Fifteen years’ follow-up on the use of vascularized fibular graft for the treatment of congenital pseudoarthrosis of the tibia: experience in Virgen del Rocio’s Hospital and review of the literature

Abstract

Treatment of congenital pseudarthrosis of the tibia remains a challenge, and many methods have been attempted with varying results. Two girls and three boys with congenital pseudarthrosis of the tibia were treated by vascularized fibular grafting (VFG). The average age at VFG was 7.8 years (range, 4–14 years) with an average follow-up term of 14.7 years (range, 8–21 years). Four of the children had undergone multiple operations before VFG, while the other one had no such history. Bone consolidation was obtained in all cases after an average term of 6.2 months (range, 4–8 months). Complication of stress fracture and ankle pain occurred in zero and two cases, respectively, only in cases undergoing multiple operations. Leg length discrepancy was more prominent in the patients with multiple previous operations (mean, 6.5 cm) than in the case with no prior surgery whose discrepancy did not have clinical signification. The long-term results of vascularized fibular grafting for congenital pseudarthrosis of the tibia were excellent, especially in the case with no prior surgery. Vascularized fibular grafting should be considered as a primary treatment option for congenital pseudarthrosis of the tibia.