Surgical treatment of congenital pseudarthrosis of the clavicle : A report on 17 cases

Published online: Apr 27 2008

Pietro Persiani, Iakov Molayem, Ciro Villani, Céline Cadilhac, Christophe Glorion

From the Policlinico Umberto I, Università “La Sapienza”, Rome, Italy and the “Hôpital des Enfants Malades”, Université René Descartes, Paris, France


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.