Non-traumatic pathology of the clavicle in children

Abstract

BACKGROUND: The clavicle in children is a site of multiple types of injuries, post traumatic pathology being predominant, and generally presents no diagnosis problems; in contrast non-traumatic lesions of the clavicle are rare and may pose a diagnostic and therapeutic problems for the orthopaedic surgeon.

AIM: The objective is to show that the clavicle in children can be a site of infectious, congenital and tumor lesions involving the functional and vital prognosis of the child.

MATERIALS AND METHODS: A retrospective study including 9 patients over an 9 year period from January 2013 to January 2022 was conducted. 4 boys and 5 girls were admitted in our institute with a mean age of 11.2 years (range 6–16 years). The right clavicle was affected in 8 patients, with no bilateral lesions.

RESULTS: There was a predominance of tumor lesions (4 benign and one malignant). Two patients had a clavicular osteomyelitis. The diagnosis of congenital pseudarthrosis of the clavicle was noted in the other two patients.

CONCLUSIONS: The aetiologies are variable, biopsy remains the key to establish the diagnosis in the majority of cases. Treatment varies according to the type of disease and may include symptomatic, expectant management, drugs therapy or surgical treatment.

Keywords

clavicle / biopsy / tumor / osteomyelitis / pseudarthrosis

References

[1] Franklin JL, Parker JC, King HA. Nontraumatic clavicle lesions in children. J Pediatr Orthop. 1987;7(5):575–578. DOI: 10.1097/01241398-198709000-00014

[2] Franklin J.L., Parker J.C., King H.A. Nontraumatic clavicle lesions in children // J. Pediatr. Orthop. 1987. Vol. 7. No. 5. P. 575–578. DOI: 10.1097/01241398-198709000-00014

[3] Di Gennaro GL, Cravino M, Martinelli A, et al. Congenital pseudarthrosis of the clavicle: a report on 27 cases. J Shoulder Elbow Surg. 2017;26(3):e65–e70. DOI: 10.1016/j.jse.2016.09.020

[4] Di Gennaro G.L., Cravino M., Martinelli A., et al. Congenital pseudarthrosis of the clavicle: a report on 27 cases // J. Shoulder Elbow Surg. 2017. Vol. 26. No. 3. P. e65–e70. DOI: 10.1016/j.jse.2016.09.020

[5] Theros EG. Radiological atlas of bone tumors radiological atlas of bone tumors. Radiology. 1974;110(2):276. DOI: 10.1148/110.2.276

[6] Theros E.G. Radiological atlas of bone tumors // Radiology. 1974. Vol. 110. No. 2. P. 276. DOI: 10.1148/110.2.276

[7] Chen Y, Yu X, Huang W, et al. Is clavicular reconstruction imperative for total and subtotal claviculectomy? A systematic review. J Shoulder Elbow Surgery. 2018;27(5):e141–e148. DOI: 10.1016/j.jse.2017.11.003

[8] Chen Y., Yu X., Huang W., et al. Is clavicular reconstruction imperative for total and subtotal claviculectomy? A systematic review // J. Shoulder Elbow Surg. 2018. Vol. 27. No. 5. P. e141–e148. DOI: 10.1016/j.jse.2017.11.003

[9] Rockwood CA, Wilkins KE, Beaty JH, et al. Rockwood and Wilkins’ fractures in children. Philadelphia: Lippincott Williams & Wilkins; 2006.

[10] Rockwood and Wilkins’ fractures in children / ed. by C.A. Rockwood, K.E. Wilkins, J.H. Beaty et al. Philadelphia: Lippincott Williams & Wilkins, 2006.

