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Congential Pseudoarthrosis of the Clavicle

- 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 toddlers & 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 Lorente Molto FJ, 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 

Congenital pseudoarthrosis of the clavicle.

The natural history of congenital pseudarthrosis of the clavicle.

Operative treatment of congenital pseudarthrosis of the clavicle.

Pseudarthrosis of the Clavicle