Congenital Pseudarthrosis of the Clavicle and Thoracic Outlet Syndrome in Adolescence

Gauzy, Jérôme Sales de; Baunin, C.; Puget, C.; Fajadet, P; Cahuzac, Jean-Philippe

doi:10.1097/01202412-199910000-00013

Cited by 8 publications

(10 citation statements)

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“…Furthermore, typical surgical complications like pin-infection and non-union were observed [24]. In all our patients, reconstruction plating was used in combination with bone grafting as recommended in the past [5,11,20]. The plate can be contoured to the natural shape of the clavicle and the original clavicular length can be reconstructed by interposition of a bicortical bone graft harvested from the iliac crest.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Congenital Pseudarthrosis of the Clavicle: A Report of Three Cases and Review of the Literature

et al. 2005

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Congenital pseudarthrosis of the clavicle is a rare entity of unknown aetiology with predominance of the right side. Our therapeutic concept is discussed with special reference to surgical therapy, histopathological findings and the most recent literature. Two girls and one boy, aged 4, 6, and 8 years, presenting with congenital pseudarthrosis of the clavicle were surgically treated between 1994 and 2000. A resection of the pseudarthrosis and internal fixation with a small reconstruction plate was performed. A bone graft from the iliac crest was used for restoration of clavicular length. Histological examination revealed a false joint with the ends of the clavicle covered by hyaline cartilage. The patients showed radiographic healing after 12 weeks. At follow-up (mean 44 months), all patients showed excellent clinical and radiological results without functional impairment. The clinical features and histological examination of the resected pseudarthroses clearly proved the diagnosis of a true congenital pseudarthrosis of the clavicle. According to our clinical and radiological results and considering the recent literature, we recommend surgical therapy with resection, bone grafting, and osteosynthesis with a reconstruction plate around the age of 4 - 6 years.

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Congenital Pseudarthrosis of the Clavicle: A Report of Three Cases and Review of the Literature

et al. 2005

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“…This mandates an assessment of the adequacy of the nonsurgical treatment and a thorough preoperative discussion of the risks and benefits of surgery. Fractured cervical rib 9-y-old male 2 mo after fall with fractured cervical rib Progressive pain, numbness, and tingling along ulnar side forearm and palmar hand Cervical rib pseudarthrosis 27 Pseudarthrosis mass of cervical rib 14-y-old girl 6 mo after blunt trauma to neck while swimming, with pseudarthrosis of cervical and first rib Disabling pain in neck, radiating down arm, paresthesias, bony supraclavicular mass, decreased grip strength Pseudarthrosis of clavicle 28 Clavicular pseudarthrosis 15-y-old girl with thoracic outlet syndrome due to congenital pseudarthrosis of clavicle Eden 29 Costoclavicular Soldiers with loaded knapsacks with arm pain, numbness, and fatigue while standing "at attention" Obese, large-breasted women; women with tight, narrow bra-straps exerting direct, downward clavicle pressure Scalene-anticus 30 Anterior and middle scalene compression Subclavian artery and brachial plexus compression due to muscular growth, tightness/spasm, and inflammation Absent anterior scalene 31 Absence of the anterior scalene muscle…”

Section: Discussionmentioning

confidence: 98%

Nerve Injuries About the Elbow in the Athlete

Harris

Lintner²

2014

Sports Medicine and Arthroscopy Review

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The athlete's elbow is a remarkable example of motion, strength, and durability. The stress placed on the elbow during sport, including the throwing motion, may lead to soft-tissue ligamentous and nerve injury. The thrower's elbow illustrates one example of possible nerve injury about the elbow in sport, related to chronic repetitive tensile and compressive stresses to the ulnar nerve associated with elbow flexion and valgus position. Besides the throwing athlete, nerve injury from high-energy direct-impact forces may also damage nerves around the elbow in contact sports. Detailed history and physical examination can often make the diagnosis of most upper extremity neuropathies. The clinician must be aware of the possibility of isolated or combined nerve injury as far proximal as the cervical nerve roots, through the brachial plexus, to the peripheral nerve terminal branches. Electrodiagnostic studies are occasionally beneficial for diagnosis with certain nerves. Nonoperative management is often successful in most elbow and upper extremity neuropathies. If conservative treatment fails, then surgical treatment should address all potentially offending structures. In the presence of medial laxity and concurrent ulnar neuritis, the medial ulnar collateral ligament warrants surgical treatment, in addition to transposition of the ulnar nerve. The morbidity of open surgical decompression of nerves in and around the elbow is potentially career threatening in the throwing athlete. This mandates an assessment of the adequacy of the nonsurgical treatment and a thorough preoperative discussion of the risks and benefits of surgery.

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“…Sales de Gauzy et al [11] and Lloyd-Roberts et al [7] suggest that the developing clavicle is divided by pressure of the right subclavian artery in the case of elevated first rib or cervical rib. A painless mass over the right clavicle in the medial third is the most common clinical finding that prompts parents to seek consultation.…”

Section: Discussionmentioning

confidence: 99%