Infantile Pseudarthrosis of the Tibia

Abstract

1. Three cases of infantile pseudarthrosis of the tibia treated successfully by delayed autogenous by-pass graft are reported. 2. The delayed autogenous graft is stouter, stronger and more easily handled and has enhanced osteogenic properties than a graft transferred immediately. 3. The by-pass graft commends itself, firstly, because it does not disturb the pseudarthrosis, which in consequence helps the immobilisation of the graft; secondly, because it is well embedded in healthy bone above and below, well away from the abnormal bone; thirdly, because it lies under compression and, ideally, is vertically disposed between the knee and the ankle; and fourthly, because there is no devitalising stripping of periosteum or introduction of foreign bodies. 4. Support to the grafted leg is needed for at least five years, but only by a polythene splint after four to six months. 5. With early grafting the deformity straightens out and shortening is overcome, as there is early return to normal use of the limb. 6. Prolonged follow-up is called for lest the basic lesion in the tibia should extend. 7. Fibrous dysplasia and similar fibrous lesions of bone account for many cases of infantile pseudarthrosis of the tibia. Many of these lesions are congenital and subsequently lead to fracture. 8. Postponement of surgery should not be countenanced.

Preventing of nonunion in congenital pseudarthrosis of the tibia cases of Crawford Type I and II through the use of allograft bypass and a brace: Midterm findings

“…At the same time, he also clarified that the cause of CPT is a mechanical reason, emphasizing the use of plaster after the operation and suggesting delaying the operation to 18 months of age. 15 After that, Lloyd-Roberts and Shaw, 22 Eyre-Brook et al, 23 and Baw 24 respectively reported 18 cases treated with the McFarland method with a total of 12 unions in tibias and two amputations. In 1981, Morrissy et al 18 reported a series of total 40 cases, of which 7 underwent prophylactic bypass grafting.…”

Locked Intramedullary Nailing of Metacarpal Fractures Secondary to Gunshot Wounds

“…Bone graft incorporation depends on many factors of which graft stability and recipient bed are crucial. 2 Would they describe the technique they used for graft stability? What proportion of grafts were sutured as opposed to slotted?…”