Surgical treatment of congenital pseudoarthrosis of the clavicle in children

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Abstract


Introduction. In the literature the issue of indications for surgical treatment of CPC (congenital pseudoarthrosis of the clavicle) is exposed to discussion. Also, there are no accurate age indications for surgery. The conducted research has shown that the course of CPC is accompanied by clavicle shortening as well as by bone fragments deformation in 60% of the cases, which has a significant effect on the planning of surgery. Purpose of study: to develop a differentiated approach to the treatment of congenital pseudoarthrosis of the clavicle in children, taking into account the clinical and radiological picture. Patients and methods. 27 patients with the congenital pseudoarthrosis of the clavicle (CPC) aged from 4 up to 16 years old were operated. In 6 observations bone fragments deformation of the clavicle was absent, and in 21 observations various deformations occurred. The surgery included restoration of clavicle axis, replacement of bone tissue defect with bone autograft, fixation of bone fragments with a needle. Results. After the first surgery, bone fragments consolidation of the false joint was reached in 82% of the cases (22 patients); the recurrence of the false joint was observed in 18% (5 patients). Repeated surgeries were successfully performed on four of them; one patient is being observed on an outpatient basis. Conclusion. The results of the surgical treatment have shown that for the union of a false joint it is necessary to use differentiated approach to the adoption of surgical technique with regard to bone fragments deformation. Partially eliminated deformation and clavicle sternal bone fragment high standing served as the main reason for the recurrence of pseudoarthrosis. Conflict of interest: the authors state no conflict of interest Funding: the study was performed with financial support «Research Institute of pediatric traumatology and orthopedics G.I. Turner» Ministry of Health Russia

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About the authors

A. P Pozdeev

Federal State Budgetary Institution The Turner Scientific Research Institute for Children’s Orthopedics

Saint-Petersburg, Russia

E. A Belousova

Federal State Budgetary Institution The Turner Scientific Research Institute for Children’s Orthopedics

Saint-Petersburg, Russia

O. N Sosnenko

Federal State Budgetary Institution The Turner Scientific Research Institute for Children’s Orthopedics

Saint-Petersburg, Russia

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Copyright (c) 2019 Pozdeev A.P., Belousova E.A., Sosnenko O.N.

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