Case report
Bilateral congenital seudarthrosis of the clavicle. A clinical case
Seudoartrosis congénita de clavícula bilateral. Caso clínico
A. Nieto Gil
, A. Gómez Navalón, P. Zorrilla Ribot
Corresponding author
Servicio de Traumatología y Cirugía Ortopédica, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
Read
1575
Timeswas read the article
326
Total PDF
1249
Total HTML
Share statistics
array:24 [ "pii" => "S1988885616300451" "issn" => "19888856" "doi" => "10.1016/j.recote.2016.09.005" "estado" => "S300" "fechaPublicacion" => "2016-11-01" "aid" => "568" "copyright" => "SECOT" "copyrightAnyo" => "2014" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Esp Cir Ortop Traumatol. 2016;60:397-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1888441515000296" "issn" => "18884415" "doi" => "10.1016/j.recot.2015.02.004" "estado" => "S300" "fechaPublicacion" => "2016-11-01" "aid" => "568" "copyright" => "SECOT" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Esp Cir Ortop Traumatol. 2016;60:397-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 84 "formatos" => array:2 [ "HTML" => 76 "PDF" => 8 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">NOTA CLÍNICA</span>" "titulo" => "Seudoartrosis congénita de clavícula bilateral. Caso clínico" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "397" "paginaFinal" => "399" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Bilateral congenital seudarthrosis of the clavicle. A clinical case" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 727 "Ancho" => 995 "Tamanyo" => 71665 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Radiografía del paciente a los 4 meses de edad donde se confirma seudoartrosis de ambas clavículas.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Nieto Gil, A. Gómez Navalón, P. Zorrilla Ribot" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Nieto Gil" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Gómez Navalón" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Zorrilla Ribot" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1988885616300451" "doi" => "10.1016/j.recote.2016.09.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885616300451?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441515000296?idApp=UINPBA00004N" "url" => "/18884415/0000006000000006/v1_201610230114/S1888441515000296/v1_201610230114/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1988885616300505" "issn" => "19888856" "doi" => "10.1016/j.recote.2016.09.009" "estado" => "S300" "fechaPublicacion" => "2016-11-01" "aid" => "628" "copyright" => "SECOT" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Rev Esp Cir Ortop Traumatol. 2016;60:400-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Sensory innervation of the dorsomedial segment of the hand due to the radial nerve as deviation from normal: Traumatic injury of this anomalous branch" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "400" "paginaFinal" => "401" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Inervación sensitiva de la porción dorsomedial de la mano por parte del nervio radial como variante de la normalidad: lesión traumática de esta rama anómala" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Published by permission of the editor. Source: García-Elías et al.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> © Masson, S.A. 2007. All rights reserved." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2482 "Ancho" => 1650 "Tamanyo" => 377352 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Variation in the pattern of cutaneous innervation in the back of the hand from the radial nerve.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Parra, J.V. Orenga, M.J. Estarelles, A.D. Ghinea, A.J. Gomis" "autores" => array:5 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Parra" ] 1 => array:2 [ "nombre" => "J.V." "apellidos" => "Orenga" ] 2 => array:2 [ "nombre" => "M.J." "apellidos" => "Estarelles" ] 3 => array:2 [ "nombre" => "A.D." "apellidos" => "Ghinea" ] 4 => array:2 [ "nombre" => "A.J." "apellidos" => "Gomis" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441516300613" "doi" => "10.1016/j.recot.2016.06.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441516300613?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885616300505?idApp=UINPBA00004N" "url" => "/19888856/0000006000000006/v3_201611120021/S1988885616300505/v3_201611120021/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1988885616300463" "issn" => "19888856" "doi" => "10.1016/j.recote.2016.09.006" "estado" => "S300" "fechaPublicacion" => "2016-11-01" "aid" => "570" "copyright" => "SECOT" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Esp Cir Ortop Traumatol. 2016;60:394-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Vesico-lumbar fistula due to migration of posterior instrumentation. Long-term complication of neuromuscular scoliosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "394" "paginaFinal" => "396" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fístula vésico-lumbar por migración de la instrumentación posterior. Complicación a largo plazo en la escoliosis neuromuscular" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 938 "Ancho" => 900 "Tamanyo" => 65304 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">X-rays showing the displacement of the left iliac anchorage screw.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "G. Rieiro, A. Matamalas, A. García-de Frutos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "Rieiro" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Matamalas" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "García-de Frutos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441515000314" "doi" => "10.1016/j.recot.2015.02.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441515000314?