Congenital Pseudoarthrosis of the Tibia: A Case Report

Abstract

Congenital pseudoarthrosis of the tibia is a rare disease with reported incidence ranging from 1:140000 to 1 :250000 neonates. It is characterized by segmental osseous weakness resulting in deformities of the bone and spontaneous fractures which progresses to a tibial non – union .The etiology is unknown . In 50% of the cases it is associated with neurofibromatosis .The pathologic process of the disorder is the growth of abnormal fibromatosis like tissue either within the periosteum (dysplastic type ) or both .It is one of the most challenging problem in paediatric orthopaedics. Various methods of treatment are modifications of illizarov’s technique, vascularised bone grafting, bone grafting with intramedullary nail fixation. We report a case of 11 year old boy having congenital pseudoarthrosis of left tibia with no prior history of any surgical treatment . During surgery , sclerotic ends of both fragment of pseudoarthrosis excised , reduction and fixation done using intra medullary nail with bone grafting. Six months later radiograph showed bony union with acceptable functional out come and no refracture. It is shown that intramedullary fixation with bone grafting is a good choice for treatment of congenital pseudoarthosis of tibia .