Densitometric study of the clavicle: bone mineral density explains the laterality of the fractures

Guerra, Marcelo Teodoro Ezequiel; Pozzi, Maria Isabel; Busin, Gabriela; Zanetti, Lucas Crestana; Lopes, José Antônio Lazzarotto Terra; Orso, Vinícius

doi:10.1016/j.rboe.2014.07.002

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Original Article • Rev. bras. ortop. 49 (5) • Sep-Oct 2014 • https://doi.org/10.1016/j.rboe.2014.07.002 copy

Densitometric study of the clavicle: bone mineral density explains the laterality of the fractures^☆ ☆ Please cite this article as: Teodoro Ezequiel Guerra M, Isabel Pozzi M, Busin G, Crestana Zanetti L, Antônio Lazzarotto Terra Lopes J, Orso V et al. Estudo densitométrico da clavícula: a densidade mineral óssea explica a lateralidade das fraturas. Rev Bras Ortop. 2014;49(5):468-72. ,^☆☆ ☆☆ Study developed at the Universidade Luterana do Brasil, Canoas, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction:

Epidemiological studies have shown laterality in clavicle fractures, such that the left side is more frequently fractured. The present study had the aim of evaluating whether the clavicle on the dominant side is denser and thus explaining the greater incidence of fractures on the non-dominant side.

Materials and methods:

This was a descriptive study on 52 healthy patients, who were classified according to age, sex and whether the dominant or non-dominant side was affected.

Results:

The participants comprised 28 women (53.8%) and 24 men (46.2%). Regarding the dominant side, 30 were right-handed (57.7%) and 22 were left-handed (42.3%). The mean age was 25 years. In this study, it could be seen that the non-dominant side had greater bone mass than the dominant side. It was also observed that the bone density was greater in the middle and distal thirds on the non-dominant side, with a statistically significant difference. In the women, the density was also greater on the non-dominant side; this difference was not significant in relation to the dominant side, but there were significant differences between the middle thirds (p<0.001) and the distal thirds (p<0.006).

Conclusion:

Variations in bone density, toward higher and lower bone mass, may have been responsible for the fractures. According to the findings from this study, fractures occur more in the middle third of the non-dominant clavicle, as a result of greater bone mineral mass, which gives rise to lower flexibility and fractures in the region.

Densitometry; Bone fracture; Physiopathology; Clavicle

Characteristics		n = 52
Sex – n (%)
	Male	24 (46.2)
	Female	28 (53.8)
Dominance – n (%)
	Right-handed	30 (57.7)
	Left-handed	22 (42.3)

Bone mineral density		Dominant median (p25–p75)	Non-dominant median (p25–p75)	p ^a a Value obtained through Wilcoxon test.
Men (n = 24)
	Middle	1.01 (0.80–1.10)	1.14 (1.02–1.54)	0.028
	Distal	0.40 (0.17–0.65)	0.71 (0.51–1.06)	0.010
	p^a a Value obtained through Wilcoxon test.	0.003	0.002
Women (n = 24)
	Middle	0.99 (0.73–1.11)	1.01 (0.78–1.15)	1.000
	Distal	0.56 (0.17–0.69)	0.59 (0.42–0.73)	0.530
	p^a a Value obtained through Wilcoxon test.	0.001	0.006
Total (n = 52)
	Middle	1.01 (0.79–1.09)	1.07 (0.93–1.24)	0.134
	Distal	0.49 (0.17–0.69)	0.64 (0.45–0.92)	0.020
	p^a a Value obtained through Wilcoxon test.	<0.001	<0.001

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[1] *Corresponding author. E-mail: gabibusin@hotmail.com (G. Busin).