Persiani Pietro, Molayem Iakov, Villani Ciro, Cadilhac Céline, Glorion Christophe
Dipartimento di Scienze dell'Apparato Locomotore, Policlinico Umberto I, Università La Sapienza, Rome, Italy.
Acta Orthop Belg. 2008 Apr;74(2):161-6.
Congenital pseudarthrosis of the clavicle (CPC) is a rare malformation of uncertain aetiopathogenesis, usually unilateral. Physical examination reveals swelling over the midportion of the clavicle, often asymptomatic; the diagnosis is confirmed by radiology. Treatment is controversial: for many authors the surgical indications are the presence of symptoms, functional impairment or cosmetic deformities. We present a retrospective analysis of 17 children with CPC treated in our institutions: 9 were treated with plate (P) and 8 with Kirschner wire (KW) fixation; a bone graft was used in 12 cases only. Five patients (4 P and 1 KW) needed a second surgical procedure. The surgical treatment led to a very good result in 7 cases, good in 4 cases, fair in 3 cases and poor in 3 other cases. We recommend early treatment of all patients with CPC with resection of the pseudarthrosis, autologous iliac bone grafting and internal fixation with Kirschner wires.
先天性锁骨假关节（CPC）是一种病因发病机制不明的罕见畸形，通常为单侧。体格检查可发现锁骨中部肿胀，通常无症状；诊断通过放射学检查确定。治疗存在争议：对许多作者来说，手术指征是出现症状、功能障碍或美容畸形。我们对在我们机构接受治疗的17例先天性锁骨假关节患儿进行了回顾性分析：9例采用钢板（P）治疗，8例采用克氏针（KW）固定；仅12例使用了骨移植。5例患者（4例钢板固定和1例克氏针固定）需要二次手术。手术治疗7例效果非常好，4例良好，3例尚可，3例较差。我们建议对所有先天性锁骨假关节患者尽早进行治疗，切除假关节，自体髂骨移植并用克氏针内固定。
