|Beitragstitel||Management of Congenital Pseudathrosis of the clavicle- a single-centre experience|
Congenital pseudarthroris of the clavicle (CPC) is very rare. It predominantly presents at the right side, in the middle part of the clavicle. As children are often asymptomatic, operative treatment is debatable.
In this retrospective study we present our single-center experience of surgical management of CPC. We analyzed all children operated between 2004 and 2012 with resection of the CPC, bone grafting with a nonvascular iliac crest and plate fixation.
Exclusion criteria were traumatic or obstetric fractures of the clavicle and children with neurological or genetic disorders. The follow-up visits 6 weeks, 3 months and 6 to 12 months postoperative included clinical as well as radiological examination.
7 patients with 8 clavicles were operated with a mean age of 7.1 years (5-8 years). Of these, 4 were girls and 3 boys. In all operated children, the diagnosis of CPC was made before the age of 5 years. At the time of diagnosis, they presented with an asymptomatic mass or swelling over the clavicle with normal range of motion. Mean follow-up was 7 years (4-10 years). One patient was affected bilaterally with challenging surgical management. One patient had delayed union. 85% of our patients showed good functional results with complete radiographic consolidation at a mean of 8.5 months (3-25 months). At the 6-12 month follow-up all children had good clinical function with a mean Constant Score of 94 points (88-98 Points). No late fractures, no wound complications occurred. 3 children had severe pain at the donor site in the early postoperative period, but at the 6 weeks follow-up none of these children had persistent donor-site morbidity.
The operative treatment with resection of the CPC, interposition of nonvascularized bone graft from the iliac crest and plate fixation, seems to be successful in early childhood. We advise operative treatment between 5 and 7 years of age.