[11] Fitzwilliams Duncan CL. Hereditary cranio – cleido-dysostosis. Lancet. 1910;176(4551):1466–1475. DOI: 10.1016/S0140-6736(01)38817-7

[12] Fitzwilliams Duncan C.L. Hereditary cranio – cleido-dysostosis // Lancet. 1910. Vol. 176. No. 4551. P. 1466–1475. DOI: 10.1016/S0140-6736(01)38817-7

[13] David-West KS, Sherlock DA. Congenital pseudarthrosis of the clavicle: surgery or conservative treatment. J Orthop Traumatol. 2002;3:109–111. DOI: 10.1007/s101950200037

[14] David-West K.S., Sherlock D.A. Congenital pseudarthrosis of the clavicle: surgery or conservative treatment // J. Orthop. Traumatol. 2002. Vol. 3. P. 109–111. DOI: 10.1007/s101950200037

[15] Masquelet AC. La technique de la membrane induite dans les reconstructions osseuses segmentaires: développement et perspectives. Bulletin de l’Académie Nationale de Médecine. 2017;201(1–3):439–453. (In Fr.) DOI: 10.1016/S0001-4079(19)30514-X

[16] Masquelet A.C. La technique de la membrane induite dans les reconstructions osseuses segmentaires: développement et perspectives // Bulletin de l’Académie Nationale de Médecine. 2017. Vol. 201. No. 1–3. P. 439–453. DOI: 10.1016/S0001-4079(19)30514-X

[17] Abdellaoui H, Atarraf K, Chater L, et al. Congenital pseudarthrosis of the clavicle treated by Masquelet technique. BMJ Case Reports. 2017;2017. DOI: 10.1136/bcr-2017-221557

[18] Abdellaoui H., Atarraf K., Chater L., et al. Congenital pseudarthrosis of the clavicle treated by Masquelet technique // BMJ Case Reports. 2017. Vol. 2017. DOI: 10.1136/bcr-2017-221557

[19] Smith J, Yuppa F, Watson RC. Primary tumors and tumor-like lesions of the clavicle. Skeletal Radiol. 1988;17(4):235–246. DOI: 10.1007/BF00401804

[20] Smith J., Yuppa F., Watson R.C. Primary tumors and tumor-like lesions of the clavicle // Skeletal. Radiol. 1988. Vol. 17. No. 4. P. 235–246. DOI: 10.1007/BF00401804

[21] Maffulli N. Osteoid osteoma of the clavicle. J Shoulder Elbow Surg. 1999;8(1):98. DOI: 10.1016/S1058-2746(99)90064-2

[22] Maffulli N. Osteoid osteoma of the clavicle // J. Shoulder Elbow Surg. 1999. Vol. 8. No. 1. P. 98. DOI: 10.1016/S1058-2746(99)90064-2

[23] Terra BB, Rodrigues LM, Padua DVH, et al. Osteoid osteoma of the distal clavicle. Revista Brasileira de Ortopedia (English Edition). 2017;52(2):210–214. DOI: 10.1016/j.rboe.2017.01.006

[24] Terra B.B., Rodrigues L.M., Padua D.V.H., et al. Osteoid osteoma of the distal clavicle // Revista Brasileira de Ortopedia (English Edition). 2017. Vol. 52. No. 2. P. 210–214. DOI: 10.1016/j.rboe.2017.01.006

[25] Parikh SN, Desai VR, Gupta A, et al. Langerhans cell histiocytosis of the clavicle in a 13-year-old boy. Case Rep Orthop. 2014;2014:1–3. DOI: 10.1155/2014/510287

[26] Parikh S.N., Desai V.R., Gupta A., et al. Langerhans cell histiocytosis of the clavicle in a 13-year-old boy // Case Rep. Orthop. 2014. Vol. 2014. DOI: 10.1155/2014/510287

[27] Jabra AA, Fishman EK. Eosinophilic granuloma simulating an aggressive rib neoplasm: CT evaluation. Pediatr Radiol. 1992;22(6):447–448. DOI: 10.1007/BF02013508

[28] Jabra A.A., Fishman E.K. Eosinophilic granuloma simulating an aggressive rib neoplasm: CT evaluation // Pediatr. Radiol. 1992. Vol. 22. No. 6. P. 447–448. DOI: 10.1007/BF02013508

