Pseudarthrosis of the clavicle in childhood: Differential diagnosis, clinical features, therapy and results.

Aim: Both congenital as well as post-traumatic pseudarthroses of the clavic le are very rare diagnoses in childhood. This study evaluates operative and non-operative therapy in relation to diagnosis, clinical appearance, and r esults. Methods: A retrospective study was performed on all patients with p seudarthrosis of the clavicle in childhood. The data were obtained from med ical records. Follow-ups were performed on patients who had undergone surge ry. Results: A total of 15 patients with 16 pseudarthroses were included, o f these five patients had congenital and nine patients had post-traumatic p seudarthroses. One patient with a bilateral defect was diagnosed as having cleidocranial dysostosis. Concerning the patients with congenital pseudarth rosis, cosmetic appearance was the leading complaint while patients with po st-traumatic pseudarthrosis suffered from pain and impaired function of the shoulder joint. Nine patients underwent surgery, including two patients wi th congenital, and seven with post-traumatie lesions. Conclusion: While pat ients with congenital pseudarthrosis mostly achieve good functional results by means of conservative therapy, surgery is optional in relation to the s everity of cosmetic damage. However, the majority of post-traumatic lesions require operative therapy due to associated pain and restricted function.