Surgical treatment of congenital pseudoarthrosis of the clavicle in children
- 作者: Pozdeev A.1, Belousova E.1, Sosnenko O.1
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隶属关系:
- Federal State Budgetary Institution The Turner Scientific Research Institute for Children’s Orthopedics
- 期: 卷 26, 编号 1 (2019)
- 页面: 27-34
- 栏目: Original study articles
- URL: https://journals.rcsi.science/0869-8678/article/view/47190
- DOI: https://doi.org/10.17116/vto201901127
- ID: 47190
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Introduction. In the literature the issue of indications for surgical treatment of CPC (congenital pseudoarthrosis of the clavicle) is exposed to discussion. Also, there are no accurate age indications for surgery. The conducted research has shown that the course of CPC is accompanied by clavicle shortening as well as by bone fragments deformation in 60% of the cases, which has a significant effect on the planning of surgery.
Purpose of study: to develop a differentiated approach to the treatment of congenital pseudoarthrosis of the clavicle in children, taking into account the clinical and radiological picture.
Patients and methods. 27 patients with the congenital pseudoarthrosis of the clavicle (CPC) aged from 4 up to 16 years old were operated. In 6 observations bone fragments deformation of the clavicle was absent, and in 21 observations various deformations occurred. The surgery included restoration of clavicle axis, replacement of bone tissue defect with bone autograft, fixation of bone fragments with a needle.
Results. After the first surgery, bone fragments consolidation of the false joint was reached in 82% of the cases (22 patients); the recurrence of the false joint was observed in 18% (5 patients). Repeated surgeries were successfully performed on four of them; one patient is being observed on an outpatient basis.
Conclusion. The results of the surgical treatment have shown that for the union of a false joint it is necessary to use differentiated approach to the adoption of surgical technique with regard to bone fragments deformation. Partially eliminated deformation and clavicle sternal bone fragment high standing served as the main reason for the recurrence of pseudoarthrosis.
作者简介
A. Pozdeev
Federal State Budgetary Institution The Turner Scientific Research Institute for Children’s Orthopedics
Email: prof.pozdeev@mail.ru
ORCID iD: 0000-0001-5665-6111
MD, PhD, Professor, Chief Researcher of the Department of Bone Pathology, Scientific Research Institute for Children’s Orthopedics
俄罗斯联邦, Saint-PetersburgE. Belousova
Federal State Budgetary Institution The Turner Scientific Research Institute for Children’s Orthopedics
Email: qeenl8@mail.ru
traumatologist-orthopedist, senior laboratory assistant of the Department of Pediatric Traumatology and Orthopedics
俄罗斯联邦, Saint-PetersburgO. Sosnenko
Federal State Budgetary Institution The Turner Scientific Research Institute for Children’s Orthopedics
编辑信件的主要联系方式.
Email: sosnenko.olga@yandex.ru
MD, PhD, Manager of the Department of Bone Pathology
俄罗斯联邦, Saint-Petersburg参考
- Fitzwilliams D. Hereditary cranio-cleido-dysostosis. Lancet. 1910;2:1466. https://doi.org/10.1016/s0140- 6736(01)38817-7.
- Поздеев А.П., Сухарская Ю.Б. Врожденный ложный сустав ключицы. Клинико-рентгенологическое исследование. Ортопедия, травматология и восстановительная хирургия детского возраста. 2016;4(1):43-8. [Pozdeev А.Р., Suharskaja Ju.В. Vrozhdennyj lozhnyj sustav kljuchicy. Kliniko-rentgenologicheskoe issledovanie. Ortopedija, travmatologija i vosstanovitel’naja hirurgija detskogo vozrasta. 2016;4( 1 ):43-8. (In Russ.)], https://doi.org/10.1016/ s0140-6736(01)38817-7.
- Owen R. Congenital pseudarthrosis of the clavicle. J Bone Joint Surg Br. 1970;52(4):644-52.
- Ahmadi B., Steel H.H. Congenital pseudarthrosis of the clavicle. Clin Orthop Relat Res. 1977;126:129-34. https:// doi.org/10.1097/00003086-197707000-00020.
- Lloyd-Roberts G.C., Apley A.G., Owen R. Reflections upon the aetiology of congenital pseudarthrosis of the clavicle. With a note on cranio-cleido dysostosis. J Bone Joint Surg Br. 1975;57(l):24-9.
- Rabenseifner L. Etiology and therapy of clavicular-pseudarthrosis. Aktuelle Traumatol. 1981;11(4): 130-2.
- Lorente Molto F.J., Bonete Lluch D.J., Garrido I.M. Congenital pseudarthrosis of the clavicle: a proposal for early surgical treatment. J Pediatr Orthop. 2001;21 (5):689-93. https://doi.org/10.1097/01241398-200109000-00026.
