[Congenital pseudarthrosis of the clavicle: a review of nine cases]

Congenital pseudarthrosis of the clavicle (CPC) is a rare malformation of the scapular waist of unknown etiology. About 200 cases have been reported. The lesion is usually right-sided and unilateral. Physical examination reveals swelling over the midportion of the clavicle, usually asymptomatic, and the diagnosis is confirmed by plain radiology. The differential diagnosis includes posttraumatic pseudarthrosis, cleidocranial dysostosis and neurofibromatosis. Surgical treatment is indicated in symptomatic patients or those with major deformity.

We performed a retrospective review of the medical records of 9 patients with CPC managed in our hospital.

We studied 5 girls and 4 boys with unilateral right CPC. None of them had a familial history of CPC. Four complained of local pain, without functional impairment, and clavicular asymmetry on x-ray ranging from 0.5 to 1 cm, without accompanying pathologic findings. Surgical treatment was performed in 5 patients, with resection of fibrous pseudarthrosis, internal fixation, and iliac bone graft. In 4 patients callus response was achieved at 2 months. The remaining patient required withdrawal of orthopaedic material 2 months after surgery because of its protrusion through the skin, without the need for further surgical treatment to date.

Although rare, CPC should be included in the differential diagnosis of clavicle abnormalities in children. Good results are achieved with current surgical techniques in patients with clear indication.