Pediatric Clavicle Fractures and Congenital Pseudarthrosis Unraveled

Water, Lisa van der; Macken, Arno A.; Eygendaal, Denise; Bergen, Christiaan J. A. van

doi:10.3390/children9010049

Cited by 8 publications

(5 citation statements)

References 59 publications

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“…The clavicle has a medial and lateral ossification center which usually fuse around the seventh week of gestation. A congenital pseudoarthrosis can develop if this fusion does not occur, leading to a painless protuberance[ 4 ]. Eighty percent of clavicular longitudinal growth occurs from the medial physis.…”

Section: Diaphyseal Clavicle Fracturesmentioning

confidence: 99%

Fractures around the shoulder in the skeletally immature: A scoping review

Kraal,

Struijs,

Langenberg

et al. 2023

World J Orthop

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Periprosthetic joint infection (PJI) is a rare but terrible complication in hip and knee arthroplasty, and the use of topical vancomycin powder (VP) has been investigated as a tool to potentially reduce its incidence. However, there remains no consensus on its efficacy. Therefore, the aim of this review is to provide an overview on the application of topical vancomycin in orthopaedic surgery focusing on the recent evidence and results in total joint arthroplasty. Several systematic reviews and meta-analyses on topical VP in hip and knee arthroplasty have been recently published reporting sometimes conflicting results. Apart from all being limited by the quality of the included studies (mostly level III and IV), confounding variables are often included potentially leading to biased conclusions. If taken into consideration the exclusive use of VP in isolation, the available data, although very limited, suggest that it does not reduce the infection rate in routine primary hip and knee arthroplasty. Therefore, we still cannot advise for a routinary application. A properly powered randomized-controlled trial would be necessary to clarify the role of VP in hip and knee arthroplasty. Based on the analysis of the current evidence, the use of topical VP appears to be safe when used locally in terms of systemic adverse reactions, hence, if proven to be effective, it could bring great benefits due to its low cost and accessibility.

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Section: Diaphyseal Clavicle Fracturesmentioning

confidence: 99%

Fractures around the shoulder in the skeletally immature: A scoping review

Kraal,

Struijs,

Langenberg

et al. 2023

World J Orthop

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“…In addition, the most common cause in the pediatric population is sports and recreation 1 . This injury should not be confused with congenital pseudoarthrosis, which is a developmental malformation of the clavicle that initially presents as a painless protuberance of the distal clavicle; however, it can result in an insidious onset of pain over time 2 . Distal clavicle physeal fractures are similar to adult AC separations and have a similar classification system as AC joint separations.…”

Section: Mechanism Of Injurymentioning

confidence: 99%

Distal Clavicle Physeal Fracture in a 15-Year-Old Adolescent Boy

Radi

Min

2022

JBJS Journal of Orthopaedics for Physician Assistants

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The following article addresses a case study regarding a 15-year-old adolescent boy who presented with right shoulder pain after a hockey injury and was diagnosed and treated for a distal clavicle physeal fracture. Topics include anatomy, mechanism of injury, prevalence, workup and diagnosis, treatment (operative vs. nonoperative), and return-to-sports guidance. This is a rare injury in the pediatric population, but with proper diagnosis and management, the prognosis is a full recovery after 3 months. The views/opinions expressed are those of the authors and do not necessarily represent the views of the Department of the Army, Department of the Air Force, Department of Defense, National Guard Bureau, or respective state National Guards. No other relevant disclosures or conflicts of interest exist. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSJOPA/A184).

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“…The incidence of CPC is unknown, with previous publications only stating that it is a rare condition with an unknown etiology [13,14]. Between January 2003 [15] and January 2022 [16] multiple authors reported that 200 CPC cases had been described in the literature, without updating the number of cases over this 19 years period. Alsaeed [17] stated in his review article in October 2021 that 200-300 CPC cases had been reported worldwide and DePaoli et al [13] published in 2022 that they had identified 284 CPC patients (293 clavicles) but included only 231 patients (240 clavicles) in their systematic review.…”

Section: Introductionmentioning

confidence: 99%

The incidence of congenital pseudarthrosis of the clavicle and review of the literature

Rehm¹,

Ashby²,

Thahir³

et al. 2022

Journal of Pediatric Orthopaedics B

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The aim of this study was to identify the hitherto unknown incidence of congenital pseudarthrosis of the clavicle (CPC), based on a cohort of continuous livebirths born in our hospital, to review the literature and investigate if there is evidence supporting the published association between left-sided CPC and dextrocardia. From our electronic medical record and radiology databases, we identified all live births and patients with the diagnosis of CPC born from 2000 to 2016. We reviewed the imaging which included one or both clavicles to search for unrecorded CPC cases and reviewed all retrievable CPC publications listed in PubMed and publications quoted within these publications going back to 1910. We identified 87 407 livebirths of which 41 800 had radiological studies done, 14 885 showing one or both clavicles. We found five cases of CPC, two from the electronic database and three from our imaging review, giving an incidence of 1 of 17 481 livebirths. We identified 138 publications reporting paediatric and adult CPC cases and 12 review articles, including 429 patients (187 female; 159 male; 83 unknown) with 456 CPCs and a minimum of 24 additional patients from case reports for which we could not retrieve details. Two publications reported one case of left-sided CPC with dextrocardia, either not showing left/right marking or only showing the CPC with the aortic knob on the same side. We report the first CPC incidence of 0.0057%, provide the by far most inclusive CPC epidemiology based on 429 patients and could not find reliable proof that there has ever been a patient with left-sided CPC which was associated with dextrocardia.

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Pediatric Clavicle Fractures and Congenital Pseudarthrosis Unraveled

Cited by 8 publications

References 59 publications

Fractures around the shoulder in the skeletally immature: A scoping review

Fractures around the shoulder in the skeletally immature: A scoping review

Distal Clavicle Physeal Fracture in a 15-Year-Old Adolescent Boy

The incidence of congenital pseudarthrosis of the clavicle and review of the literature

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