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[Clavicular pseudarthrosis in childhood: differential diagnosis, clinical aspects, therapy and results]
B Schmidt-Rohlfing1, C Niedhart, E H Schwer
1Orthopädische Klinik der RWTH Aachen. bernhard.schmidt@post.rwth-aachen.de
Aim:
Both congenital as well as post-traumatic pseudarthroses of the clavicle are very rare diagnoses in childhood. This study evaluates operative and non-operative therapy in relation to diagnosis, clinical appearance, and results.
Methods:
A retrospective study was performed on all patients with pseudarthrosis of the clavicle in childhood. The data were obtained from medical records. Follow-ups were performed on patients who had undergone surgery.
Results:
A total of 15 patients with 16 pseudarthroses were included, of these five patients had congenital and nine patients had post-traumatic pseudarthroses. One patient with a bilateral defect was diagnosed as having cleidocranial dysostosis. Concerning the patients with congenital pseudarthrosis, cosmetic appearance was the leading complaint while patients with post-traumatic pseudarthrosis suffered from pain and impaired function of the shoulder joint. Nine patients underwent surgery, including two patients with congenital, and seven with post-traumatie lesions.
Conclusion:
While patients with congenital pseudarthrosis mostly achieve good functional results by means of conservative therapy, surgery is optional in relation to the severity of cosmetic damage. However, the majority of post-traumatic lesions require operative therapy due to associated pain and restricted function.
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