Orthopedic and Trauma Surgery Service, Miguel Servet University Hospital, Paseo de Isabel la Católica, 50009 Zaragoza. Spain.
Jt Dis Relat Surg. 2021;32(1):224-229. doi: 10.5606/ehc.2021.79576. Epub 2021 Jan 6.
This study reports the surgical outcomes in a patient cohort with congenital pseudarthrosis of the clavicle (CPC).
A total of nine pediatric patients (5 males, 4 females; mean age: 4.43 years; range, 2 to 12 years) who were diagnosed with CPC and treated surgically with a minimum one-year follow-up between January 1996 and December 2018 were retrospectively analyzed. The patients were divided into two groups according to the fixation method as the Kirschner wire (K-wire; Group A, n=2) or stabilization with a plate (Group B, n=7). The physical function and symptoms were evaluated using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scale.
The mean age at the time of diagnosis was 2.95 (range, 0 to 12) years. Six cases were atrophic pseudarthrosis and three cases were hypertrophic. Radiographic consolidation occurred in all cases with a mean duration of 103.8±39.1 days, indicating no significant difference between the groups (p>0.05). Complications registered were a K-wire breakage in a patient in Group A and an internal fixation plate loosening in a patient in Group B. The mean postoperative follow-up was 2.98±1.82 years. The QuickDASH score was 0 points in all patients.
The early surgical indication based on refreshment of the pseudarthrosis focus, with bone autograft interposition when a failure exists to restore adequate clavicular length, and fixation are reliable alternatives with favorable clinical and radiological results in the mid- and long-term with fewer complications.
本研究报告了一组先天性锁骨假关节（CPC）患者的手术结果。
回顾性分析了 1996 年 1 月至 2018 年 12 月期间，共 9 例经手术诊断为 CPC 且至少随访 1 年的儿科患者（5 男，4 女；平均年龄 4.43 岁；年龄范围 2-12 岁）。根据固定方法将患者分为两组：克氏针（K 线；A 组，n=2）或钢板固定（B 组，n=7）。使用快速上肢、肩部和手功能障碍（QuickDASH）量表评估患者的身体功能和症状。
诊断时的平均年龄为 2.95 岁（年龄范围 0-12 岁）。6 例为萎缩性假关节，3 例为肥大性假关节。所有病例均发生影像学愈合，平均愈合时间为 103.8±39.1 天，两组间无显著差异（p＞0.05）。A 组 1 例患者的 K 线断裂，B 组 1 例患者的内固定钢板松动。术后平均随访时间为 2.98±1.82 年。所有患者的 QuickDASH 评分为 0 分。
基于对假关节焦点的刷新，当存在失败以恢复足够的锁骨长度时进行骨自体移植介入，并进行固定，这是一种可靠的选择，具有良好的临床和影像学结果，且并发症较少。在中期和长期随访中，该方法是一种可靠的选择。