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885616300463?idApp=UINPBA00004N" "url" => "/19888856/0000006000000006/v3_201611120021/S1988885616300463/v3_201611120021/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Bilateral congenital seudarthrosis of the clavicle. A clinical case" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "397" "paginaFinal" => "399" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Nieto Gil, A. Gómez Navalón, P. Zorrilla Ribot" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Nieto Gil" "email" => array:1 [ 0 => "a.nieto@hotmail.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Gómez Navalón" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Zorrilla Ribot" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Traumatología y Cirugía Ortopédica, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Seudoartrosis congénita de clavícula bilateral. Caso clínico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 414 "Ancho" => 995 "Tamanyo" => 49242 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">X-ray of the patient one week old where the pseudarthrosis of both clavicles is noted.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical case</span><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a male aged 3 months, the third of three siblings, whose delivery was normal with cephalic presentation. We detected a family history of “coffee stain” marks suggestive of neurofibromatosis inherited from the maternal grandmother and a sister.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the study conducted by the neuropaediatric unit, no neurological changes were found in the patient.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The child was referred to the Department of orthopaedics and traumatology by his paediatrician after it was noted that he had a small lump in both clavicles.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Examination revealed normal movement of the neck and arms. There was an absence of asymmetry and there were small nodules in the middle third of both clavicles. The parents mentioned that at no time since birth had the child suffered from pain or impaired mobility.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The X-ray at one week old (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>.) shows an image compatible with a fracture versus bilateral pseudarthrosis of the clavicles. The study was repeated at 4 months (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) and the persistence of the image of pseudarthrosis may be observed in both clavicles. Since there was neither sign of consolidation nor any background of a traumatic birth or previous trauma, bilateral congenital pseudarthrosis of the clavicle was diagnosed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Congenital pseudarthrosis of the clavicle is a rare pathology and there are few references to it in literature. 200 cases have been described in literature, most frequently in girls.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Bilateralism is uncommon, and there are 7 published cases.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Its aetiology has not been clarified with certainty. Several authors believe that this is due to a failure in the consolidation of the two ossification centres of the clavicle.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a> Others believe it originates from a defect in embryological development during the initial stages.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> It has also been attributed to a causal link between the foetal head and cephalic delivery.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Several authors have found a certain relationship between congenital pseudarthrosis of the clavicle and narrow superior thoracic outlet syndome,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> and between Ehlers–Danlos syndrome<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> and neurofibromatosis.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Although cases of autosomal inheritance have been described, in general their presentation is sporadic. However, autosomal dominant genetic transmission is a possibility. Cases of family involvement also exist. A relationship with the chromosome 10p11.21p12<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> has also been found.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Diagnosis is clinical and radiological. It presents as a painless deformity at the clavicle in the absence of any background of obstetric trauma and with no mobility impairment. It is usually diagnosed in the first few years of life, due to the aesthetic defect it entails. Usually the mother realises there is a lump.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In the majority of cases a biopsy is not necessary. An X-ray reveals the bone involvement at both ends of the clavicle with the middle and anterior bone fragment being wider than the lateral one.</p><p id="par0055" class="elsevierStylePara elsevierViewall">If hypertrophic pseudarthrosis is present the anatomopathological imaging shows up hyaline cartilage<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> with chondrocytes in different stages of maturity with the same pattern as that of the growth plate.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> If it is a case of atrophic pseudarthrosis we may have a pattern of fibrous connective tissue.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,5</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Differential diagnosis must primarily take place with obstetric fracture of the clavicle. In these cases there may be a background of trauma, from, for example, a delivery with dystocia, macrosomia or the use of forceps. The fracture callus would be visible in an X-ray and there would be pain on physical examination. It is also necessary to differentiate from cleidocranial dysostosis,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> where the patient would also present with bulging fontanelles, an impairment in the development of the sternum, spine and pelvis in addition to having bilateral involvement and a family history of the condition.