Congenital Pseudarthrosis of the Tibia: Combined Pharmacologic and Surgical Treatment Using Biphosphonate Intravenous Infusion and Bone Morphogenic Protein with Periosteal and Cancellous Autogenous Bone Grafting, Tibio-Fibular Cross Union, Intramedullary

Paley, Dror

doi:10.5772/31149

Cited by 22 publications

(29 citation statements)

References 34 publications

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“…Her iki yöntemde de uzun dönem sonuçlar yeterli kanıt düzeyine ulaşmamıştır. [16,17] Çocukluk çağında meydana gelen epifiz hasarları, ya da genetik bir takım hastalıklarda fibula olması gerekenden daha yüksek pozisyonda kalabilir. Bu durumu Malhotra, dört ayrı seviyede sınıflamıştır.…”

Section: Ayak Bileği Deformitelerine Sebep Olan Fibular Patolojilerunclassified

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Ayak bileği deformiteleri ve tedavi yöntemleri

Cıvan¹,

Çakmak²

2020

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Section: Ayak Bileği Deformitelerine Sebep Olan Fibular Patolojilerunclassified

“…Son yıllarda biyolojik stimülasyon ile kombine edilen cerrahiler ile başarı oranları yükselse de uzun dönem sonuçlar henüz yeterli kanıt düzeyine ulaşmamıştır. [16] KTP uzun dönemde ayak bileğinde çok yüksek…”

Section: Ayak Bileği Deformitelerine Sebep Olan Fibular Patolojilerunclassified

Ayak bileği deformiteleri ve tedavi yöntemleri

Cıvan¹,

Çakmak²

2020

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“…Presently, the global primary union rate of congenital pseudarthrosis of the tibia (CPT) is relatively high [1][2][3][4][5][6]. However, preventing complications is challenging.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, we designed a modified surgical approach for treating children with CPT with intact fibula (Type A; normal fibular integrity in the presence of established atrophic type CPT [8]) to increase the cross sectional area in the healed segment, thereby reducing the incidence of re-fracture. Presently, increasing the crosssectional area in the healing segment involves 4-in-1 osteosynthesis along with a shotgun operation [2,8].…”

Section: Introductionmentioning

confidence: 99%

Combined surgery with 3-in-1 osteosynthesis in congenital pseudarthrosis of the tibia with intact fibula

Liu

Yang

Liu

et al. 2020

Orphanet J Rare Dis

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Background: Re-fracture is the most serious complication in congenital pseudarthrosis of the tibia (CPT). There are reports that children with small cross-sectional areas in the sections of the pseudarthrosis are more prone to refracture. Presently, preventing complications is a challenge. Increasing the cross-sectional area in healed segments may reduce the incidence of re-fracture. Purpose: To elucidate the indications, surgical technique, and outcomes of combined surgery and 3-in-1 osteosynthesis in CPT with intact fibula. Methods: We retrospectively assessed 17 patients with Crawford Type IV CPT with intact fibula (Type A) who were treated with combined surgical technique and 3-in-1 osteosynthesis between March 2014 and August 2015. The average age of the patients at the time of surgery was 3 years. Incidence of re-fracture, ankle valgus, proximal tibial valgus, and limb length discrepancy (LLD) were investigated over an average follow-up time of 47 months. Results: Primary union was achieved in all patients. The average time for primary union was 4.9 months. Fifteen (88%) cases showed LLD with an average limb length of 1.6 cm; 6 (35%) cases exhibited tibial valgus with an average tibial valgus deformity of 7.8°; 2 cases had ankle valgus, wherein the ankle valgus deformity was 12°in one and 17°in another; and the cross-sectional area of the bone graft was enlarged to 1.74 times that of the tibia shaft. No case had re-fracture during the follow-up period. Movement of the ankle joint was restored in 16 patients with an average dorsiflexion of 22°and an average plantar flexion of 41°; the function of the ankle joint was normal. One patient had plantar flexion of 20°but did not have dorsiflexion. Conclusion: Combined surgical technique with 3-in-1 osteosynthesis, which is primarily considered for bone union with a large cross-sectional area, results in a high primary union rate. This can provide satisfactory results in shortterm follow-up when treating CPT with intact fibula (Type A).

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“…Заболевание встречается относительно редко, по данным литературы, один случай на 140 000-190 000 родившихся [15,17]. По данным D. Paley [22], 50% случаев ассоциировано с нейрофиброматозом I типа, 10% -с остеофиброзной дисплазией Кампанацци и 40% -остаются идиопатическими. Другие авторы также выделяют нейрофиброматоз I типа, как основную причину развития дефекта берцовых костей [3,7].…”

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