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ORIGINAL RESEARCH article

Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 12 - 2024 | doi: 10.3389/fbioe.2024.1413679

Residual Kinematic Deviations of the Shoulder During Humeral Elevation after Conservative Treatment for Mid-Shaft Clavicle Fractures

Provisionally accepted
Li-Wei Hung Li-Wei Hung 1,2,3Hsuan-Yu Lu Hsuan-Yu Lu 1Tsan-Yang Chen Tsan-Yang Chen 1,4Ting-Ming Wang Ting-Ming Wang 5,6Tung-Wu Lu Tung-Wu Lu 1,5*
  • 1 Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
  • 2 Department of Orthopedic Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
  • 3 School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
  • 4 Department of Sports Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
  • 5 Department of Orthopedic Surgery, School of Medicine, National Taiwan University, Taipei, Taiwan
  • 6 Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan

The final, formatted version of the article will be published soon.

    Despite residual functional deficits clinically observed in conservatively treated mid-shaft clavicle fractures, no study has reported a quantitative assessment of the treatment effects on the kinematics of the shoulder complex during functional movement. Using computerised motion analysis, the current study quantified the 3D residual kinematic deviations or strategies of the shoulder complex bones during multi-plane elevations in fifteen patients with conservatively treated mid-shaft clavicle fractures and fifteen healthy controls. Despite residual clavicular malunion, the patients recovered normal shoulder kinematics for arm elevations up to 60° in all three tested planes. For elevations beyond 60°, normal clavicle kinematics but significantly increased scapular posterior tilt relative to the trunk was observed in the patient group, leading to significantly increased clavicular protraction and posterior tilt relative to the scapula (i.e., AC joint). Slightly different changes were found in the sagittal plane, showing additional changes of increased scapular upward rotations at 90° and 120° elevations. Similar kinematic changes were also found on the unaffected side, indicating a trend of symmetrical bilateral adaptation. The current results suggest that shoulder kinematics in multi-plane arm elevations should be monitored for any compromised integrated motions of the individual bones following conservative treatment. Rehabilitation strategies, including muscle strengthening and synergy stability training, should also consider compensatory kinematic changes on the unaffected side to improve the bilateral movement control of the shoulder complex during humeral elevation.

    Keywords: Motion analysis, range of motion, Scapula, Clavicle fracture, conservative treatment

    Received: 07 Apr 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Hung, Lu, Chen, Wang and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Tung-Wu Lu, Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.