Skip Navigation LinksHome > April 15, 2009 - Volume 34 - Issue 8 > Does the Fists-on-Clavicles Position Represent a Functional...
doi: 10.1097/BRS.0b013e31819e2191
Diagnostic Imaging

Does the Fists-on-Clavicles Position Represent a Functional Standing Position?

Aota, Yoichi MD; Saito, Tomoyuki MD; Uesugi, Masaaki MD; Ishida, Koh MD; Shinoda, Keisuke MD; Mizuma, Koichi MD

Collapse Box


Study Design. Prospective analysis of sagittal vertical axis (SVA) on lateral spine radiographs using 3 different arm positions.

Objective. To examine whether fists-on-clavicles position represents a functional standing position.

Summary of Background Data. Radiographic visualization of spinal and pelvic sagittal morphology is difficult during relaxed standing because of interference from the arms; however, standing with arms forward-flexed results in a negative shift in SVA. The fists-on-clavicles position was proposed to provide a more functional sagittal profile and adequate visualization of the spine. No existing study compares the SVA between the fists-on-clavicle and relaxed standing positions.

Methods. The SVA was measured on standing lateral radiographs of 14 healthy subjects using 3 different arm positions: relaxed with arms-at-side, arms forward-flexed to 45° (shoulder flexion [SF]), and fists-on-clavicles.

Results. The mean SVA with relaxed standing was 1.4 ± 1.9 cm. SF produced a significant SVA negative shift (−3.7 ± 2.3 cm, P < 0.001). The fists-on-clavicle position resulted in a reduced but significant SVA negative shift (−2.3 ± 2.1 cm, P < 0.001) compared with relaxed standing.

Conclusion. Although the fists-on-clavicles position was better than SF in reducing the SVA negative shift, a significant negative shift did occur in the fists-on-clavicle position compared with relaxed standing.

© 2009 Lippincott Williams & Wilkins, Inc.

Follow Us!



Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.