Serendipitous Healing of a Congenital Pseudoarthrosis of the Clavicle Following Acute Injury: A Case Report.

INTRODUCTION: Congenital pseudoarthrosis of the clavicle (CPC) is a rare pathology first described by Fitzwilliams in 1910, with fewer than 300 cases reported worldwide. It arises from failure of the primary ossification centers to coalesce, resulting in a false joint connected by periosteum and a synovial membrane. The pathology classically presents in early childhood as a painless midshaft clavicle deformity with no history of trauma, most commonly occurring unilaterally on the right side and more frequently in females. While conservative management is an option in asymptomatic patients, surgical intervention is generally recommended as the deformity progresses in functional and cosmetic significance with age. To our knowledge, spontaneous ossification with conservative treatment has not been previously reported. CASE REPORT: A 5-year-old boy was referred for a possible non-union clavicle fracture. After assessment, a CPC with an acute fracture was diagnosed. This was treated conservatively and followed an acceptable healing process. Radiographs 2 years later, after conservatively treating a separate acute fracture to the same clavicle, show no evidence of the prior pseudoarthrosis. CONCLUSION: The aim of this study was to present radiological outcomes of a CPC that spontaneously healed without intervention. The results of this study show the possibility of less invasive treatment for a CPC.