title: Tunnels and grooves for supraclavicular nerves within the clavicle: review of the literature and clinical impact.
abstract: Perforation of the clavicle by supraclavicular nerves is a common anatomical variation. This variation has been reported in several studies based on post-mortem, surgical and radiologic findings, with an overall frequency between 1 and 6.6 %. The penetrating branch passes either through a bony tunnel or a groove on the superior surface of the bone. Entrapment neuropathy of the perforating branch is a documented clinical entity reported in the literature. The intraosseous course of the supraclavicular nerves makes them vulnerable to injury in case of clavicular fractures or during surgical manipulations of these fractures. Furthermore, this variation should be taken into account during the interpretation of chest and shoulder radiographs. The purpose of the current study is to perform an extended review of the relevant literature, highlighting the clinical impact of this variation, as well as to incorporate our own findings into them.
authors.affiliation: Laboratory of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P. O. Box 300, 54124, Macedonia, Greece. natsis@auth.gr.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Natsis
authors.affiliation: Laboratory of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P. O. Box 300, 54124, Macedonia, Greece.
authors.forename: Trifon
authors.initials: T
authors.lastname: Totlis
authors.affiliation: Laboratory of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P. O. Box 300, 54124, Macedonia, Greece.
authors.forename: Angeliki
authors.initials: A
authors.lastname: Chorti
authors.affiliation: Laboratory of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P. O. Box 300, 54124, Macedonia, Greece.
authors.forename: Marinos
authors.initials: M
authors.lastname: Karanassos
authors.affiliation: Laboratory of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P. O. Box 300, 54124, Macedonia, Greece.
authors.forename: Matthaios
authors.initials: M
authors.lastname: Didagelos
authors.affiliation: Laboratory of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P. O. Box 300, 54124, Macedonia, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Lazaridis
mesh_terms: D063405:Anatomic Variation; D002102:Cadaver; D002572:Cervical Plexus / Q000033:anatomy & histology* / Q000293:injuries; D002968:Clavicle / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000196:embryology / Q000294:innervation*; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery; D006801:Humans; D008297:Male; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology*; D011859:Radiography
keywords: Clavicle anatomy; Clavicle fracture complications; Clavicle radiography; Entrapment neuropathy; Shoulder pain; Supraclavicular nerves anatomy