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Postnatal growth of the clavicle: birth to 18 years of age
Molly A McGraw1, Charles T Mehlman, Christopher J Lindsell
1Ohio University College of Osteopathic Medicine, Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
Insights
This study tracked clavicle (collarbone) growth from birth to 18 years. Girls reach 80% of their clavicle length by age 9, and boys by age 12, with limited growth thereafter.
Area of Science:
- Pediatric Orthopedics
- Radiology
- Human Growth and Development
Background:
- The clavicle's postnatal growth pattern is crucial for understanding skeletal development.
- Limited data exists on clavicle growth trajectories across a wide age range.
Purpose of the Study:
- To determine the postnatal growth pattern of the clavicle from birth to 18 years.
- To establish age-specific growth benchmarks for clavicle length.
Main Methods:
- Cross-sectional analysis of 961 digital chest radiographs from individuals aged 0-18 years.
- Measurement of right and left clavicle lengths in millimeters.
- Stratification into 19 age subgroups and by sex, with a minimum of 25 patients per group.
Main Results:
- Mean clavicle length at 18 years: 149 mm (females) and 161 mm (males).
- Steady growth rate (8.4 mm/year) observed until age 12 for both genders.
- Accelerated growth in males (5.4 mm/year) versus females (2.6 mm/year) after age 12.
Conclusions:
- Females achieve 80% of clavicle length by age 9; males by age 12.
- Limited clavicle growth potential remains after these age thresholds.
- Contralateral clavicle length can serve as a reference for assessing symmetry.
Background:
The purpose of our study was to perform a large cross-sectional study aimed at determining the postnatal growth pattern of the clavicle from birth to 18 years of age.
Methods:
We analyzed the digital chest radiographs of a convenience sample of 961 individuals between birth and 18 years of age. Malrotated radiographs were excluded. Right and left clavicle lengths were measured in millimeters from the most lateral ossified border to the most medial ossified border of each clavicle. Study patients were divided into 19 subgroups with the first group being labeled as "birth to 11 months of age" followed by 1-year-olds, 2-year olds, etc. Patients were also grouped by sex. There was a minimum of 25 patients in each group.
Results:
At 18 years of age the mean+/-SD clavicle length for females was 149+/-12 mm and for males it was 161+/-11 mm. Although a statistically significant difference (P=0.049) was noted between the length of right and left clavicles it was not clinically significant (0.036 mm). A steady growth rate was noted for both genders from birth to the age of 12 years (8.4 mm/y). Above the age of 12 years there were significant differences in the growth of the clavicles of girls (2.6 mm/y) versus boys (5.4 mm/y) (P<0.001). Our data suggest that females achieve 80% of their clavicle length by 9 years of age and boys by 12 years of age.
Conclusion:
This cross-sectional study establishes that relatively little clavicle growth (20%) remains for girls beyond age 9 years and for boys beyond 12 years. The length of one clavicle may be properly judged by comparing it with the contralateral clavicle.
Clinical Relevance:
Remodeling of the clavicle shaft fractures is currently believed to be proportional to remaining growth. Our study questions the capacity of the clavicle to re-establish normal length beyond the age thresholds we have identified.
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