- Persiani P., Molayem I., Villani C. et al. Surgical treatment of congenital pseudarthrosis of the clavicle: a report on 17 cases. Acta Orthop Belg. 2008;74(2):161-6.
- Herring J.A. Pseudarthrosis of the clavicle. Tachdjian’s pediatrics orthopaedics. 4th ed.: Philadelphia: WB Saunders; 2008.
- Studer K., Baker M.P., Krieg A.H. Operative treatment of congenital pseudarthrosis of the clavicle: a single-centre experience. J Pediatr Orthop. 2017;26(3):245-9. https:// doi.org/10.1097/BPB.0000000000000400.
- Di Gennaro G.L., Cravino M., Martinelli A. et al. Congenital pseudarthrosis of the clavicle: a report on 27 cases. J Shoulder Elbow Surg. 2017;26(3):e65-e70. https://doi. org/10.1016/j.jse.2016.09.020.
- Sloan A., Paton R. Congenital pseudarthrosis of the clavicle: the role of CT-scanning. Acta Orthop Belg. 2006;72(3):356- 8.
- Ahmadi B., Steel H.H. Congenital pseudarthrosis of the clavicle. Clin Orthop Relat Res. 1977; 126:129-34. https:// doi.org/10.1097/00003086-197707000-00020.
- Lloyd-Roberts G.C., Fixsen J.A. Congenital pseudarthrosis of the clavicle. In: Canale S.T., ed. Orthopaedics in infancy and childhood. London: Butterworth-Heinemann; 1989.
- Gibson D.A., Carroll N. Congenital pseudarthrosis of the clavicle. J Bone Joint Surg Br. 1970;2013:629-43.
- Al-Hadidy A., Haroun A., Al-Ryalat N. et al. Congenital pseudarthrosis associated with venous malformation. Skeletal Radiol. 2007;2013:15-8. https://doi.org/10.1007/ S00256-006-0175-4.
- Beslikas T.A., Dadoukis D.J., Gigis I.P. et al. Congenital pseudarthrosis of the clavicle: a case report. J Orthop Surg (Hong Kong). 2007;2013:87-90. https://doi. org/10.1177/230949900701500120.
- Russo M.T., Maffulli N. Bilateral congenital pseudarthrosis of the clavicle. Arch. Orthop. Trauma Surg. 1990; 109(3): 177- 8. https://doi.org/10.1007/bf00440584.
- Веселовский Ю.А. Ложные суставы ключицы у детей и подростков и их лечение. Ортопедия, травматология и протезирование. 1980;10:44-5. [Veselovsky Yu.A. Lozhnyjе sustavy klyuchitsy u detej i podrostkov i ikh lechenie. Ortopedija, travmatologija i protezirovanie. 1980;10:44-5. (In Russ.)].
- Корж A.A., Шевченко С.Д., Филиппенко В.А. Лечение врожденного псевдоартроза ключицы. Ортопедия, травматология и протезирование. 1983;4:22-4. [Korzh А.А., Shevchenko S.D., Filippenko V.A. Lechenie vrozhdennogo psevdoartroza klyuchitsy. Ortopedija, travmatologija i protezirovanie. 1983;4:22-4. (In Russ.)].
- Price C.T., Phillips J.H., Devito D.P. Pseudartrosecongenita da clavicula. In: Morrissy R.T., Weinstein S.L., eds. Ortopediapediatrica de Lovelle Winter. Philadelphia: Lippincott Wiliams&Wilkins; 2005.
- Cadilhac C., Fenoll B., Peretti A. et al. Congenital pseudarthrosis of the clavicle: 25 childhood cases. Rev Chir Orthop Reparatrice Appar Mot. 2000;86(6):575-80.
- Salati S.A. Congenital pseudarthrosis of the clavicle. East Cent Afr J Surg (online). 2012; 17( 1): 111.
- Chandran P., George H., James L.A. Congenital clavicular pseudarthrosis: comparison of two treatment methods. J Child Orthop. 2011;5(1): 1-4. https://doi.org/10.1007/ sl 1832-010-0313-3.
- Toledo L.C., MacEwen G.D. Severe complication of surgical treatment of congenital pseudarthrosis of the clavicle. Clin Orthop Relat Res. 1979;139:64-7. https://doi. org/10.1097/00003086-197903000-00009.
- Shim J.S., Chang M.J. Congenital pseudarthrosis of the clavicle — report of 4 cases treated with surgical methods. J Korean Orthop Assoc. 2008;43:396-9. https://doi. org/10.4055/jkoa.2008.43.3.396.
- Поздеев А.П. Ложные суставы и дефекты костей у детей (этиология, клиника, лечение): Дис.... д-ра мед. наук. СПб; 1998. [Pozdeev А.Р. Pseudarthroses and bone defects in children (etiology, clinical picture, treatment). Dr. med. sci. Diss. St. Petersburg; 1998. (In Russ.)].