[29] Abdelaal AHK, Sedky M, Gohar S, et al. Skeletal involvement in children with Langerhans cell histiocytosis: healing, complications, and functional outcome. SICOT J. 2020;6:28. DOI: 10.1051/sicotj/2020024

[30] Abdelaal A.H.K., Sedky M., Gohar S., et al. Skeletal involvement in children with Langerhans cell histiocytosis: healing, complications, and functional outcome // SICOT J. 2020. Vol. 6. P. 28. DOI: 10.1051/sicotj/2020024

[31] Mascard E, Gomez-Brouchet A, Lambot K. Bone cysts: unicameral and aneurysmal bone cyst. Orthop Traumatol Surg Res. 2015;101(1):S119–S127. DOI: 10.1016/j.otsr.2014.06.031

[32] Mascard E., Gomez-Brouchet A., Lambot K. Bone cysts: unicameral and aneurysmal bone cyst // Orthop. Traumatol. Surg. Research. 2015. Vol. 101. No. 1. P. S119–S127. DOI: 10.1016/j.otsr.2014.06.031

[33] Kaiser CL, Yeung CM, Raskin KA, et al. Aneurysmal bone cyst of the clavicle: a series of 13 cases. J Shoulder Elbow Surgery. 2019;28:71–76. DOI: 10.1016/j.jse.2018.06.036

[34] Kaiser C.L., Yeung C.M., Raskin K.A., et al. Aneurysmal bone cyst of the clavicle: a series of 13 cases // J. Shoulder Elbow Surg. 2019. Vol. 28. P. 71–76. DOI: 10.1016/j.jse.2018.06.036

[35] Hoffman EB, Knudsen CJ, Paterson MP. Acute osteomyelitis and septic arthritis in children: a spectrum of disease. Pediatr Surg Int. 1990;5. DOI: 10.1007/BF00174330

[36] Hoffman E.B., Knudsen C.J., Paterson M.P. Acute osteomyelitis and septic arthritis in children: a spectrum of disease // Pediatr. Surg. Int. 1990. Vol. 5. DOI: 10.1007/BF00174330

[37] Gerszten E, Allison MJ, Dalton HP. An epidemiologic study of 100 consecutive cases of osteomyelitis. Southern Med J. 1970;63(3):365–367. DOI: 10.1097/00007611-197004000-00003

[38] Gerszten E., Allison M.J., Dalton H.P. An epidemiologic study of 100 consecutive cases of osteomyelitis // Southern Med. J. 1970. Vol. 63. P. 365–367.

[39] Khan MA, Osborne NJ, Anaspure R, et al. Clavicular swelling – classic presentation of chronic non-bacterial osteomyelitis. Arch Dis Childhood. 2013;98:238. DOI: 10.1136/archdischild-2012-303187

[40] Khan M.A., Osborne N.J., Anaspure R., et al. Clavicular swelling – classic presentation of chronic non-bacterial osteomyelitis // Arch. Dis. Childhood. 2013. Vol. 98. No. 3. P. 238–238. DOI: 10.1136/archdischild-2012-303187

[41] Wilson D. Diagnosis of bone and joint disorders. Clinical Radiol. 2003;58(5):412. DOI: 10.1016/S0009-9260(02)00578-0

[42] Wilson D. Diagnosis of bone and joint disorders // Clinical Radiol. 2003. Vol. 58. No. 5. P. 412. DOI: 10.1016/S0009-9260(02)00578-0

[43] Srivastava KK, Garg LD, Kochhar VL. Tuberculous osteomyelitis of the clavicle. Acta Orthop Scand. 1974;45(5):668–672. DOI: 10.3109/17453677408989676

[44] Srivastava K.K., Garg L.D., Kochhar V.L. Tuberculous osteomyelitis of the clavicle // Acta Orthop. Scand. 1974. Vol. 45. No. 5. P. 668–672. DOI: 10.3109/17453677408989676

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