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.