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VOLUME 7 , ISSUE 1 ( January-June, 2023 ) > List of Articles


Morphological Study of Attachment of Costoclavicular Ligament on the Dry Human Clavicles in North Indian Population

Priyanka Sharma, Anupama Mahajan, Poonam Verma

Keywords : Diagnosis, Radiologists, Surgical procedures

Citation Information : Sharma P, Mahajan A, Verma P. Morphological Study of Attachment of Costoclavicular Ligament on the Dry Human Clavicles in North Indian Population. Curr Trends Diagn Treat 2023; 7 (1):3-6.

DOI: 10.5005/jp-journals-10055-0157

License: CC BY-NC 4.0

Published Online: 21-07-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Background: The clavicle bone performs a significant role in the movements of the upper limb. Clavicle is a long horizontal bone bearing two ends, i.e., asternal end, an acromial end, and a shaft. The sternal end bears an impression on its lower surface that may be in the form of a tubercle, fossae, or a depression called a costoclavicular area or rhomboid impression. This costoclavicular groove provides the attachment of the costoclavicular ligament. The mostly rough and elevated type was seen. Morphology of this area is clinically vital for the determination of age and sex and also for radiological and orthopedical points of view. Materials and methods: This study was conducted on 100 dry clavicles, out of which 50 were of the right and 50 were of the left side with unknown sex and age. In this study, rhomboid impressions were observed with variations, photographed, and compared with literature. Bones were taken from a department in a tertiary care medical institute in Punjab. Result: In this study 100 clavicles comprising 50 right and 50 left were taken and impressions were noticed, i.e., flat and smooth (FS), rough and elevated (RE), depressed and rough (DR), flat and rough (FR), and no impression. We found 18 (18%) flat and smooth (FS), 33 (33%) rough and elevated (RE), 13 (13%) depressed and rough (DR), and 19 (19%) flat and rough (FR) impressions on the clavicle. Out of 100 clavicles, 17 of them had no impressions. Conclusion: A mostly rough and elevated pattern was observed on the rhomboid impression of the clavicle bone. Knowledge of the costoclavicular impression area is clinically useful for orthopedical, radiological, and also for forensic as well as anthropological points of view.

