ArticleAnatomical science international2026
Microstructural analysis of a malunited clavicular fracture in a human cadaver.
Article in Anatomical science international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Clavicle fractures are common, with midshaft fractures accounting for approximately 70-80% of cases. Malunion often occurs following conservative treatment, but the microstructural characteristics of the malunited region remain poorly understood. This case report describes a rare instance of clavicular malunion identified in a 85-year-old male cadaver during a gross anatomy dissection course. Both clavicles were analyzed using radiography, micro-computed tomography (micro-CT), and histology to investigate the microstructural alterations associated with the malunion. Radiographically, the right clavicle demonstrated anterior-posterior displacement and approximately 10% shortening compared with the intact side. Micro-CT analysis revealed decreased tissue mineral density, reduced trabecular bone volume, marked cortical thinning, and elevated structural indices, including the trabecular bone pattern factor and structure model index, suggesting a loss of trabecular connectivity and a transition from plate-like to rod-like architecture. Histological examination showed that the cortical bone at the fractured site exhibited a disorganized bone matrix lacking a lamellar structure, while the intact side displayed a well-organized lamellar pattern with regularly aligned osteocyte lacunae. These findings suggest that microstructural disorganization and decreased mineral density may contribute to reduced bone strength in the malunion region. Because high-resolution peripheral quantitative CT (HR-pQCT) cannot assess the clavicle, this cadaveric micro-CT and histological analysis provide valuable insights into the microstructural characteristics of clavicular malunion that are not accessible through conventional clinical imaging.
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