Congenital pseudoarthrosis of clavicula

Right clavicula fracture was found in a male patient who was brought to our outpatient clinic at the age of 7 days with a complaint of swelling on the right clavicula. The patient had no history of difficult delivery or resuscitation. He was born at term by spontaneous vaginal delivery with a birth weight of 3 340 g from the first pregnancy of his mother and there was no consanguinity between the parents. Orthopaedic examination repeated at the age of 2 months revealed pathological movement in the middle of the clavicula and a swelling with a diameter of 1 cm. There was no tenderness. Asymmetry was noted between the shoulders, but range of motion was normal in both shoulders. On radiographic examination, it was observed that the proximal and distal fragment in the middle region of the clavicula were displaced by 1 cm and there was no callus. It was noted that the medial end of the distal fragment was blunt and sclerotic. There was no other pathology related with the musculosketal system. Examination of the other systems was found to be normal. Thus, a diagnosis of congenital clavicula pseudoarthrosis was made. This condition is rare and there are less than 200 cases in the literature. Congenital clavicula pseudoarthrosis almost always develops on the right side. Pseudoarthrosis was also on the right side in our patient. It is rarely bilateral (10%). It rarely occurs on the left clavicula and is usually associated with dextrocardia. Familial association is present in very few of the reported cases, but there is no genetic background. It is rarely diagnosed in the neonatal period. The diagnosis was made in the neonatal period in our patient. Shoulder functions are not affected, but painful deformity, cosmetic problems or thoracic outlet syndrome may be observed in the adolescence and afterwards.