Vascularized free fibular graft in the treatment of congenital pseudarthrosis of tibia.

UNLABELLED: Aim of the study was to evaluate the results of the patients with "congenital pseudartrosis of tibia" treated by vascularized fibular graft transferred from the contralateral calf. MATERIAL AND METHODS: The cohort consist of four patients (2 boys and 2 girls) aged 5.75 y (range 4-8 years) in the time of the transfer of vascularized fibular graft from the contralateral calf into the resected tibia suffered from pseudarthrosis Crawford type II, III and IV. Patients were operated on between 1999-2007. RESULTS: A total graft union was achieved in three patients in one-year follow-up period. In one girl, treatment failed due to infection and was treated later with intramedullar Rush nail fixation and additional spongioplasty with an unsatisfactory result. CONCLUSION: Authors believe that after an accurate preoperative planning in cooperation with the microsurgeon, the treatment of congenital pseudarthrosis of the tibia by vascullarized fibular graft should be considered as a very effective, accurate and relatively safe method (Tab. 2, Fig. 4, Ref. 7). Full Text (Free, PDF) www.bmj.sk.

"Different" approach in the operative treatment of congenital clubfoot and its results.

OBJECTIVES: This study compared long-term results of the treatment of idiopathic clubfoot at two different University orthopaedic departments. BACKGROUND: The treatment of clubfoot is still controversial due to different severity and different treatment philosophies. METHODS: Authors retrospectively analyzed a group of 273 feet (145 patients) operated on at the Unit of Pediatric orthopaedics, Children University Hospital, Bratislava (group A) and the cohort of 60 feet (33 patients) operated on at the Ist University Department of Orthopaedics, Bratislava (group B), between 1993 and 2002 with follow up period from 2 to 11 years (average 72 months). In the group A, McKay procedure was indicated in 3 feet, Carroll operation in 35 feet and 160 feet were operated by Brockmanns posteromedial release and its modifications (cuboid and metatarsal osteotomies). In the group B, McKay procedure was done in 8 feet and 50 feet were operated on by Turco/ Zacepin procedure. RESULTS: Recurrences in both groups due to the insufficient first step operative reduction and mistakes in after treatment were 12%. Satisfactory results (excellent and good) were achieved in 88% of cases in both groups. CONCLUSION: This study shows, that the results of operative treatment of congenital clubfoot from two different departments (using different operative techniques but "a la carte philosophy") were comparable in most of the cases (Tab. 4, Fig. 3, Ref: 9).