Young M C, Richards R R, Hudson A R
Upper Extremity Reconstructive Service, St. Michael's Hospital, Toronto, Ont.
Can J Surg. 1988 Mar;31(2):131-3.
Although a number of cases of congenital pseudarthrosis of the clavicle have been described in the literature, they provide little direction for the treatment of this condition when it is associated with thoracic outlet syndrome. The authors describe their experience with such a case in a 20-year-old woman. Symptoms of pain in the ulnar distribution of the right forearm and discoloration of the hand with abduction of the extremity had developed over 3 years. The radial pulse was obliterated by abduction of the arm. Exploration of the brachial plexus revealed a constricting band arising from the distal fragment of the clavicle running to the first rib which, together with the mass of the pseudarthrosis, comprised the thoracic outlet. The patient was successfully treated by division of the fibrous band, reduction of the clavicle, internal fixation with a plate and iliac crest bone grafting. At follow-up the patient had a full range of motion in the shoulder and was asymptomatic.
尽管文献中已描述了一些先天性锁骨假关节病例，但当这种情况与胸廓出口综合征相关时，它们对该病症的治疗几乎没有指导作用。作者描述了他们对一名20岁女性此类病例的治疗经验。右前臂尺侧分布区疼痛以及上肢外展时手部变色的症状已持续3年。手臂外展时桡动脉搏动消失。对臂丛神经进行探查发现，一条由锁骨远端伸向第一肋的束带形成压迫，该束带与假关节肿块共同构成胸廓出口。通过切断纤维束带、复位锁骨、用钢板内固定并取自体髂骨植骨，成功治疗了该患者。随访时，患者肩部活动范围正常且无症状。
