先天性锁骨假关节的诊断与治疗——6例报道及文献复习

目的探讨临床上诊断与治疗先天性锁骨假关节的方法。方法回顾性分析2004～2012年我们收治的6例（6侧）先天性锁骨假关节患儿临床资料，其中男2例，女4例；年龄4—7．5岁，平均5．3岁，5例为右侧发病，1例为左侧发病合并右位心；1例术前有患侧上肢上举痛及活动范围受限（较对侧减少20°），5例为初次手术病例，1例为二次手术病例。6例（6侧）均采用假关节切除、自体髂骨植骨重建、钢板内固定术治疗。结果6例患儿均获随访，随访时间6～63个月。患儿肩部外观及症状均明显改善，影像学检查均显示骨性愈合，愈合时间为2．5～5个月，平均3．5个月。结论假关节切除、自体髂骨植骨及重建、钢板内固定术治疗先天性锁骨假关节临床疗效满意。

Diagnosis and treatment of the Congenital pseudarthrosis of the clavicle -6 Cases report and review.

Objetive To Explore the clinical ideal method of surgical diagnosis and treatment of the Congenital pseudarthrosis of the clavicle in children. Methods From 2004 to 2012, 6 cases （6 side）of the Congenital pseudarthrosis of the clavicle were fulfilled the inclusion criteria. 2 males and 4 females ; aged 5.3 years （ from 4 to 7.5 years） , 5 eases oeeured on tile right side,the only one with dextrocardia occured on the left. 1 had a certain degree of difficulty during overhead activities and felt pain in preoperative. 5 cases of them were primary surgical cases, the other one was secondary surgical case. All of the cases had undergone the sur- gery of excision of the pseudarthrosis, autogenous iliae bone grafting and stabilisation with reconstruction plate. Results The cases were followed up for 6 to 63 months. Excision of the pseudarthrosis, autogenous iliae bone grafting and stahilisation with plate achieved union of clavicle,shoulder movement were normalhnd preoperative pain disappeared. The Bone healing time were from 2.5 to 5 months, an average of 3.5 months. Conclusion The excision of the pseudarthrosis, autogenous iliac bone grafting and stahilisation with reconstruction plate has the good effect for the Congenital pseudarthrosis of clavicle.