[Congenital pseudarthrosis of the forearm. Report of two cases and review of the literature]. / Pseudarthrose congénitale de l'avant-bras. A propos de deux cas et revue de la littérature.

Congenital pseudarthrosis of the forearm represents a rare entity which is often associated with neurofibromatosis type I. Isolated pseudarthrosis of the ulna is the most frequent deformity, followed by pseudarthrosis of the radius and both forearm bones. The treatment of these deformities remains difficult: conventional bone grafts rarely lead to complete fusion. The reconstruction by a vascularized fibular graft represents the treatment of choice if the radial head is not dislocated. This procedure allows restoration of a balance between radius and ulna during growth. The presence of a vascularized graft enhances the potential for bony fusion in a fibrous environment. In cases of isolated ulna pseudarthrosis, a luxation of the proximal radial epiphysis may occur when the ulnar deformity increases with time. The single-bone forearm represents a salvage procedure that creates a stable upper limb with a satisfactory wrist and elbow function. The two clinical cases of a pseudarthrosis of both forearm bones and of an ulna pseudarthrosis are presented.

Congenital pseudarthrosis of the forearm treated by free vascularized fibular graft: a report of three cases and a review of the literature.

Congenital pseudarthrosis of the forearm is a rare condition; approximately 60 cases have been reported in the English literature. We report 3 patients treated by wide excision of the pseudarthrosis and free vascularized fibular grafting. The pseudarthrosis involved the radius in 1 patient and the ulna in 2. Neurofibromatosis was present in 2 patients. The technical problems encountered during the procedures included preservation of the distal epiphysis and attaining stable fixation of the fibular graft without damaging its vascular supply. A review of 15 previously reported patients treated by free vascularized fibular grafting showed that this procedure is excellent in the treatment of congenital pseudarthrosis of the forearm and that the result is consistently reproducible.

Congenital pseudoarthrosis of the radius. A case report and review of the literature.

Congenital pseudoarthrosis of the radius (CPR) is rare. Only ten cases seem to have been found in the literature. Congenital pseudoarthrosis of the radius usually is associated with neurofibromatosis or fibrous dysplasia. This is a report of a congenital pseudoarthrosis of the left radius associated with congenital dislocation of the left hip in a five-month-old girl. Apart from the pseudoarthrosis, there were no visible abnormalities. This patient was treated successfully with excision of the pseudoarthrosis, shortening osteotomy of the ulna, grafting, and intramedullary fixation of both the radius and the ulna. Review of the literature disclosed the extreme difficulties in treating this condition. It was also found that vascularized fibular graft has been used successfully.