Related Experiment Videos
Distal clavicular physeal injury.
Clinical Orthopaedics and Related Research
|September 1, 1984
Summary
Distal clavicular physeal injuries in children mimic acromioclavicular separation but are distinct growth-plate injuries. Early recognition is crucial for appropriate management and to avoid complications.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Sports Medicine
Background:
- Separation of the distal clavicular metaphysis from the epiphysis is a specific type of physeal injury.
- These injuries are often misdiagnosed as acromioclavicular separation in older children and adolescents.
Observation:
- The epiphysis and physis maintain their relationship with the shoulder joint.
- The distal clavicular metaphysis displaces superiorly, while the periosteal sleeve and ligaments typically remain intact inferiorly.
- Ligamentous structures remain attached to the periosteal sleeve, connecting the clavicle to the coracoid.
Findings:
- Treatment varies from closed reduction to pin fixation based on displacement.
- The periosteal sleeve demonstrates significant osteogenic potential, often bridging the metaphyseal gap.
- One case presented with clavicular duplication due to excessive periosteal new bone formation, requiring surgical intervention.
Implications:
- Accurate diagnosis of these physeal injuries is critical in skeletally immature patients.
- Distinguishing these injuries from acromioclavicular separation ensures appropriate treatment and prevents potential complications.
- Understanding the osteogenic capacity of the periosteal sleeve aids in predicting healing and potential complications.