Congenital pseudarthrosis of the tibia: treatment with free vascularized fibular graft.

ABSTRACT

Five children with congenital pseudarthrosis of the tibia were treated by resection of the lesion and reconstruction of the extremity with a free vascularized fibular graft (FVFG). Two of five cases had had multiple surgical procedures before FVFG. These two cases were complicated with the non-union of the proximal grafthost junction. Of these, one case achieved bone union after further resection of the non-union and adding allogenic bone graft and another case denied further operation and was lost to follow-up 6 months postoperatively. Three cases, two of which underwent FVFG as a primary treatment and another one after failure from the Sofield procedure respectively, were initially treated successfully and solid union of the grafthost junctions was within four months postoperatively. Problems including anterior bowing, refracture, valgus deformity of the ankle and leg length discrepancy occurred in all four followed cases.