Clavicular Pseudarthrosis

Hi!

I am a sports physio who has very little experience in paediatrics, and I have a one year old boy with a pseudarthrosis of his right clavicle. On X-ray it is clear that it is in two peices, with quite a large separation and overlap. He is unable to bear weight through his arm, and subsequently can not crawl or lift himself up from a prone position.

My question is what options are there to deal with this problem? Is this something that can be pinned like a normal clavicular fracture? If so, at what age would this be considered? If surgery is not an option then are there conservative options such as bracing available?

Some background: He has a chromosome disorder that has never been recorded in the literature - an unbalanced translocation between 11 and Y (a small piece of 11 has been duplicated onto the end of the Y chromosome). The consequences of this are that he has had cardiac surgery for atrial and ventricular septum defects and a PDA, and he has delayed motor and cognitive development. Obviously the clavicle problem is holding him back even further with the motor development, so I am desperate to improve that in any way I can.

Interestingly the only case in the literature that is similar (but a diffrent combination of chromosomes) to my son had several common features, including the cardiac defects. That child also had incompletely developed clavicles bilaterally. So I assume this is a congenital defect in my son, and not an un-united fracture from his birth.

Have you already had contact with specialist physios in Norway for advice regarding treatment of the motor development? Your location says Oslo. If you haven't found anyone I have a contact in Stavanger who is one, and may be able to help further as she'll know who is around and maybe which consultants are the best for advice. Let me know if would help and I'll try and contact her. Regards. JM

Hi - I can appreciate that this is an old thread, but I am hoping that someone might be able to help. I am a health professional and mum to 4 little ones. My youngest son, 9months has been diagnosed with Left Congenital Clavicular Psueudoarthrosis yesterday, I have scoured the net and there just doesn't seem to be any support or information out there! I do understand that it is an extremely rare condition. My little one is not yet crawling and rolling and it is thought that he never might...., he is using the arm but as another member has said he is not weight bearing at all in a prone position. We have just been referred to specialists from every angle, paediatricians, cardiologists etc and the truth is at our local hospital they just can't give us any answers. His motor skills are delayed but cognitively he doesn't appear to be affected. We are just facing a whole series of tests and I would appreciate if anyone has got any stories or experiences that they are willing to share with us, as at the moment we feel that we have entered the world of the unknown! Is physio an option for these children or do we leave alone.....any advice would be extremely welcome!! Many thanks

dear colleagues,

I didn´t see this post at the time, because of a long break, but will try to answer it now.

I have never treated children with a pseudo arthosis of the clavicle but I can tell you that:

Lots of children suffer from the either a missing limb or a weak limb (OBPL) and are not able to use both arms to support themselves. These children often bottom shuffle and have their own ways of reaching all the motor milestones. They adapt to their possibilties and it is great to marvel at how they sometimes go about doing this.
As far as literature is concerned,very little can be found on this subject and what I have found is old... but probably still relevant...you may both know them all......

CONGENITAL PSEUDARTHROSIS OF THE CLAVICLE -- Gibson and Carroll 52-B (4): 629 -- Journal of Bone and Joint Surgery - British Volume
[Congenital pseudarthrosis of the clavicle: 25 chi... [Rev Chir Orthop Reparatrice Appar Mot. 2000] - PubMed result
Familial congenital pseudoarthrosis of the clavicle: case report and literature review.
ISPUB - Non Traumatic Clavicular Disorder: A Diagnostic Challenge
http://journals.tubitak.gov.tr/medic...15-0104-38.pdf
http://www.josonline.org/pdf/v15i1p87.pdf
http://www.jbjs.org.uk/cgi/reprint/52-B/4/644.pdf
congenital pseudoarthrosis clavicle - Health Resources - Health Resources website provide up-to-date news and information about medicine, wellness, diet, nutrition, fitness, recipes, and weight-loss. Health combines expert medical information with th

Hope all goes well with your children,

Esther