Congenital clavicular pseudarthrosis: Comparison of two treatment methods

Prakash Chandran,Harvey George,Leroy A James

doi:10.1007/s11832-010-0313-3

Prakash Chandran, Harvey George + Show 1 more

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https://doi.org/10.1007/s11832-010-0313-3

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Abstract

Congenital pseudarthrosis of the clavicle is rare and popular surgical options include excision of the non-union, iliac crest bone grafting and stabilisation with either a fully threaded pin or stabilisation with a reconstruction plate. Between 1995 and 2009, ten patients with congenital pseudarthrosis of the clavicle were retrospectively reviewed for outcome of two different forms of surgical management. Five patients had excision of the non-union, iliac crest bone grafting and stabilisation with a fully threaded pin (group A) and the other five patients had excision of the non-union, iliac crest bone grafting and stabilisation with a reconstruction plate (group B). One patient in the second group had bilateral pseudarthrosis. In group A, three patients achieved radiological union at a median of 6months. Two patients failed to unite at the pseudarthrosis and one of them had further surgery with a reconstruction plate in order to achieve union. In group B, all five patients (six clavicles) achieved radiological union at a median of 3months. All patients had painless full range of shoulder movement and were engaging in unrestricted activities. Excision of the pseudarthrosis, autogenous iliac bone grafting and stabilisation with plate achieves union quicker and with lower incidence of complications compared to excision of the pseudarthrosis, autogenous iliac bone grafting and stabilisation with fully threaded pins.

Highlights

Congenital pseudarthrosis of the clavicle is a rare condition; following its first report in 1910 [1], many individual cases and case series have been published
Between 1995 and 2009, ten patients with congenital pseudarthrosis of the clavicle were retrospectively reviewed for outcome of two different forms of surgical management
Two patients failed to unite at the pseudarthrosis and one of them had further surgery with a reconstruction plate in order to achieve union

Summary

Introduction

Congenital pseudarthrosis of the clavicle is a rare condition; following its first report in 1910 [1], many individual cases and case series have been published. Congenital pseudarthrosis of the clavicle usually presents as a swelling in the clavicular region at or soon after birth. The swelling is usually painless and occasionally present as weakness and inability to push the arm while crawling due to excessive movement at the pseudarthrosis site. Congenital pseudarthrosis of the clavicle is rare and popular surgical options include excision of the non-union, iliac crest bone grafting and stabilisation with either a fully threaded pin or stabilisation with a reconstruction plate. Results In group A, three patients achieved radiological union at a median of 6 months. Two patients failed to unite at the pseudarthrosis and one of them had further surgery with a reconstruction plate in order to achieve union. In group B, all five patients (six clavicles) achieved radiological union at a median of 3 months. All patients had painless full range of shoulder movement and were engaging in unrestricted activities

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