Congenital pseudarthrosis of the clavicle: a report on 27 cases.
OBJECTIVE
We aimed to report our experience in treating congenital pseudarthrosis of the clavicle (CPC).


METHODS
A retrospective search of the archive of our institute was performed; 27 cases (12 male and 15 female patients) affected by CPC were recorded. Among these patients, 19 underwent surgical intervention for cosmetic appearance between 1960 and 2015. Of 19 patients, 18 were treated by pseudarthrosis resection and stabilization with a Kirschner wire, whereas in 1 case, the osteosynthesis was performed with a plate. Iliac crest bone autograft was used in 15 patients, whereas 4 patients were treated with a fibular allograft.


RESULTS
The mean follow-up period was 36.3 ± 49.1 months. Bone healing was achieved in 14 of 19 operated cases (74%); none of the patients had complaints regarding cosmetic abnormalities or unesthetic appearance. All the operated patients were pain free, range of motion was complete, and no other subjective anomalies were found. No vascular or neurologic complications were observed. However, the use of allograft was associated with high rates of nonunion in this case series (P = .037).


CONCLUSIONS
CPC can be satisfactorily treated by K-wire fixation and autologous iliac crest bone grafting, which showed better results in terms of functional and cosmetic outcome.
Department of Paediatric Orthopedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy.
Giovanni Luigi
GL
Di Gennaro
Department of Paediatric Orthopedics and Traumatology, Cesare Arrigo Pediatric Hospital, Alessandria, Italy.
Mattia
M
Cravino
Ospedale dei Bambini Vittore Buzzi, Milan, Italy.
Alessandro
A
Martinelli
Department of Paediatric Orthopedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy.
Eleonora
E
Berardi
GMERS Medical College, Valsad, India.
Anish
A
Rao
Department of Paediatric Orthopedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy.
Stefano
S
Stilli
Department of Paediatric Orthopedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy. Electronic address: giovanni.trisolino@ior.it.
Giovanni
G
Trisolino
D000293:Adolescent; D064592:Autografts; D001860:Bone Plates; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D002968:Clavicle / Q000002:abnormalities* / Q000293:injuries / Q000601:surgery*; D005260:Female; D005592:Fracture Fixation; D005598:Fractures, Spontaneous / Q000150:complications / Q000601:surgery; D006801:Humans; D007085:Ilium / Q000637:transplantation; D007223:Infant; D008297:Male; D008875:Middle Aged; D011542:Pseudarthrosis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies
Congenital pseudarthrosis of clavicle; bone graft; clavicle; congenital; pseudarthrosis; shoulder girdle; surgical procedures