Use of an Intramedullary Rod for the Treatment of Congenital Pseudarthrosis of the Tibia

Dobbs, Matthew B.; Rich, Margaret M.; Gordon, Joel; Szymanski, Deborah A.; Schoenecker, Perry L.

doi:10.2106/jbjs.d.02764

Cited by 35 publications

(49 citation statements)

References 3 publications

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“…Treating the fibula pseudarthrosis if it exists also appears to be indispensable [20]. Fibular union associated or not with internal fixation by intramedullary nailing reinforces stability by distributing loads and protects, in particular, from rotational trauma [11,21]. In the induced membrane technique, the fibular surgery is an important step.…”

Section: Discussionmentioning

confidence: 99%

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: Preliminary results of five cases

Pannier

Péjin

Dana

et al. 2013

Journal of Children's Orthopaedics

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Purpose The purpose of this study was to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of congenital pseudarthrosis of the tibia (CPT). Methods Three boys and two girls were treated by this technique between 2003 and 2008. All patients had type IV CPT in Crawford's classification. Four of them had a limited dystrophic form, whereas one case presented an extensive tibia bone dystrophy. The average age of patients at the time of surgery was 23 months (range 10-30 months), with an average follow-up of 5.8 years (range 2.4-8.1 years). Results Satisfactory tibial bony union was achieved in all cases at the last follow-up. Bone healing was obtained in the four limited forms after an average term of 4 months. One patient suffered from a non-displaced fracture that healed by casting in a usual period of time. The patient with an extensive dystrophic bone had to undergo a secondary inter-tibiofibular bone graft to finally achieve bone union. Conclusions The preliminary results show that this technique is successful in CPT. It may be used even in young children and offers a good alternative to other treatments available, avoiding external fixation and the technical difficulties of microvascular surgery.

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Section: Discussionmentioning

confidence: 99%

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: Preliminary results of five cases

Pannier

Péjin

Dana

et al. 2013

Journal of Children's Orthopaedics

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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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“…Consequently, there is still room for improvement! [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. There is, however, consensus that all pseudarthrotic tissue should be resected and bone graft applied to promote healing.…”

Section: Introductionmentioning

confidence: 99%

Preliminary experience with the combined use of recombinant bone morphogenetic protein and bisphosphonates in the treatment of congenital pseudarthrosis of the tibia

Birke

Schindeler

Ramachandran

et al. 2010

Journal of Children's Orthopaedics

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Purpose Congenital pseudarthrosis of the tibia (CPT) is a rare but serious disorder in children. No single approach has clearly emerged as superior in terms of operative procedure, fixation, optimal time for surgery or adjunctive pharmaceutical intervention. CPT is frequently associated with neurofibromatosis type 1 (NF1), a condition featuring deficient bone anabolism and excessive catabolism. We have therefore combined the use of bone morphogenetic proteins (BMP) with bisphosphonates (BP) as an adjunct to surgical intervention. Methods Between 2002 and 2008 we administered BMP-7 (OP-1) at the time of surgery followed by BP (pamidronate or zoledronic acid) in eight Crawford type IV CPT cases in seven patients (six with a confirmed diagnosis of NF1) with a median age of 7 years (range 2 years 11 months to 12 years) at surgery.

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Use of an Intramedullary Rod for the Treatment of Congenital Pseudarthrosis of the Tibia

Abstract: This technique produced a satisfactory long-term functional outcome in sixteen of twenty-one patients and should be considered for the management of congenital pseudarthrosis of the tibia.

Cited by 35 publications

References 3 publications

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: Preliminary results of five cases

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: Preliminary results of five cases

Skeletal abnormalities in neurofibromatosis type 1: Approaches to therapeutic options

Preliminary experience with the combined use of recombinant bone morphogenetic protein and bisphosphonates in the treatment of congenital pseudarthrosis of the tibia

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