Abstract
The purpose of this study was to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of congenital pseudarthrosis of the tibia (CPT). Three boys and two girls were treated by this technique between 2003 and 2008. All patients had type IV CPT in Crawford's classification. Four of them had a limited dystrophic form, whereas one case presented an extensive tibia bone dystrophy. The average age of patients at the time of surgery was 23months (range 10-30months), with an average follow-up of 5.8years (range 2.4-8.1years). Satisfactory tibial bony union was achieved in all cases at the last follow-up. Bone healing was obtained in the four limited forms after an average term of 4months. One patient suffered from a non-displaced fracture that healed by casting in a usual period of time. The patient with an extensive dystrophic bone had to undergo a secondary inter-tibiofibular bone graft to finally achieve bone union. The preliminary results show that this technique is successful in CPT. It may be used even in young children and offers a good alternative to other treatments available, avoiding external fixation and the technical difficulties of microvascular surgery.
Highlights
Congenital pseudarthrosis of the tibia (CPT) is a rare condition and surgical treatment is one of the most challenging problems in pediatric orthopedics because of the difficulty in achieving healing, the residual deformities, and the limb-length discrepancies
The preliminary results show that this technique is successful in congenital pseudarthrosis of the tibia (CPT)
Masquelet and Begue [2] reported the use of an innovative two-stage technique that involves the insertion of a cement spacer, induction of a membrane and reconstruction of the defect with cancellous bone graft in the treatment of extensive diaphyseal bone defect
Summary
Congenital pseudarthrosis of the tibia (CPT) is a rare condition and surgical treatment is one of the most challenging problems in pediatric orthopedics because of the difficulty in achieving healing, the residual deformities, and the limb-length discrepancies. Masquelet and Begue [2] reported the use of an innovative two-stage technique that involves the insertion of a cement spacer, induction of a membrane and reconstruction of the defect with cancellous bone graft in the treatment of extensive diaphyseal bone defect. It is a simple two-stage technique enabling early surgery in children suffering from CPT [3, 4]. The purpose of this study is to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of CPT
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