</p><p id="par0065" class="elsevierStylePara elsevierViewall">With regards to treatment, this is controversial. Several authors prefer conservative treatment, provided that there are no functional limitations,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> vascular nerve compression and that the aesthetic defect is tolerated by the patient.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Those who prefer surgical treatment advise non-intervention until the age of 4.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,2</span></a> The majority of authors only recommend surgery in the case of symptomatic patients or those with major deformities. Surgical correction basically consists of the resection of fibrous tissue and osteosynthesis using Kirschner<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> needles or plates in addition to grafts.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Prakash Chandran et al.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> in their study refer to a lower rate of infection and complications with the use of plates compared to osteosynthesis with Kirschner needles.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Unlike congenital pseudarthrosis, in post-traumatic pseudarthrosis the majority of patients require surgical treatment due to pain and impaired mobility associated with these lesions.</p><p id="par0080" class="elsevierStylePara elsevierViewall">To conclude, we presented this case due to its exceptional nature, low prevalence and because it concerned a male patient with bilateral involvement.</p><p id="par0085" class="elsevierStylePara elsevierViewall">We would highlight the scarcity of published literature in this regard and the absence of long term studies. As a result, from our point of view, it would be essential to carry out a follow-up of the patient to periodically assess the evolution of the condition. Should clinical symptoms, outstanding deformity and/or impairment of mobility occur we would suggest surgery be performed.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Ethical disclosures</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Protection of people and animals subjects</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors declare that no experiments have been carried out on humans or animals for this investigation.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Confidentiality of data</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare that they have adhered to the protocols of their centre of work regarding the publication of patient data.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Right to privacy and informed consent</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Funding</span><p id="par0105" class="elsevierStylePara elsevierViewall">There was no type of financing.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interests</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres755987" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec758116" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres755986" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec758115" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Clinical case" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Protection of people and animals subjects" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Right to privacy and informed consent" ] ] ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Funding" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-11-30" "fechaAceptado" => "2015-02-10" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec758116" "palabras" => array:3 [ 0 => "Congenital seudarthrosis" 1 => "Clavicle" 2 => "Bilateral" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec758115" "palabras" => array:3 [ 0 => "Seudoartrosis congénita" 1 => "Clavícula" 2 => "Bilateral" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Congenital pseudarthrosis of the clavicle is a rare malformation in which the aetiology is still unclear. Bilateral involvement is exceptional. Although it is a congenital malformation, it may not be diagnosed until late childhood, with patients presenting with a painless deformity of the middle third of the clavicle in the absence of prior trauma. The treatment is controversial, and may be surgical, depending on the functional impact and aesthetics. A case of bilateral involvement is presented, together with a review of the relevant literature.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La seudoartrosis congénita de clavícula es una rara malformación de etiología todavía no aclarada. La afectación bilateral es excepcional. Aun siendo una malformación congénita su diagnóstico puede prolongarse hasta avanzada la niñez, presentando los pacientes una deformidad indolora del tercio medio de la clavícula en ausencia de traumatismo previo. El tratamiento es controvertido, y puede ser quirúrgico o no según la repercusión funcional y estética. Presentamos un caso de afectación bilateral y analizamos la bibliografía encontrada al respecto.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Nieto Gil A, Gómez Navalón A, Zorrilla Ribot P. Seudoartrosis congénita de clavícula bilateral. Caso clínico. Rev Esp Cir Ortop Traumatol. 2016;60:397–399.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 414 "Ancho" => 995 "Tamanyo" => 49242 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">X-ray of the patient one week old where the pseudarthrosis of both clavicles is noted.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 727 "Ancho" => 995 "Tamanyo" => 70557 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">1 X-ray of the patient 4 months old where the pseudarthrosis of both clavicles is confirmed.