{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:56:02Z","timestamp":1780379762536,"version":"3.54.1"},"reference-count":17,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"9","license":[{"start":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T00:00:00Z","timestamp":1314835200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:p> This study investigated the anatomical relationship between the clavicle and its adjacent vascular structures, in order to define safe zones, in terms of distance and direction, for drilling of the clavicle during osteosynthesis using a plate and screws following a fracture. We used reconstructed three-dimensional CT arteriograms of the head, neck and shoulder region. The results have enabled us to divide the clavicle into three zones based on the proximity and relationship of the vascular structures adjacent to it. The results show that at the medial end of the clavicle the subclavian vessels are situated behind it, with the vein intimately related to it. In some scans the vein was opposed to the posterior cortex of the clavicle. At the middle one-third of the clavicle the artery and vein are a mean of 17.02 mm (5.4 to 26.8) and 12.45 mm (5 to 26.1) from the clavicle, respectively, and at a mean angle of 50\u00b0 (12 to 80) and 70\u00b0 (38 to 100), respectively, to the horizontal. At the lateral end of the clavicle the artery and vein are at mean distances of 63.4 mm (46.8 to 96.5) and 75.67 mm (50 to 109), respectively. <\/jats:p><jats:p> An appreciation of the information gathered from this study will help minimise the risk of inadvertent iatrogenic vascular injury during plating of the clavicle. <\/jats:p>","DOI":"10.1302\/0301-620x.93b9.25739","type":"journal-article","created":{"date-parts":[[2011,9,12]],"date-time":"2011-09-12T17:42:08Z","timestamp":1315849328000},"page":"1247-1252","source":"Crossref","is-referenced-by-count":68,"title":["A radiological study to define safe zones for drilling during plating of clavicle fractures"],"prefix":"10.1302","volume":"93-B","author":[{"given":"A.","family":"Sinha","sequence":"first","affiliation":[{"name":"Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Edwin","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Sreeharsha","sequence":"additional","affiliation":[{"name":"Wirral University Teaching Hospital NHS Foundation Trust, Upton, Wirral CH49 5PE, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Bhalaik","sequence":"additional","affiliation":[{"name":"Wirral University Teaching Hospital NHS Foundation Trust, Upton, Wirral CH49 5PE, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Brownson","sequence":"additional","affiliation":[{"name":"Royal Liverpool and Broadgreen University Teaching Hospitals NHS Trust, Prescot Street, Liverpool L7 8XP, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Nordqvist A, Petersson C. The incidence of fractures of the clavicle. \nClin Orthop1994;\n300:\n127\u2013132.","DOI":"10.1097\/00003086-199403000-00016"},{"key":"R2","unstructured":"Crenshaw AH Jr. Fractures of the shoulder, arm and forearm. In: Canale ST, ed. Campbell\u2019s operative orthopaedics. Vol. 3. Tenth ed. St Louis: Mosby, \n2003:2985\u20133069."},{"key":"R3","unstructured":"Craig EV. Fractures of the clavicle. In: Rockwood CA Jr, Buchholz RW, Green DP, Heckman JD, eds. Rockwood and Green\u2019s fractures in adults. Vol. 1. Fourth ed. Philadelphia: Lippincott Williams and Wilkins, \n1996:1109\u201361."},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Khan LA, Bradnock TJ, Scott C, Robinson CM. Fractures of the clavicle. \nJ Bone Joint Surg [Am]2009;\n91-A:\n447\u2013460.","DOI":"10.2106\/JBJS.H.00034"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Robinson CM, Court-Brown CM, McQueen MM, Wakefield AE. Estimating the risk of nonunion following nonoperative treatment of a clavicular fracture. \nJ Bone Joint Surg [Am]2004;\n86-A:\n1359\u20131365.","DOI":"10.2106\/00004623-200407000-00002"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.79B4.0790537"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"McKee MD, Wild LM, Schemitsch EH. Midshaft malunions of the clavicle. \nJ Bone Joint Surg [Am]2003;\n85-A:\n790\u2013797.","DOI":"10.2106\/00004623-200305000-00003"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1097\/01.bot.0000172287.44278.ef"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1002\/ca.20350"},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Lyons FA, Rockwood CA Jr. Migration of pins used in operations on the shoulder. \nJ Bone Joint Surg [Am]1990;\n72-A:\n1262\u20131267.","DOI":"10.2106\/00004623-199072080-00023"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"Norrell H Jr, Llewellyn RC. Migration of a threaded Steinmann pin from an acromioclavicular joint into the spinal canal: a case report. \nJ Bone Joint Surg [Am]1965;\n47-A:\n1024\u20131026.","DOI":"10.2106\/00004623-196547050-00012"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1964.01320060092018"},{"key":"R13","unstructured":"Glauser F, Kremens V. Unusual sequela following pinning of medial clavicular fracture. \nAm J Roentgenol Radium Ther Nucl Med1956;\n76:\n1066\u20131069."},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1016\/0967-2109(95)00095-X"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199707000-00035"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000085862.32648.05"},{"key":"R17","unstructured":"Warwick R, Williams PL. The subclavian system of arteries. In: Gray\u2019s anatomy. 35th ed. Edinburgh: Longmans Green and Co. \n1973:1551."}],"container-title":["The Journal of Bone and Joint Surgery. British volume"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.93B9.25739","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/0301-620X.93B9.25739","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.93B9.25739","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T18:53:29Z","timestamp":1629140009000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/0301-620X.93B9.25739"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,9]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2011,9]]}},"alternative-id":["10.1302\/0301-620X.93B9.25739"],"URL":"https:\/\/doi.org\/10.1302\/0301-620x.93b9.25739","relation":{},"ISSN":["0301-620X","2044-5377"],"issn-type":[{"value":"0301-620X","type":"print"},{"value":"2044-5377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,9]]}}}