Use of an intramedullary rod for the treatment of congenital pseudarthrosis of the tibia.

Anderson, D J; Schoenecker, Perry L.; Sheridan, J J; Rich, Margaret M.

doi:10.2106/00004623-199274020-00002

Cited by 66 publications

(52 citation statements)

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“…Therefore, it should perhaps be noted that there was a tendency for previous unoperated cases to have ankle pain at long-term follow-up, even though there had been no pain of short-term follow-up. In a previous report, ankle pain after the surgical procedure for VFG is associated with multiple operations utilizing intramedullary nails, consistent with our results [14], and degenerative changes in the ankle because of the ankle valgus deformity and the intramedullary rod passing through the ankle joint is considered to be the cause of the ankle pain [14][15][16]. Refracture is not uncommon following consolidation of VFG [13,17,18].…”

Section: Discussionsupporting

confidence: 87%

Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia

et al. 2008

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Section: Discussionsupporting

confidence: 87%

Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia

et al. 2008

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“…Fracture grading was determined from the radiographs at three weeks with tibiae scored as completely, partly, or not bridged, 23 similar to the Johnston criteria used for clinical assessment. 9 Fractured tibiae and surrounding soft-tissue were removed and fixed overnight in 10% formalin and stored in 70% alcohol at 4°C. Bones were scanned by micro-computed tomography (microCT) using a SkyScan 1174 compact microCT scanner (SkyScan, Kontich, Belgium) at 17 μm pixel resolution with 0.5 mm aluminium filter, 50 kV radiological tube voltage and 800 μA tube electric current.…”

Section: Methodsmentioning

confidence: 99%

Distal tibial fracture repair in a neurofibromatosis type 1-deficient mouse treated with recombinant bone morphogenetic protein and a bisphosphonate

Birke

Morse

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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Congenital pseudarthrosis of the tibia is an uncommon manifestation of neurofibromatosis type 1 (NF1), but one that remains difficult to treat due to anabolic deficiency and catabolic excess. Bone grafting and more recently recombinant human bone morphogenetic proteins (rhBMPs) have been identified as pro-anabolic stimuli with the potential to improve the outcome after surgery. As an additional pharmaceutical intervention, we describe the combined use of rhBMP-2 and the bisphosphonate zoledronic acid in a mouse model of NF1-deficient fracture repair. Fractures were generated in the distal tibiae of neurofibromatosis type 1-deficient (Nf1(+/-)) mice and control mice. Fractures were open and featured periosteal stripping. All mice received 10 μg rhBMP-2 delivered in a carboxymethylcellulose carrier around the fracture as an anabolic stimulus. Bisphosphonate-treated mice also received five doses of 0.02 mg/kg zoledronic acid given by intraperitoneal injection. When only rhBMP but no zoledronic acid was used to promote repair, 75% of fractures in Nf1(+/-) mice remained ununited at three weeks compared with 7% of controls (p < 0.001). Systemic post-operative administration of zoledronic acid halved the rate of ununited fractures to 37.5% (p < 0.07). These data support the concept that preventing bone loss in combination with anabolic stimulation may improve the outcome following surgical treatment for children with congenital pseudarthosis of the tibia and NF1.

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“…Several series of surgical outcomes have been reported [von Satzger and Herbst, 1981;Murray and Lovell, 1982;Anderson et al, 1992;Coleman and Coleman, 1994;Gilbert and Brockman, 1995;Traub et al, 1999;Grill et al, 2000;Romanus et al, 2000;Tudisco et al, 2000;Wientroub and Grill, 2000;Dobbs et al, 2004; Ohnishi et al, 2005;Bara et al, 2007]; however, the number of patients is usually small and there is no consensus regarding the treatment for pseudarthrosis. Comparison of studies is difficult because of limited follow up, age differences, lack of designation of NF1, severity of the dysplasia, number of surgeries, and use of ancillary treatments.…”

Section: Dysplasia Of the Tibia And Other Long Bonesmentioning

confidence: 99%

Skeletal abnormalities in neurofibromatosis type 1: Approaches to therapeutic options

Elefteriou

Kolanczyk

Schindeler

et al. 2009

American J of Med Genetics Pt A

138

114

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The skeleton is frequently affected in individuals with neurofibromatosis type 1, and some of these bone manifestations can result in significant morbidity. The natural history and pathogenesis of the skeletal abnormalities of this disorder are poorly understood and consequently therapeutic options for these manifestations are currently limited. The Children's Tumor Foundation convened an International Neurofibromatosis Type 1 Bone Abnormalities Consortium to address future directions for clinical trials in skeletal abnormalities associated with this disorder. This report reviews the clinical skeletal manifestations and available preclinical mouse models and summarizes key issues that present barriers to optimal clinical management of skeletal abnormalities in neurofibromatosis type 1. These concepts should help advance optimal clinical management of the skeletal abnormalities in this disease and address major difficulties encountered for the design of clinical trials. © 2009 Wiley‐Liss, Inc.

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Use of an intramedullary rod for the treatment of congenital pseudarthrosis of the tibia.

Cited by 66 publications

References 0 publications

Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia

Long-term follow-up on the use of vascularized fibular graft for the treatment of congenital pseudarthrosis of the tibia

Distal tibial fracture repair in a neurofibromatosis type 1-deficient mouse treated with recombinant bone morphogenetic protein and a bisphosphonate

Skeletal abnormalities in neurofibromatosis type 1: Approaches to therapeutic options

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