Reconstruction of Congenital Pseudarthrosis of the Clavicle with Use of the Masquelet Technique A Case Report Richard Gouron, MD, PhD, Franc xois Deroussen, MD, Marie Juvet-Segarra, MD, Marie-Christine Plancq, MD, and Louis-Michel Collet, MD Investigation performed at the Department of Pediatric Orthopaedic Surgery, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France C ongenital pseudarthrosis of the clavicle is a rare disor- der that is usually discovered during the first months of life, characterized by a bone defect in the middle third of the clavicle. It is an isolated congenital malformation of the shoulder girdle that should be distinguished from the nonunion observed in familial cleidocranial dysostosis and the nonunion associated with von Recklinghausen neurofibroma- tosis 1 . At diagnosis, pseudarthrosis of the clavicle is generally asymptomatic, but it can be responsible for aesthetic issues as the child grows and functional symptoms related to more in- tense activities. Surgical repair of pseudarthrosis of the clavicle is indicated for both cosmetic and functional reasons 2,3 . The surgical approach most commonly used consists of resection of the pseudarthrosis, placement of an iliac crest bone graft, and internal fixation 4,5 . When surgical resection is performed early and when periosteal repair is possible, internal fixation is not required 6 . Postoperative complications are rare and essentially consist of nonunion 4-9 . Since 2000, Masquelet et al. have developed a technique for bone regeneration in the metaphyseal and diaphyseal re- gions of long bones 10,11 . This technique was first used in adults after trauma with bone loss 12,13 and in cancer surgery after bone resection 14 . More recently, it has been introduced in the treat- ment of congenital deformities and is currently used by some surgeons to treat congenital pseudarthrosis of the tibia 15 . We describe the use of the Masquelet technique with internal Kirschner-wire fixation in the reconstruction of a congenital pseudarthrosis of the clavicle. The patient and her family were informed that data concerning the case would be submitted for publication, and they provided consent. Fig. 1 Fig. 2 Fig. 1 The deformity of the right clavicle is evident. Fig. 2 Anteroposterior radiograph showing the congenital pseudarthrosis of the right clavicle. Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article. 1 COPYRIGHT Ó 2012 BY THE J OURNAL OF BONE AND J OINT SURGERY,I NCORPORATED JBJS Case Connect 2012;2:e77 d http://dx.doi.org/10.2106/JBJS.CC.L.00095