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Seudoartrosis congénita de clavícula" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Ullot-Font" 1 => "S. Cepero-Campà" 2 => "A. Gargantilla-Vázquez" 3 => "S. Hernández-Bou" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "An Pediatr Barc" "fecha" => "2006" "volumen" => "64" "paginaInicial" => "273" "paginaFinal" => "276" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16527097" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Seudoartrosis congénita de clavícula asociada a síndrome del estrecho torácico superior Presentación de un caso y revisión de la literatura" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.R. Rodríguez" 1 => "A. Martínez" 2 => "C. Carbonell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Cir Osteoart" "fecha" => "1997" "volumen" => "32" "paginaInicial" => "220" "paginaFinal" => "224" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital pseudarthrosis of the clavicle" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.J. Alldred" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bone Joint Surg" "fecha" => "1963" "volumen" => "45-B" "paginaInicial" => "312" "paginaFinal" => "319" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital pseudarthrosis of the clavicle histologic examination for the etiology of the disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.D. Soichiro Hirata" 1 => "M.D. Hidetoshi Miya" 2 => "M.D. Kosaku Mizuno" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Orthop" "fecha" => "1995" "volumen" => "315" "paginaInicial" => "242" "paginaFinal" => "245" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital pseudoarthrosis of the clavicle" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R. Owen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bone Joint Surg" "fecha" => "1970" "volumen" => "52-B" "paginaInicial" => "644" "paginaFinal" => "652" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pseudoartrosis congénita de clavícula. A propósito de un caso" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V. Fernández Moral" 1 => "A. Braña Vigil" 2 => "M.L. Castañon Muñiz" 3 => "A. Braña Vigil" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Cir Osteoart" "fecha" => "1993" "volumen" => "28" "paginaInicial" => "51" "paginaFinal" => "53" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pseudoarthrosis of the clavicle and copper beaten skull associated with chromosome 10p11.21p12.1 mirodeletion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Shahdadpuri" 1 => "B. de Vries" 2 => "R. Pfundt" 3 => "N. de Leeuw" 4 => "W. Reardon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ajmg.a.32088" "Revista" => array:6 [ "tituloSerie" => "Am J Med Genet" "fecha" => "2008" "volumen" => "146A" "paginaInicial" => "233" "paginaFinal" => "237" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18080323" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital seudoarthrosis of the clavicle" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.R. Morin" 1 => "F.P. Fossey" 2 => "A. Besseliévre" 3 => "J.C. Loisel" 4 => "J.N. Edwars" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Obstet Gynecol Scand" "fecha" => "1993" "volumen" => "72" "paginaInicial" => "120" "paginaFinal" => "121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8383407" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical treatment of congenital pseudarthrosis of the clavicle: a report on 17 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Persiani" 1 => "I. Molayem" 2 => "C. Villani" 3 => "C. Cadilhac" 4 => "C. Glorion" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Orthop Belg" "fecha" => "2008" "volumen" => "74" "paginaInicial" => "161" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18564469" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital clavicular pseudarthrosis: comparison of two treatment methods" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Chandran" 1 => "H. George" 2 => "L.A. James" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11832-010-0313-3" "Revista" => array:6 [ "tituloSerie" => "J Child Orthop" "fecha" => "2011" "volumen" => "5" "paginaInicial" => "1" "paginaFinal" => "4" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22295044" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/19888856/0000006000000006/v3_201611120021/S1988885616300451/v3_201611120021/en/main.assets" "Apartado" => array:4 [ "identificador" => "7586" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/19888856/0000006000000006/v3_201611120021/S1988885616300451/v3_201611120021/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885616300451?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 1 | 0 | 1 |
| 2024 October | 9 | 1 | 10 |
| 2024 September | 13 | 5 | 18 |
| 2024 August | 18 | 2 | 20 |
| 2024 July | 24 | 5 | 29 |
| 2024 June | 15 | 2 | 17 |
| 2024 May | 9 | 2 | 11 |
| 2024 April | 12 | 10 | 22 |
| 2024 March | 14 | 7 | 21 |
| 2024 February | 12 | 5 | 17 |
| 2024 January | 43 | 3 | 46 |
| 2023 December | 27 | 5 | 32 |
| 2023 November | 29 | 6 | 35 |
| 2023 October | 29 | 5 | 34 |
| 2023 September | 32 | 4 | 36 |
| 2023 August | 13 | 5 | 18 |
| 2023 July | 29 | 3 | 32 |
| 2023 June | 43 | 2 | 45 |
| 2023 May | 62 | 3 | 65 |
| 2023 April | 48 | 7 | 55 |
| 2023 March | 28 | 8 | 36 |
| 2023 February | 19 | 3 | 22 |
| 2023 January | 31 | 12 | 43 |
| 2022 December | 33 | 5 | 38 |
| 2022 November | 38 | 4 | 42 |
| 2022 October | 21 | 7 | 28 |
| 2022 September | 36 | 7 | 43 |
| 2022 August | 31 | 7 | 38 |
| 2022 July | 23 | 7 | 30 |
| 2022 June | 30 | 8 | 38 |
| 2022 May | 35 | 6 | 41 |
| 2022 April | 35 | 10 | 45 |
| 2022 March | 69 | 11 | 80 |
| 2022 February | 60 | 4 | 64 |
| 2022 January | 37 | 8 | 45 |
| 2021 December | 29 | 13 | 42 |
| 2021 November | 25 | 9 | 34 |
| 2021 October | 16 | 10 | 26 |
| 2021 September | 21 | 15 | 36 |
| 2021 August | 22 | 4 | 26 |
| 2021 July | 17 | 14 | 31 |
| 2021 June | 18 | 6 | 24 |
| 2021 May | 11 | 7 | 18 |
| 2021 April | 47 | 36 | 83 |
| 2021 March | 17 | 10 | 27 |
| 2021 February | 12 | 10 | 22 |
| 2021 January | 6 | 3 | 9 |
Show all
