Updated: 10/17/2017

Congenital Pseudoarthrosis of Clavicle

Topic
Review Topic
0
0
Questions
1
0
0
Evidence
2
0
0
https://upload.orthobullets.com/topic/4039/images/congenital pseudoarthosis of clavicle.jpg
https://upload.orthobullets.com/topic/4039/images/clavicular_pseudarthrosis physical exam.jpg
https://upload.orthobullets.com/topic/4039/images/Clinical photo - colorado_moved.jpg
Introduction
  • Congenital failure of fusion of the medial and lateral ossification centers of the clavicle
  • Epidemiology
    • incidence
      • rare 
    • location
      • right side most common q
        • situs inversus is the exception
        • bilateral in <10%
  • Pathophysiology
    • postulated to be due to extrinsic compression by the subclavian artery 
  • Genetics
    • no clear genetic involvement 
  • Prognosis
    • usually is asymptomatic and does not require treament
    • if symptomatic, successful union predicted with surgical treatment
Presentation
  • Symptoms
    • usually asymptomatic
  • Physical exam
    • inspection
      • painless, nontender mass on clavicle 
      • may be associated with winging of scapula
Imaging
  • Radiographs
    • recommended views
      • AP of clavicle
    • findings
      • show rounded sclerotic bone at pseudoarthrosis site 
Treatment
  • Nonoperative
    • observation
      • indications
        • minimal symptoms and cosmetic deformity
  • Operative - very uncommmon
    • ORIF with iliac crest bone grafting at age 3-6 years
      • indications
        • pain
        • functional impairment
        • cosmesis
      • outcomes
        • successful union is usually obtained
        • avoid bone graft substitute, higher rates of non-union
 

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Questions (1)

(OBQ04.179) Congenital pseudoarthrosis of the clavicle almost always presents on: Review Topic

QID: 1284
1

the right side, middle 1/3

53%

(217/406)

2

the right side, lateral 1/3

18%

(72/406)

3

the left side, middle 1/3

13%

(52/406)

4

the left side, lateral 1/3

10%

(40/406)

5

both sides equally

6%

(23/406)

ML 3

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PREFERRED RESPONSE 1
ARTICLES (3)
Topic COMMENTS (5)
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