicular approach and to summarize the surgical experiences. METHOD: Thirty-five cases were subjected to endoscopic thyroid lobectomy through subclavicular approach. Briefly, operative cavities were established by automatic retractors and the affected lobes were dissected and removed using suction dissectors combined with the harmonic scalpels. The inferior thyroid artery was used as the mark to locate the recurrent laryngeal nerve. RESULT: All the operations achieved successfulness with no complication. 33 out of 35 were intraoperatively diagnosed by frozen-pathology as goiter and the last two cases were diagnosed as papillary thyroid carcinoma. There were no postoperative swelling, numbness or other kinds of uncomfortableness with benign patients and they were satisfied with the cosmetic outcomes. CONCLUSION Endoscopic thyroid lobectomy through subclavicular approach for thyroid benign lesions has the advantages of minimal invasion, high safety, easy manipulation and good cosmetic outcomes, which are worth of wide applications.
Adolescent ; Adult ; Clavicle ; surgery ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Thyroid Gland ; pathology ; surgery ; Thyroidectomy ; methods ; Young Adult

OBJECTIVETo study the radiologic and pathologic features of primary intermediate hemangioendothelioma of the bone.

METHODSFive cases of primary intermediate hemangioendothelioma of bone encountered in the past three years were enrolled into the study. The clinical, radiologic, pathologic and immunohistochemical features of the tumors were reviewed.

RESULTSThe patients included 3 children with Kaposiform hemangioendothelioma and 2 elderly with retiform hemangioendothelioma. Four of the cases affected long bones and the remaining case affected the clavicle. One case showed multifocal involvement of the humerus. Radiologically, the tumors showed borderline to low-grade bony destruction, with various degrees of cortical defect. Intralesional or perilesional bone formation was demonstrated in 4 cases and radial spicules were seen in 1 case. The histopathologic features of primary intermediate hemangioendothelioma of bone were similar to those of soft tissue, except for the presence of reactive bone formation. Immunohistochemically, the tumor cells were positive for CD31 (5/5), CD34 (5/5), vimentin (5/5) and smooth muscle actin (3/5) but negative for cytokeratin and epithelial membrane antigen.

CONCLUSIONSPrimary intermediate hemangioendothelioma of bone is a distinct entity and similar histologic classification applies as in its soft tissue counterparts. Comparison of the biologic behavior requires long-term follow-up studies.

Actins ; metabolism ; Antigens, CD34 ; metabolism ; Bone Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Child ; Clavicle ; pathology ; Diagnosis, Differential ; Female ; Femur ; pathology ; Hemangioendothelioma ; diagnostic imaging ; metabolism ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Humerus ; pathology ; Immunohistochemistry ; Infant ; Kasabach-Merritt Syndrome ; diagnostic imaging ; metabolism ; pathology ; Male ; Middle Aged ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Radiography ; Sarcoma, Kaposi ; diagnostic imaging ; metabolism ; pathology ; Vimentin ; metabolism

According to the literature, thoracic outlet syndrome (TOS) secondary to the malunion of displaced fractures of the clavicle is rare. Various surgical methods, including simple neurolysis, resection of the first rib or clavicle and corrective osteotomy, have been reported. We report a case of TOS secondary to malunion of the clavicle that was treated by an anterior and middle scalenectomy without a rib resection.
Adult ; Humans ; Low Back Pain/etiology ; Lumbar Vertebrae/surgery ; Male ; Postoperative Complications/*microbiology ; Spondylitis/etiology/*microbiology ; Thoracic Vertebrae/*microbiology/pathology ; Tuberculosis/drug therapy/*microbiology ; Tuberculosis, Spinal/complications/drug therapy/*microbiology ; Adult ; Clavicle/*injuries ; Fractures, Malunited/*complications ; Humans ; Male ; Thoracic Outlet Syndrome/etiology/radiography/*surgery

Adolescent ; Adult ; Child ; Clavicle ; injuries ; physiopathology ; surgery ; External Fixators ; Female ; Fractures, Bone ; pathology ; physiopathology ; surgery ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged ; Young Adult

OBJECTIVETo study the surgical management of tumors in the conjunctive area among the neck, thorax and axilla and its efficacy.

METHODSFrom Oct. 1999 to March 2006, eleven cases with benign tumors in the area between the neck, thorax and axilla were collected and analysed. Among them, five neurilemmoma, three neurofibroma, two chondroma and one meningioma, respectively. CT scans showed that the neck, thorax and axilla were affected simultaneously more or less. In this group, direct invasion to the vertebra was found in 4 cases, and spinal compression in one patient. After the disarticulation and displacement of the clavicle, the tumor was removed with the structures of importance in the neck, thorax and axilla under direct views. A bypass was constructed between the axillary vein and the medial end of the subclavian vein.

RESULTSAll these tumors were completely removed, injury of vertebral artery was encounter in two cases, and immediate repair was successfully carried out. No other serious complications were found in this group. During the follow-up period from 3 months to 3 years and 5 months, local recurrence was found in no patient.

CONCLUSIONSBenign tumors in the area between neck, thorax and axilla could be successfully dissected and removed with displacement of the medial portion of the clavicle.

Adolescent ; Adult ; Axilla ; pathology ; surgery ; Clavicle ; surgery ; Female ; Groin ; surgery ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thoracic Neoplasms ; pathology ; surgery ; Young Adult

OBJECTIVETo investigate surgical treatment approach of transclavicular and transsternal tumor.

METHODSTwelve cases of neck-root and mediastinum thoracis tumor subjected to cervicothoracic-combined surgical treatment were retrospectively analyzed and summarized.

RESULTSSeven cases of benign tumor survived 1-8 years after surgery. The other 5 patients were malignant tumor. Among 4 cases of metastatic squamous cell carcinoma without definite origin at neck-root site who underwent operation and routine radiotherapy, one case died of orthotopic relapse and armpit metastasis at the 16th months postoperatively; one case was lost of follow-up after surgery; another two cases showed no relapse after follow-up of 50 months and 27 months, respectively. In addition, one case of thyroid papillary carcinoma located at neck-root and mediastinum remained alive for 40 months after operation combined with radiotherapy and chemotherapy.

CONCLUSIONSThe evaluation of twelve cases of transclavicular and transsternal tumor with adoption of cervicothoracic-combined surgical approach improves and develops traditional knowledge of surgical therapy of neck-root tumors.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Clavicle ; pathology ; Female ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Male ; Mediastinal Neoplasms ; pathology ; Middle Aged ; Neck ; surgery ; Retrospective Studies ; Sternum ; pathology ; Thoracic Cavity ; surgery ; Young Adult