Clavicle fracture nonunion in the paediatric population: A systematic review of the literature

Hughes, Kendall L.; Kimpton, James; Wei, Ran; Williamson, Mike; Yeo, Andrea; Arnander, Magnus; Gelfer, Yael

doi:10.1302/1863-2548.12.170155

Cited by 24 publications

(36 citation statements)

References 46 publications

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“…The exact pathophysiological reason for such a connection is not further elaborated nor known, yet Smith and William identify the fact that many subclinical congenital pseudoarthrosis may not be identified or visible on X-ray nor by physical exam. This may lead to a lack of pathology recognition, thus predisposing such patients to a line of weakness in the case of trauma, leading to fracture at this pseudoarthritic site and subsequent misdiagnosis as a "posttraumatic nonunion" [5].…”

Section: Discussionmentioning

confidence: 99%

“…The reported incidence of nonunion in the paediatric population is extremely rare, in contrast to that known of the adult population, where the rate is from 8% to 14% [4]. A systematic review undertaken by Hughes et al reported 21 paediatric cases of nonunion, the majority of which occurred after a displaced right-sided fracture and with typical presentation occurring at a distance of one year [5].…”

Section: Introductionmentioning

confidence: 99%

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Posttraumatic Pseudoarthrosis of a Clavicle Fracture in an 11-Year-Old Girl: A Case Report and Analysis

Odorizzi¹,

FitzGerald²,

Gonzalez³

et al. 2020

Case Reports in Orthopedics

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Clavicular fractures are some of the most common bone injuries in the paediatric population, yet the rates of nonunion are very low under 18 years. To the best of our knowledge, posttraumatic nonunion of the clavicle in a paediatric population is rarely reported. We report the case of an 11-year-old girl who presented with a nondislocated fracture of the midshaft to the proximal third of the right clavicle. Initial conservative treatment by sling immobilization demonstrated radiologically confirmed healing at 3 months. However, at 1-year follow-up, she presented with painful nonunion. Diagnostic MRI and CT exams confirmed a pseudoarthrosis, requiring elective open reduction and internal fixation with the aid of an ipsilateral iliac crest bone graft.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Posttraumatic Pseudoarthrosis of a Clavicle Fracture in an 11-Year-Old Girl: A Case Report and Analysis

Odorizzi¹,

FitzGerald²,

Gonzalez³

et al. 2020

Case Reports in Orthopedics

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“…Fractures on the left side (58%) and on the non-dominant side (56%) are slightly more common [ 4 ]. Most clavicle fractures occur in the middle section of the bone, accounting for 70% to 95% of all pediatric clavicle fractures [ 1 , 5 , 6 ]. Displaced fractures of the clavicle are relatively common, ranging from 28% to 67% of all clavicle fractures in children and adolescents [ 1 , 4 , 6 , 7 ].…”

Section: Epidemiologymentioning

confidence: 99%

Pediatric Clavicle Fractures and Congenital Pseudarthrosis Unraveled

et al. 2022

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Clavicle fractures are commonly seen in the pediatric and adolescent populations. In contrast, congenital pseudarthrosis of the clavicle is rare. Although both conditions may present with similar signs and symptoms, especially in the very young, clear differences exist. Clavicle fractures are often caused by trauma and are tender on palpation, while pseudarthrosis often presents with a painless protuberance on the clavicle, which becomes more prominent as the child grows. Its presence may only become apparent after trauma, as it is usually asymptomatic. The diagnosis is confirmed on plain radiography, which shows typical features to distinguish both entities. Both clavicle fractures and congenital pseudarthrosis are generally treated conservatively with a high success rate. Operative treatment for a fracture can be indicated in the case of an open fracture, severely displaced fracture, floating shoulder, neurovascular complications or polytrauma. Congenital pseudarthrosis requires operative treatment if the patient experiences progressive pain, functional limitation and late-onset thoracic outlet symptoms, but most operations are performed due to esthetic complaints.

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“…• Clavicle fractures represent 95% of fractures seen during childbirth while passing through the birth canal [24].…”

Section: Incidencementioning

confidence: 99%

ticle Uncovering secrets of the beauty bone: A comprehensive review of anatomy and regional anesthesia techniques of clavicle surgeries

Sonawane¹,

Dixit²,

Balavenkatasubramanian³

et al. 2021

Open J Orthop Rheumatol

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The clavicle is the most frequently fractured bone in humans. General anesthesia with or without Regional Anesthesia (RA) is most frequently used for clavicle surgeries due to its complex innervation. Many RA techniques, alone or in combination, have been used for clavicle surgeries. These include interscalene block, cervical plexus (superficial and deep) blocks, SCUT (supraclavicular nerve + selective upper trunk) block, and pectoral nerve blocks (PEC I and PEC II). The clavipectoral fascial plane block is also a safe and simple option and replaces most other RA techniques due to its lack of side effects like phrenic nerve palsy or motor block of the upper limb. We present a comprehensive review of anatomy and RA techniques of clavicle surgeries. This review will help readers understand the functional anatomy and nature of clavicle fractures, and apply an algorithmic approach to procedure-specific blocks for complexly innervated structures like clavicle.

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Clavicle fracture nonunion in the paediatric population: A systematic review of the literature

Cited by 24 publications

References 46 publications

Posttraumatic Pseudoarthrosis of a Clavicle Fracture in an 11-Year-Old Girl: A Case Report and Analysis

Posttraumatic Pseudoarthrosis of a Clavicle Fracture in an 11-Year-Old Girl: A Case Report and Analysis

Pediatric Clavicle Fractures and Congenital Pseudarthrosis Unraveled

ticle Uncovering secrets of the beauty bone: A comprehensive review of anatomy and regional anesthesia techniques of clavicle surgeries

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