Surgical treatment of congenital pseudoarthrosis of the clavicle: Our 22-year, single-center experience
Carmen Martínez-Aznar1, Isabel Parada-Avendaño1, Victoria E Gómez-Palacio1, Sandra Abando-Ruiz1, Jorge Gil-Albarova1,2
1Orthopedic and Trauma Surgery Service, Miguel Servet University Hospital, Zaragoza, Spain
2Department of Surgery, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain.
Keywords: Clavicle, congenital pseudarthrosis of clavicle, quick disabilities of the arm, shoulder and hand, surgical procedures
Abstract
Objectives: This study reports the surgical outcomes in a patient cohort with congenital pseudarthrosis of the clavicle (CPC).
Patients and methods: A total of nine pediatric patients (5 males, 4 females; mean age: 4.43 years; range, 2 to 12 years) who were diagnosed with CPC and treated surgically with a minimum one-year follow-up between January 1996 and December 2018 were retrospectively analyzed. The patients were divided into two groups according to the fixation method as the Kirschner wire (K-wire; Group A, n=2) or stabilization with a plate (Group B, n=7). The physical function and symptoms were evaluated using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scale.
Results: The mean age at the time of diagnosis was 2.95 (range, 0 to 12) years. Six cases were atrophic pseudarthrosis and three cases were hypertrophic. Radiographic consolidation occurred in all cases with a mean duration of 103.8±39.1 days, indicating no significant difference between the groups (p>0.05). Complications registered were a K-wire breakage in a patient in Group A and an internal fixation plate loosening in a patient in Group B. The mean postoperative follow-up was 2.98±1.82 years. The QuickDASH score was 0 points in all patients.
Conclusion: The early surgical indication based on refreshment of the pseudarthrosis focus, with bone autograft interposition when a failure exists to restore adequate clavicular length, and fixation are reliable alternatives with favorable clinical and radiological results in the mid- and long-term with fewer complications.
Citation: Martínez-Aznar C, Parada-Avendaño I, Gómez- Palacio VE, Abando-Ruiz S, Gil-Albarova J. Surgical treatment of congenital pseudoarthrosis of the clavicle: Our 22-year, single- center experience. Jt Dis Relat Surg 2021;32(1):224-229.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.