Post-Traumatic Osteolysis of the Distal End A Case of Post-Traumatic Osteolysis of the Distal End of the Clavicle by G. Kinoshita, M. Maeda, H.Takaiwa and K. Nakano Department of Orthopaedic Surgery, Hyogo College of Medicine K. Nobuhara Nobuhara Hospital Post-traumatic osteolysis of the distal end of the clavicle is a rare condition. It was first described by Dupas in 1936, and so far the total number of recoded cases is about a hundred. This condition is characterized by erosion and progressive resorption of the distal end of the clavicle following trauma. The interval between physical insult and radiographical recognition is from several weeks to several months. No more than 3 cm of bone have been lost in any recorded case, and remnants of bone may remain between the acromion and the clavicle. The usual symptoms are pain and restricted range of motion of the shoulder. The etiology of the osteolytic process is uncertain. Osteoclastic resorption, nervous system dysfunction, vascular compromise, and arising from the synovium have all been hypothesized. Now we will report a case of this condition. CASE REPORT A 47-year-old man presented himself with a painful left shoulder girdle on 21 st January, 1987. He had been injured on his left shoulder in a bicycle accident 3 months before. A rediograph taken soon after the accident showed no abnormalities. Physical exaninations showed a prominence of the distal end of the clavecle, tenderness over the acromio-clavicular joint and restricted range of motion. Radiographs revealed loss of the distal tip of the left clavicle. Resection of the distal clavicle was performed on 17 th April, 1987. The A-C joint had been filled with granulation tissue, but the disc was not detected. The end of the clavicle had disappeared, and the stump was sclerotic. The cartilage of the acromion remained. Histologically, this case suggests that "ARISING FROM THE SYNOVIUM THEORY" is the etiology of this condition.
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