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Congenital clavicle pseudoarthrosis

  Congenital clavicle pseudoarthrosis is a rare malformation that can be found at birth with a fissure in the middle of the right clavicle. As the child grows older, a painless mass appears locally. Congenital clavicle malformation is rare, and clavicle pseudoarthrosis is even rarer.

Table of Contents

1. What are the causes of congenital clavicle pseudoarthrosis
2. What complications can congenital clavicle pseudoarthrosis easily lead to
3. What are the typical symptoms of congenital clavicle pseudoarthrosis
4. How to prevent congenital clavicle pseudoarthrosis
5. What laboratory examinations are needed for congenital clavicle pseudoarthrosis
6. Diet taboos for patients with congenital clavicle pseudoarthrosis
7. Conventional methods of Western medicine for the treatment of congenital clavicle pseudoarthrosis

1. What are the causes of congenital clavicle pseudoarthrosis

  Some scholars recently pointed out that the embryonic cartilage center connection at both ends of the clavicle fails to develop during the 7th week of embryogenesis, leading to clavicle pseudoarthrosis. The subclavian artery on the right side is located higher and closer to the clavicle, increasing the pulsatile pressure on the clavicle, which may be the cause of involvement of the right clavicle. Occasionally, a case of involvement on the left side is found, which is due to the high position of the left subclavian artery due to the rightward position of the heart; bilateral involvement is due to bilateral cervical ribs or a high first rib.

 

2. What complications can congenital clavicle pseudoarthrosis easily lead to

  The clinical symptoms of congenital clavicle pseudoarthrosis are rare, and it generally does not cause functional impairment to patients. Only a few patients have limited shoulder abduction and weakened arm strength, so complications of this disease are extremely rare.

3. What are the typical symptoms of congenital clavicle pseudoarthrosis

  Pulsatile mass on the clavicle above the sternum, enlargement of the supraclavicular and anterior scalene muscle lymph nodes

  Congenital clavicle malformation is rare, and clavicle pseudoarthrosis is even rarer. Pseudoarthrosis formation is more common in the middle third of the right clavicle, and the acromial segment often moves downward due to the gravitational effect of the upper limb. The clavicle end on the sternum side is enlarged, and some patients may have an enlargement on the acromial side, which may be related to the long-term activity stimulation of the upper limb causing the ends to proliferate. This disease generally does not affect the function of the upper limb, there is no pain at the pseudoarthrosis, and it is usually discovered by chance on routine X-ray examination.

  During infancy, due to the relationship of upper limb gravity, the lateral part of the clavicle inclines downward, the shoulder joint descends, the range of motion at the pseudoarthrosis increases, the superficial skin becomes thin and atrophic, the edge of the scapula protrudes, the shoulder joint is asymmetric, but the shoulder joint movement is generally normal, only a few patients have limited shoulder abduction and weakened arm strength, and X-ray films show that the two ends of the clavicle pseudoarthrosis have increased in size and thickness.

4. How to prevent congenital clavicle pseudoarthrosis

  Congenital clavicle pseudoarthrosis seriously affects the daily life of patients, so it should be actively prevented. However, there is currently no effective preventive method for this disease, so early detection and early treatment are of great significance for the treatment of the disease.

 

5. What laboratory tests are needed for congenital clavicle pseudoarthrosis

  Joint examination of the bones and joints of the limbs, CT examination of bone and joint soft tissues, bone and joint MRI examination

  Swelling in the middle of the clavicle can be found at birth, without a history of birth injury. As the child grows older, a painless mass appears locally, and different degrees of movement can be felt between the ends of the clavicle without tenderness. The clavicle sternal end is slightly above, located in the inner anterior aspect of the other end. In the infancy, due to the gravitational relationship of the upper limb, the lateral side of the clavicle is tilted downward, the shoulder joint descends, the range of motion at the pseudoarthrosis increases, the surface skin becomes thin and atrophic, the edge of the scapula protrudes, the shoulder joint is asymmetric, but the activity of the shoulder joint is generally normal, only a few patients have limited shoulder abduction and weakened arm strength, and X-ray films show that the two ends of the clavicle pseudoarthrosis are enlarged and thickened.

6. Dietary taboos for patients with congenital clavicle pseudoarthrosis

    The diet of patients with congenital clavicle pseudoarthrosis should be light and easy to digest, with more fruits and vegetables, a reasonable diet, and attention to sufficient nutrition. In addition, patients should also pay attention to avoiding spicy, greasy, and cold foods.

7. Conventional Methods for the Treatment of Congenital Clavicle Pseudoarthrosis in Western Medicine

  Owen, Gilson, and Carroll believe that the best treatment age for congenital clavicle pseudoarthrosis is between 3 and 4 years old, but Tachdjian advocates surgical treatment at 1 year. The surgery includes the removal of the pseudoarthrosis, internal fixation, and autologous iliac bone grafting.

  Key Points of Surgery:

  1. A 4-6 cm long arched incision is made along the skin crease above the clavicle.

  2. The subperiosteal membrane of the artificial joint is removed, and the clavicle is exposed, and the soft tissue, cartilage, and ossified bone tissue at the artificial joint site are resected until normal bone tissue is reached.

  3. One screw thread pin is used for intramedullary fixation for internal fixation and bone grafting, and then autologous iliac bone fragments are implanted into the defect of the clavicle.

  4. After the operation, Velpeau plaster fixation is used, and the plaster is changed once every 3 weeks. After fixation for 8-10 weeks, shoulder joint exercise can begin, and the screw thread pin can be removed after the bone graft heals.

 

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