Vascularised fibula grafts for early tibia reconstruction in infants with congenital pseudarthrosis

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
Dominique ErniTheddy Slongo

Abstract

Congenital pseudarthrosis of the tibia (CPT) is caused by an ill-defined, segmental disturbance of periosteal bone formation leading to spontaneous bowing, followed by fracture and subsequent pseudarthrosis in the first 2 years of life. The results of conventional treatment modalities (e.g., bracing, internal and external fixation and bone grafting) are associated with high failure rates in terms of persisting pseudarthrosis, malunion and impaired growth. As a more promising alternative, a more aggressive approach, including wide resection of the affected bone, reconstruction with free vascularised fibula grafts from the healthy contralateral leg and stable external fixation at a very early stage has been suggested. Between 1995 and 2007, 10 children (age 12-31 months, median 20 months) suffering from CPT were treated at our institutions according to this principle. Two patients were treated before a fracture had occurred. The length of the fibula graft was 7-9cm. End-to-end anastomoses were performed at the level of the distal tibia stump. The follow-up was 80 months (median, range 12 months to 12 years). Radiologic examination at 6 weeks postoperatively showed normal bone density and structure of the transplanted fibula in al...Continue Reading

References

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Jan 23, 2008·Journal of Pediatric Orthopedics·Tae-Joon ChoDong Yeon Lee
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Citations

Sep 10, 2014·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Christoph HeidtAlexander Joeris
Nov 30, 2016·Archives of Plastic Surgery·Ki Ho KimHeechang Ahn
Apr 4, 2017·Journal of Pediatric Orthopedics. Part B·Ilaria MorelliCarlo L Romanò
Jun 8, 2018·Journal of Pediatric Orthopedics. Part B·Nithin KesireddyNabil A Ebraheim
Jan 20, 2012·The Journal of Bone and Joint Surgery. American Volume·Sanjeev Sabharwal, S Robert Rozbruch
May 7, 2016·The Journal of Craniofacial Surgery·Michael R MarkiewiczRui Fernandes
Jun 11, 2021·Archives of Orthopaedic and Trauma Surgery·Pietro FeltriGiuseppe Filardo

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