Pourtaheri Neema, Strongwater Allan M
Department of Pediatric Orthopedics, St Joseph’s Children’s Hospital, 703 Main St, Paterson, NJ 07503, USA.
Orthopedics. 2012 Mar 7;35(3):e442-3. doi: 10.3928/01477447-20120222-36.
Posttraumatic clavicle nonunion is rare, particularly in children. Four cases of clavicle fracture nonunion in patients aged 10 years and younger have been reported. A variety of techniques have been used to treat pediatric clavicle nonunions. A 10-year-old boy presented to our institution after a fall, sustaining a right closed midshaft clavicle fracture. No other injuries occurred, and neurovascular examination of the right upper extremity was normal. The fracture was initially treated with a sling for >4 months, and the fracture progressed to a hypertrophic nonunion. Serial radiographs failed to demonstrate progression to union. The patient continued to have pain with activity 4 months after his injury. Clavicle pseudarthrosis was considered; however, radiographs did not have the characteristic appearance of this condition. This fracture nonunion was treated with internal fixation and united with no complication. The patient was back to full activities of daily living 6 months postoperatively. He reported no tenderness at the fracture site or along the hardware. The treating surgeon (A.M.S.) prefers to remove hardware in young children, but the family declined removal. Pediatric posttraumatic nonunion of the clavicle is rare but can be safely treated with plate fixation, with excellent results.
创伤后锁骨骨不连很罕见，尤其是在儿童中。文献报道了4例10岁及以下患者的锁骨骨折骨不连。已经采用了多种技术来治疗儿童锁骨骨不连。一名10岁男孩跌倒后前来我院就诊，导致右侧锁骨中段闭合性骨折。未发生其他损伤，右侧上肢神经血管检查正常。骨折最初用吊带治疗超过4个月，随后进展为肥大性骨不连。系列X线片未能显示骨折愈合进展。受伤4个月后，患者活动时仍有疼痛。考虑为锁骨假关节；然而，X线片没有这种疾病的典型表现。该骨折骨不连采用内固定治疗，愈合良好，无并发症。术后6个月，患者恢复了全部日常生活活动。他报告骨折部位及内固定物沿线无压痛。主刀医生（A.M.S.）倾向于为幼儿取出内固定物，但家属拒绝取出。儿童创伤后锁骨骨不连很少见，但采用钢板固定可安全治疗，效果良好。