  1. Cave AJE. The nature and morphology of the costoclavicular ligament. J Anat 1961;95(Pt 2):170–179. PMID: 1369176.
  2. Wood Jones F. The Bones of The Upper Limb. In Buchanan's Manual of Anatomy. 7th edition. London: Bailliere Tindall and Cox; 1946. p. 268.
  3. Neer C. Fractures of the clavicle. In: Rockwood CA, Green DP (Eds). Fractures in adults, 2nd edition. Philadelphia: JB Lippincott; 1984. pp. 707–713.
  4. Rowe CR. An atlas of anatomy and treatment of midclavicular fractures. Clin Orthop Rel Res 1968;58:29–42. PMID: 5666865.
  5. Renfree KJ, Wright TW. Anatomy and biomechanics of the acromioclavicular and sternoclavicular joints. Clinical Sports Med 2003;22(2):219–237. DOI: 10.1016/s0278-5919(02)00104-7.
  6. Frazer JE. The Anatomy of The Human Skeleton. 4th edition. London: J&A Churchill Ltd.; 1948. PMCID: 1988079.
  7. Schaeffer's JP. Osteology In: Morris’ Human Anatomy: A complete systematic treatise, 10th edition. Philladelphia: The Blakiston Company; 1942. p. 187.
  8. Williams PL, Bannister LH, Berry MM, et al. Skeleton System In: Gray's Anatomy. 38th edition. Edinburgh: Churchill Livingston; 1995. p. 621.
  9. Bearn JG. Direct observations on the function of the capsule of the sternoclavicular joint in clavicular support. J Anat 1967;101 (Pt 1):159–170. PMID: 6047697.
  10. Booth CM, Roper BA. Chronic dislocation of the sternoclavicular joint: An operative repair. Clin Orthop Relat Res 1979;140:17–20. PMID: 477070.
  11. Robinson CM, Jenkins PJ, Markham PE, et al. Disorders of the sternoclavicular joint. J Bone Joint Surg 2008;90(6):685–696. DOI: 10.1302/0301-620X.90B6.20391.
  12. Bhat SA, Bhat KA, Gupta S, et al. Changing trends in the management of adult clavicular fractures. A prospective study. Int J Adv Res 2014;2(6):843–849. ISSN 2320-5407.
  13. Akhlaghi M, Moradi B, Hajibeygi M. Sex determination using anthropometric dimensions of the clavicle in Iranian population. J Forensic Leg Med 2012;19(7):381–385. DOI:
  14. Prado FB, de Mello Santos LS, Caria PHF, et al. Incidence of clavicular rhomboid fossa (Impression for costoclavicular ligament) in the Brazilian population: Forensic application. J Forensic Odontostomatol 2009;27(1):12–16. PMID: 22717953.
  15. Carrera EF, Archetti Neto N, Carvalho RL, et al. Resection of the medial end of clavicle: An anatomic study. J Shoulder Elbow Surg 2007;16(1):112–114. DOI: 10.1016/j.jse.2006.04.010.
  16. Schaeffer's JP. Osteology. In: Morris’ Human Anatomy: A complete systematic treatise, 10th edition. Philadelphia: The Blakiston Company; 1942. p. 187.
  17. Shimizu T, Chigira M. Roentgenological analysis of sternocostoclavicular hyperostosis by computed tomography. J Jpn Orthop Assn 1989;63(1):18–24. PMID: 2786044.
  18. Krutchen AE, Bjarnason H, Stackhouse DJ, et al. The mechanisms of positional dysfunction of subclavian venous catheters. Radiology 1996;200(1):159–163. DOI: 10.1148/radiology.200.1.8657904.
  19. Paraskevas G, Natsis K, Spanidou S, et al. Excavated type of rhomboid fossa of the clavicle: A radiological study. Folia Morphol 2009;68(3):163–166. PMID: 19722160.
  20. Flournoy LE, Rogers NL, McCormick WF. The rhomboid fossa of the clavicle as a sex and age estimator. J Forensic Sci 2000;45(1):61–67. PMID: 10641920.
  21. Rani A, Chopra J, Rani A, et al. A study of morphological features of attachment area of costoclavicular ligament on clavicle and first rib in Indians and its clinical relevance. Biomedical Research 2011;22(3):349–354.
  22. Tubbs RS, Loukas M, Slappey JB, et al. Surgical and clinical anatomy of the interclavicular ligament. Surg Radiol Anat 2007;29(5):357–360. DOI: 10.1007/s00276-007-0219-z.
  23. Rathnakar P, Remya K, Chaitra D, et al. Morphological study of attachment of costoclavicular ligament on the clavicle in South Indian population. J Evolution Med Dent Sci 2018;7(33):3684–3686. DOI: 10.14260/jemds/2018/827.
  24. Rai R, Shrestha S. Incidence of rhomboid impression and subclavian groove in the adult human clavicles. Int Jour of Biomed Res 2014;5(3):161–163. DOI: 10.7439/ijbr.v5i3.546.
  25. Devi KVS, Sakthivel S. Morphology and anthropometry of rhomboid impression of clavicle and its clinical applications – A South Indian population study. Acad Anat Int 2020;6(2):16–20. DOI:
  26. Vani PC, Malsawmzuali JC, Anbalagan J, et al. Morphological study of clavicular rhomboid impression in South Indian population with its clinical significance. Int J Sci Res 2018;7(2):30–32. DOI: 10.36106/ijsr.
  27. Dyutimoy Datta, Chhitij Anand. Incidence of rhomboid impression and subclavian groove in the adult human clavicles. Int J Med Res Prof 2021;7(3):35–37. DOI: 10.21276/ijmrp.2021.7.3.010.
  28. Trupti, Keshavrao, Balvir, et al. Estimation of stature from the length of clavicle in Vidarbha region of Maharashtra. Int J Biol. Med Res 2015;3(4):2535–2537.
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