- Discussion:
- occurs due to failure of union between medial & lateral ossification centers of clavicle;
- involve the
right clavicle most often (when left side is involved, look for dextrocardia);
- birth trauma plays no role in this condition, and this condition is not associated w/ neurofibromatosis;
- patients should not have tenderness over the site of pseudoarthrosis;
-
diff dx:
-
clavicular frx
- among toddler's & children, 80% of clavicle frx occur in midshaft;
- unlike pseudoarthrosis, clavicle fractures will be expected to heal on their own;
-
cleidocranial dysplasia
- Radiographs:
- evident is the lack of callous formation, w/ rounded appearance to ends of two fragments;
- Treatment:
- typically congenital pseudarthrosis of the clavicle causes little discomfort and requires no treatment;
- ORIF & bone grafting are performed if cosmesis or functional capacity are not satisfactory;
- in the report by FJ Lorente Molto et al, the authors reviewed six cases of children with congenital pseudarthrosis of the clavicle;
- 5 of them, including the bilateral case, were surgically treated at ages ranging from 18 months to 4 years;
- bone graft and internal fixation with a Kirschner wire were used;
- healing of the pseudarthrosis was obtained in all patients in 6-8 weeks;
- ref: Congenital Pseudarthrosis of the Clavicle: A Proposal for Early Surgical Treatment
Francisco J. Lorente Molto, M.D. J Pediatr Orthop 2001 September/October;21(5):689-693
Congenital pseudoarthrosis of the clavicle.
JJ Wall. JBJS. Vol 52(5)-A. 1970. p 1003-1009.
The natural history of congenital pseudoarthrosis of the clavicle.
A Shalom et al.
JBJS. Vol 76(5)-B. 1994. p 846-847.
Operative Treatment of congential pseudoarthrosis.
DP Grogan et al.
J. Pediatric Orthop. Vol 11(2) 1991. p 176-180.
