Treatment of congenital pseudarthrosis of the tibia with the Ilizarov technique

Rose, R. E. C.; Wright, Dean E

doi:10.1590/s0043-31442007000300022

Cited by 5 publications

(9 citation statements)

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“…The Ilizarov method takes considerable time and effort to obtain good results. [22] Intra-medullary nailing with bone grafting was considered as an option, but was found to have more complication rate with low target rate. [23] Generally, in patients with congenital pathologies who present with a well-vascularised bed, bone defects smaller than 6 cm can be repaired easily with autologous transplantation of de-vascularised cancellous bone harvested from the iliac crest and stabilized with external fixation.…”

Section: Discussionmentioning

confidence: 99%

Experience with free fibula transfer with screw fixation as a primary modality of treatment for congenital pseudarthosis of tibia in children - Series of 26 cases

Kalra

Agarwal

2012

Indian J Plast Surg

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Background:Congenital pseudarthrosis is one of the greatest challenges of paediatric orthopaedic practice. Treatment options and literature addressing this condition are numerous, reflecting the difficulty in management. We aimed to study the effectiveness of free fibula transfer as a primary modality of treatment in children with this condition in terms of achieving length, union, and normal axis of the involved leg.Materials and Methods:During the period of 2001 to 2010, 26 children with congenital pseudarthrosis of tibia between age group of 2-8 years were evaluated and were reconstructed using contra-lateral free fibula graft, and then patients were followed up for 5 years subsequently. Patients were examined and time of bony union, weight bearing ability and walking without support were noted. Any complication directly or indirectly related to surgery with any complication seen in the due course of follow up of 5 years was also taken care of.Results:In our experience with treatment of congenital pseudarthrosis over a span of 10 years with free fibula transfer, the results have been gratifying with no flap loss. All our patients had UNEVENTFUL post-op recovery. Only 2 patients out of 26 had non-union, for which cancellous bone grafting was done (7.6%). Most of the patients were ambulatory with support by 3-6 months and continued to walk without support after a span of 18-24 months. The incidence of stress fracture in our study over the follow-up period was 4 out of 26 pts (15.3%). None of them had any deformity in the donor leg.Conclusion:When compared to other surgical modalities of treatment of the problem in question, vascularised free fibula transfer has emerged as a real saviour with good patient compliance and less complication rate in our study. It achieves the desired target with no residual deformities and near normal to normal gait with no stigma of bone removal from other leg.

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Section: Discussionmentioning

confidence: 99%

Experience with free fibula transfer with screw fixation as a primary modality of treatment for congenital pseudarthosis of tibia in children - Series of 26 cases

Kalra

Agarwal

2012

Indian J Plast Surg

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“…The superiority of any specific procedure is difficult to determine as that depends on different factors, e.g., type of CPT, the effect of previous operation, age at time of surgery, the need for follow-up until skeletal maturity and definition of what is a successful outcome. All these factors make it difficult to compare the outcome of the different procedures [1] . In series of VFG for treatment of CPT, bone consolidation was reported to be obtained in about 94% of cases, nevertheless complications of refracture, non-union, tibial angular deformities may occur, as well as severe ankle valgus deformity with ankle pain [1][2][3][4] .…”

Section: Discussionmentioning

confidence: 99%

“…Congenital Pseudarthrosis of tibia (CPT) is one of the most challenging problems in pediatric orthopedics [1] . It is an uncommon entity with a reported incidence of 1:140,000 to 1:250,000 neonates.…”

Section: Introductionmentioning

confidence: 99%

“…The natural history is persistent instability and progressive deformity [5] . The condition exhibits a wide range of severity, and the response to the treatment is unpredictable [1] . The classification of CPT includes that of Anderson et al [6] , which differentiates the morphology of pseudarthrosis as dysplastic, cystic or sclerotic [6] .…”

Section: Introductionmentioning

confidence: 99%

“…Although, no single method has proven ideal, the highest rate of union have been reported with surgery. The surgical procedures mostly used are intramedullary nail (IMN) with bone graft, vascularized fibular graft (VFG) and Ilizarov circular external fixator (CEF) technique [1] . Bone morphogenetic proteins (BMPs) have been used successfully in adult patients for treating tibial non-union and spinal fusion.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Congenital Pseudarthrosis of the Tibia with Complex Deformity and Multiple Previous Surgeries Treated by Taylor Spatial Frame at Age of 16 Years

Abumunaser

Alsayyed

2010

JKAU Med Sci

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Congenital pseudarthrosis of the tibia remains one of the most difficult conditions in pediatric orthopedic surgery. The numerous treatment options reflect this difficulty. The aim of successful treatment is to achieve union, length and deformity correction. This reports a 16-years-old male patient with congenital pseudarthrosis of the tibia diagnosed at age of two years, who previously underwent 14 different operations. The patient was referred to King Abdulaziz University Hospital, where he was treated with Taylor Spatial Frame, excision of pseudarthrosis, autogenus bone grafts and Demineralized Bone Matrix was performed, and union was achieved. Stability and deformity correction permitted by Taylor Spatial Frame, in addition to stimulation of bone healing through proper grafting provided a successful option to treat this complex condition.

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Physeal and Subphyseal Distraction Osteogenesis in Atrophic-type Congenital Pseudarthrosis of the Tibia: Efficacy and Safety

Jang

Choi

Park

et al. 2019

Journal of Pediatric Orthopaedics

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Treatment of congenital pseudarthrosis of the tibia with the Ilizarov technique

Cited by 5 publications

References 0 publications

Experience with free fibula transfer with screw fixation as a primary modality of treatment for congenital pseudarthosis of tibia in children - Series of 26 cases

Experience with free fibula transfer with screw fixation as a primary modality of treatment for congenital pseudarthosis of tibia in children - Series of 26 cases

Congenital Pseudarthrosis of the Tibia with Complex Deformity and Multiple Previous Surgeries Treated by Taylor Spatial Frame at Age of 16 Years

Physeal and Subphyseal Distraction Osteogenesis in Atrophic-type Congenital Pseudarthrosis of the Tibia: Efficacy and Safety

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