Congenital pseudarthrosis of the clavicle: a report on 27 cases

Hypothesis: We aimed to report our experience in treating congenital pseudarthrosis of the clavicle (CPC). Materials and methods: A retrospective search of the archive of our institute was performed; 27 cases (12 male and 15 female patients) affected by CPC were recorded. Among these patients, 19 underwent surgical intervention for cosmetic appearance between 1960 and 2015. Of 19 patients, 18 were treated by pseudarthrosis resection and stabilization with a Kirschner wire, whereas in 1 case, the osteosynthesis was performed with a plate. Iliac crest bone autograft was used in 15 patients, whereas 4 patients were treated with a fibular allograft. Results: The mean follow-up period was 36.3 +/- 49.1 months. Bone healing was achieved in 14 of 19 operated cases (74%); none of the patients had complaints regarding cosmetic abnormalities or unesthetic appearance. All the operated patients were pain free, range of motion was complete, and no other subjective anomalies were found. No vascular or neurologic complications were observed. However, the use of allograft was associated with high rates of nonunion in this case series (P =.037). Conclusion: CPC can be satisfactorily treated by K-wire fixation and autologous iliac crest bone grafting, which showed better results in terms of functional and cosmetic outcome. Level of evidence: Level IV; Case Series; Treatment Study (C) 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.