J Korean Orthop Assoc.  2008 Jun;43(3):396-399. 10.4055/jkoa.2008.43.3.396.

Congenital Pseudarthrosis of the Clavicle: Report of 4 Cases Treated with Surgical Methods

• Shim JS
• Chang MJ

• KMID: 2186459
• DOI: http://doi.org/10.4055/jkoa.2008.43.3.396

Abstract

Congenital pseudarthrosis of the clavicle is a rare condition, and optimal treatment strategies are controversial because this benign condition rarely produces functional disabilities except for an unsightly lump and occasional mild weakness of muscle strength around the shoulder girdle. Nevertheless, its prominence increases with age and it can cause cosmetic problems by drooping and shortening of the shoulder. Thoracic outlet syndromes have been reported in a few patients who did not receive treatment. The authors here report on congenital pseudarthrosis of a unilateral clavicle in 3 patients and bilateral clavicles in 1 patient. All patients were treated with autogenous iliac bone grafts and internal fixation, with a complete union and cosmetically satisfying results.

Keyword

Clavicle; Congenital pseudarthrosis; Surgical treatment; Outcome

MeSH Terms

Clavicle
Cosmetics
Humans
Muscle Strength
Pseudarthrosis
Shoulder
Thoracic Outlet Syndrome
Transplants
Cosmetics

Figure

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  Fig. 1 Case 2, A 3-year-old girl had a painless lump over the right clavicle.

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  Fig. 2 (A) Case 3, Preoperaive radiograph showing bilateral congenital pseudarthrosis of the clavicle. (B) Case 2, A columnar distribution of chondrocytes with different stages of maturation, as is seen in the growth cartilage (H&E, ×200).

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  Fig. 3 (A) Case 3, Postoperative radiograph. Fixation of the right clavicle with aplate and of the left clavicle with a threaded Steinmann pin. (B) Case 3, An eight-year postoperative radiograph showed complete remodeling of the pseudarthrosis.

Reference

1. Alldred AJ. Congenital pseudarthrosis of the clavicle. J Bone Joint Surg Br. 1963. 45:312–319.

2. Bargar WL, Marcus RE, Ittleman FP. Late thoracic outlet syndrome secondary to pseudarthrosis of the clavicle. J Trauma. 1984. 24:857–859.

3. Grogan DP, Love SM, Guidera KJ, Ogden JA. Operative treatment of congenital pseudarthrosis of the clavicle. J Pediatr Orthop. 1991. 11:176–180.

4. Hirata S, Miya H, Mizuno K. Congenital pseudarthrosis of the clavicle. Histologic examination for the etiology of the disease. Clin Orthop Relat Res. 1995. 315:242–245.

5. Jeon IH, Wilson I, Wallace WA. Reconstruction of congenital pseudarthrosis of the clavicle in an adult. J Orthop Sci. 2006. 11:229–231.

6. Lloyd-Roberts GC, Apley AG, Owen R. Reflections upon the aetiology of congenital pseudarthrosis of the clavicle. With a note on cranio-cleido dysostosis. J Bone Joint Surg Br. 1975. 57:24–29.

7. Lorente Molto FJ, Bonete Lluch DJ, Garrido IM. Congenital pseudarthrosis of the clavicle: a proposal for early surgical treatment. J Pediatr Orthop. 2001. 21:689–693.

8. Owen R. Congenital pseudarthrosis of the clavicle. J Bone Joint Surg Br. 1970. 52:644–652.

9. Shalom A, Khermosh O, Wientroub S. The natural history of congenital pseudarthrosis of the clavicle. J Bone Joint Surg Br. 1994. 76:846–847.

10. Toledo LC, MacEwen GD. Severe complication of surgical treatment of congenital pseudarthrosis of the clavicle. Clin Orthop Relat Res. 1979. 139:64–67.