CLAVICULAR encyclopedia topics

Overview


Right clavicle - from below, and from above.

Left clavicle - from above, and from below.

The clavicle is a doubly curved short bone that connects the arm (upper limb) to the body (trunk), located directly above the first rib. It acts as a shunt to keep the scapula in position so the arm can hang freely. Medially, it articulates with the manubrium of the sternum (breast-bone) at the sternoclavicular joint. At its lateral end it articulates with the acromion of the scapula (shoulder blade) at the acromioclavicular joint. It has a rounded medial end and a flattened lateral end.

From the roughly pyramidal sternal end, each clavicle curves laterally and posteriorly for roughly half its length. It then forms a smooth posterior curve to articulate with a process of the scapula (acromion). The flat, acromial end of the clavicle is broader than the sternal end. The acromial end has a rough inferior surface that bears prominent lines and tubercles. These surface features are attachment sites for muscles and ligaments of the shoulder.

Functions

The clavicle serves several functions:

It serves as a rigid support from which the scapula and free limb are suspended. This arrangement keeps the upper limb (arm) away from the thorax so that the arm has maximum range of movement.
Covers the cervicoaxillary canal (passageway between the neck and arm), through which several important structures pass.
Transmits physical impacts from the upper limb to the axial skeleton.

Even though it is classified as a long bone, the clavicle has no medullary (bone marrow) cavity like other long bones. It is made up of spongy (cancellous) bone with a shell of compact bone. It is a dermal bone derived from elements originally attached to the skull.

Attachments

Muscles and ligaments that attach to the clavicle include:

Attachment on clavicle	Muscle/Ligament	Other attachment
Superior surface and anterior border	Deltoid muscle	deltoid tubercle, anteriorly on the lateral third
Superior surface	Trapezius muscle	posteriorly on the lateral third
Inferior surface	Subclavius muscle	subclavian groove
Inferior surface	Conoid ligament (the medial part of the coracoclavicular ligament)	conoid tubercle
Inferior surface	Trapezoid ligament (the lateral part of the coracoclavicular ligament)	trapezoid line
Anterior border	Pectoralis major muscle	medial third (rounded border)
Posterior border	Sternocleidomastoid muscle (clavicular head)	superiorly, on the medial third
Posterior border	Sternohyoid muscle	inferiorly, on the medial third
Posterior border	Trapezius muscle	lateral third

Development

The clavicle is the first bone to begin the process of ossification (laying down of minerals onto a preformed matrix) during development of the embryo, during the 5th and 6th weeks of gestation. However, it is one of the last bones to finish ossification, at about 21-25 years of age. It forms by intramembranous ossification. It consists of a mass of cancellous bone surrounded by a compact bone shell. The cancellous bone forms via two ossification centres, one medial and one lateral, which fuse later on. The compact forms as the layer of fascia covering the bone stimulates the ossification of adjacent tissue. The resulting compact bone is known as a periosteal collar.